Macular Degeneration

Understanding Macular Degeneration

The macula is the most sensitive part of the retina, or nerve layer covering the back of the eye. It serves our central vision and allows us to read, distinguish faces, and see fine detail. Macular degeneration occurs in “dry” and “wet” forms. Early on macular degeneration may result in only mild symptoms of blurred or distorted vision but as the condition progresses central vision loss becomes more severe making it difficult to perform daily activities. Early macular degeneration can be identified with a dilated eye exam performed by your ophthalmologist. If findings of macular degeneration are identified additional testing (insert hyperlink to retinal testing) may be recommended.

Types of Age-Related Macular Degeneration


In non-exudative AMD or the dry form of macular degeneration, debris called drusen accumulate in the deep layers of the retina causing parts of the macula to function poorly and eventually degenerate, leading to slow progressive central vision loss.

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In exudative AMD or the wet form of macular degeneration, abnormal blood vessels begin to grow in the macula. These abnormal blood vessels, called choroidal neovascularization, leak fluid or blood into the macula causing it to swell which leads to loss of vision which can be gradual but is often abrupt.

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Macular Degeneration Treatment

The first step in treatment of macular degeneration is screening and prevention. Early detection of disease can often result in better vision over time if you are diagnosed with macular degeneration. A screening dilated eye exam is recommended annually for individuals over the age of 50. If you have a family history of macular degeneration earlier screening may be indicated. Large-scale studies evaluating the causes of macular degeneration have determined that the risk of developing AMD is determined by many factors. The strongest associations are genetics, race and age. There is clear evidence that smoking increases the risk of AMD and is the only modifiable risk factor. Other environmental and dietary factors have been evaluated but not proven such as increased exposure to sunlight or high fat diets. In general eating foods that are rich in vitamin C, E, zinc, lutein, zeaxanthin and omega 3 fatty acids are good for eye health. These nutrients are linked to lower risk of age-related macular degeneration (AMD) and can be found in a variety of food items. The following are a few examples of foods rich in these nutrients: dark green leafy vegetables, red, orange, yellow and other colorful fruits and vegetables, cold water fish such as salmon and halibut. Wearing sunglasses is not proven to prevent AMD but is recommended and can prevent other eye conditions associated with exposure to ultraviolet light.

A large study performed by the National Eye Institute of the National Institutes of Health, called AREDS2 (Age-Related Eye Disease Study), showed that for certain individuals, vitamins C, E, zinc, copper, lutein and zeaxanthin can decrease the risk of vision loss in patients with intermediate to advanced dry age-related macular degeneration. For patients with no AMD or mild AMD there was no benefit associated with taking vitamin supplementation to prevent AMD. Ask your eye doctor if these vitamin supplements will benefit you before taking them.

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Low vision aids
In some cases significant vision loss can occur from macular degeneration despite treatment. In these cases low vision devices that have special lenses and magnifiers or electronic systems that produce enlarged images can be used to make the most of remaining vision.
Intravitreal Injection of Anti-angiogensis Drugs
New drugs target growth factors that cause the abnormal blood vessel growth in wet macular degeneration. This drug class known as anti-VEGF (anti-vascular endothelial growth factor) drugs can prevent the growth of the abnormal blood vessels within the eye, halting or in many cases restoring some of the vision lost from wet macular degeneration. These medications are administered by injection into the middle cavity of the eye called the vitreous.

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Laser Therapy
High-energy laser light can sometimes be used to destroy actively growing abnormal blood vessels that occur in age-related macular degeneration if the diseased area falls outside of the central macula.

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