Adult Macular Degeneration
The retina is the tissue that lines the back of the eye. It sends visual signals to the brain. The macula is part of the retina. It is responsible for central vision. Macular degeneration is decline of the macula. It causes a gradual loss of sharp, central vision. The condition is mainly a disease of aging. In rare cases, it can occur in younger people.
There are two types of adult (or age-related) macular degeneration (AMD):
Factors that may increase your risk for AMD include:
In some people, AMD advances very slowly. It has little effect on their vision. In others, the disease progresses faster. It may lead to significant vision loss. Neither dry AMD nor wet AMD causes pain.
The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor may suspect AMD if you are older and have had recent changes in your central vision. A specialist will look for signs of the disease. The doctor will use eye drops to dilate (enlarge) your pupils. This will allow a view of the back of the eye.
You may also be asked to view an Amsler grid. This is a pattern that looks like a checkerboard. Changes in your central vision will cause the grid to appear distorted. This is a sign of AMD.
Treatment may include:
Research has suggested certain high-dose vitamins and minerals may slow the progression of the disease in some people.
This procedure is used in some cases of wet AMD. A strong laser light beam is aimed at the new blood vessels. The beam destroys the vessels. It usually takes less than 30 minutes to complete. You may need more laser treatments. This treatment is used less often since the development of newer treatments.
This procedure is a type of treatment that involves injecting a light-sensitive dye into your blood. The affected areas in the back of the eye are then hit with a special laser light. The light activates the dye to destroy certain blood vessels. It also takes less than 30 minutes. You may need to have additional treatments.
Vascular Endothelial Growth Factor Inhibitor
Another way to treat wet AMD is an injection of a special medicine. It is called a vascular endothelial growth factor (VEGF) inhibitor. The medicine is injected into the vitreous (fluid) in the back of the eye. This method is growing quickly in popularity. It usually needs to be repeated multiple times. About 1/3 of patients show significant improvement in vision.
There are no guidelines for preventing AMD. For overall eye health:
If you have AMD, your doctor may advise you to use an Amsler grid at home. This will help you monitor for problems. Your ophthalmologist should discuss the various treatment options with you.
American Macular Degeneration Foundation
Macular Degeneration Foundation
AMD Alliance International
The National Coalition for Vision Health
Age-related macular degeneration. National Eye Institute website. Available at: http://www.nei.nih.gov/health/maculardegen/index.asp. Accessed July 20, 2009.
Liew G, Mitchell P, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1419-1431.
Macular Degeneration Foundation website. Available at: http://www.eyesight.org. Accessed July 20, 2009.
National Eye Institute website. Available at: http://www.nei.nih.gov/. Accessed July 20, 2009.
Photodynamic therapy: an emerging treatment for classically leaky neovascularizations. Macular Degeneration Foundation website. Available at: http://www.eyesigh.... Accessed July 20, 2009.
11/1/2007 DynaMed's Systematic Literature Surveillance.
Available at: http://dynamed.ebscohost.com/about/about-us: Wormald R, Evans J, et al. Photodynamic therapy for neovascular age-related macular degeneration.
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3/6/2013 DynaMed's Systematic Literature Surveillance.
Available at: http://dynamed.ebscohost.com/about/about-us: Sui GY, Liu GC, Liu GY, et al. Is sunlight exposure a risk factor for age-related macular degeneration: A systematic review and meta-analysis. Br J Ophthalmol. 2012 Nov 10. [Epub ahead of print].
3/11/2013 DynaMed's Systematic Literature Surveillance.
Available at: http://dynamed.ebscohost.com/about/about-us: Christen WG, Glynn RJ, Sesso HD, et al. Vitamins E and C and medical record-confirmed age-related macular degeneration in a randomized trial of male physicians. Ophthalmology. 2012 Aug;119(8):1642-9.
Last reviewed [Under Medical Review] by Christopher Cheyer, MD