Age related macular degeneration (AMD) is a common ocular disease affecting the retina, the tissue in the back of the eye that receives and processes light. Because the retina is a highly active tissue, it generates a high volume of waste. This waste may build up as deposits underneath the retina, known as drusen. Drusen formation is the presenting sign of dry macular degeneration. As these deposits form, they may become larger or more numerous, which may cause the tissue to atrophy. The accumulation of drusen with atrophy may also increase risk of blood accumulating underneath the retina. If bleeding occurs within the retina associated with macular degeneration, the condition is then classified as wet macular degeneration.
Age related macular degeneration is most common in fair-skinned and light-eyed individuals. AMD is known to be hereditary, therefore, if you have a family history of macular degeneration, it is important to follow up with your eye care provider on a routine basis to assess for macular degeneration. Though AMD is hereditary, there are also several environmental risk factors that may predispose a patient to develop AMD, including UV light exposure and tobacco smoking. Patients with high blood pressure and diabetes are also known to have an increased risk of macular degeneration.
Macular degeneration is diagnosed through a routine dilated eye exam. Your doctor may perform specialty testing, including retinal scans and retinal photography, to monitor macular degeneration.
At this time, there are limited treatments for dry age related macular degeneration. If the condition is considered “early,” your doctor will recommend lifestyle modifications (see below) and perform routine monitoring. If the condition is considered “intermediate,” nutritional supplementation may be recommended to slow the rate of progression of the condition (see below). If the condition is considered to be “advanced dry macular degeneration” with tissue atrophy, an ophthalmologist may perform injections within the eye (known as intravitreal injections). These injections deliver medication that slows the rate of tissue atrophy. If the condition is considered “wet macular degeneration,” an ophthalmologist will perform injections to reduce the presence of bleeding. The injections serve to reduce the rate of progression of the disease. Unfortunately, injections will not cure the condition. Therefore, vision may remain reduced following treatment. The ultimate goal is to ensure vision does not get worse.
Lifestyle modifications for macular degeneration include dietary supplementation and use of UV protection. The AREDS 2 formula is known to be the safest and most efficacious nutritional supplement to reduce the progression of dry macular degeneration to wet macular degeneration. AREDS 2 is shown to reduce the advancement of dry macular degeneration to wet macular degeneration; therefore, if you do not currently have macular degeneration or have an early stage of the condition, AREDS may not show any benefit.
Your doctor may recommend monitoring your vision at home using a special test known as an Amsler grid. The Amsler grid will help you detect if there are new changes in your vision, such as distortions or blind spots, which may indicate a progression of your macular degeneration.