Age-related macular degeneration (or AMD) is an eye condition in which the macula, the sensitive area of the retina responsible for central and detail vision, is damaged, often causing loss of central vision.

Types
  -       "Dry" form - Most people (about 90%) have a form of AMD called "atrophic" or "dry" AMD.  Dry AMD usually progresses slowly and causes central vision loss.  
  -       "Wet" form - A second, smaller group of people (about 10%) have a condition called "exudative" or "wet" AMD.  Wet AMD occurs when abnormal blood vessels grow underneath the retina. These unhealthy vessels may leak blood and fluid, which can scar the macula.  For patients with wet AMD, vision loss may be rapid and severe.

Who Gets It
AMD is the leading cause of vision loss in people 50 years or older in the United States.  As life expectancy increases, the disease is becoming a significant problem.   Causes No conclusive proof exists.  However, some scientists believe heredity may play a part, as well as UV light exposure and nutrition.  Studies are ongoing.

Symptoms
 ·        Blurred or fuzzy vision
 ·        Straight lines, such as sentences on a page or telephone poles, appear wavy
 ·        Blind spot in the center of vision
 ·        Decreased ability to distinguish colors
 ·        Difficulty seeing at a distance.

Prevention
 ·        Regular eye exams by your Eye M.D.  Your Eye M.D. is specially trained to detect many vision-threatening conditions even before you develop symptoms.  The earlier problems are detected, the better the chance of preventing vision loss.
 ·        Protection from UV-A and UV-B rays.  Some studies have suggested that prolonged or frequent exposure to UV-A and UV-B rays may be a factor in macular degeneration and other eye conditions, so always wear sunglasses that block 99 percent to 100 percent of UV rays when outdoors.
 ·        Proper nutrition.  High levels of zinc and antioxidants may play a role in slowing the progression of macular degeneration.  A healthy diet can't hurt and can prevent many other health problems.

Treatment
 ·        "Dry" form - No proven effective treatment.
 ·        "Wet" form - laser surgery, photodynamic therapy, or anti-VEGF therapy may help as well as low vision rehabilitation.

Laser Surgery
If the abnormal blood vessels are not under the center of the macula, they may be treated with thermal laser surgery, using a focused beam of light of high-intensity light to seal the abnormal blood vessels.  A small, permanent blind spot is left at the point of laser contact.

Photodynamic Therapy
Photodynamic therapy (PDT) involves the injection of the FDA-approved drug, VisudyneTM, into the bloodstream, followed by a brief laser treatment.  The laser "activates" the drug, which helps destroy abnormal blood vessels in the eye that damage the macula.  Several treatments may be necessary for it to be effective.

Anti-VEGF Therapy
Recently, scientists have developed several new drugs (Lucentis, Avastin, and Macugen) that can block the chemical that causes abnormal blood vessels to grow under the retina.  That chemical is called vascular endothelial growth factor, or VEGF.  Blocking VEGF reduces the growth of abnomal blood vessels, slows their leakage, and helps to slow vision loss.  The anti-VEGF drug must be injected into the eye with a very fine needle.  Usually, patients receive multiple anti-VEGF injections over the course of many months.

Unproven Treatments
Be wary of any treatment that promises to restore vision, cure or prevent macular degeneration.  There are many so-called "miracle cures" advertised (often in magazines or on the Internet) that have not been adequately tested for safety or efficacy.  These treatments may be expensive and are generally not covered by insurance.  If you are considering trying a new or untested treatment make sure you talk to your Eye M.D. to ensure they are safe and won't interfere with timely and effective treatment of other eye problems.

Current Research
There is a great deal of research and several major scientific studies being conducted to find the causes of AMD and to develop effective treatments for all types of macular degeneration.  Visit the National Eye Institute Web site for additional information www.nei.nih.gov.   Low Vision Rehabilitation There are resources that can help people who have experienced mild to severe vision loss adjust to their condition and continue to enjoy active and independent lifestyles.  Rehabilitation may involve anything from adjusting the lighting in your home to learning to use low vision aids to help you read and perform daily tasks.  Your Eye M.D. can arrange rehabilitation or refer you to organizations that can help.   Support Adjusting to vision loss can be difficult at first.  Your Eye M.D. may be able to recommend some support groups for people with low vision.  You can support friends and family by encouraging them in their rehabilitation efforts and providing help (such as rides to appointments) when needed.

Resources
Your Eye M.D is your best resource for any eye care question or need.  Your Eye M.D. is a medical doctor specially trained to provide the full range of eye care, from eye exams and prescribing glasses and contacts to complex surgery for eye problems.

Copyright © 2002 and 2005 American Academy of Ophthalmology

Health Information from the National Eye Institute:
Age-Related Macular Degeneration Resource Guide
Age-Related Eye Disease Study (AREDS) -- Results

Photographs Courtesy of National Eye Institute, National Institutes of Health