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Macular Degeneration

Definition

Macular degeneration is an eye disease that damages the macula, the central part of the retina responsible for sharp, detailed vision. It mainly affects people over age 50 and can lead to loss of central vision, making it difficult to read, drive, recognize faces, and perform close-up tasks. Peripheral (side) vision is usually preserved.

Types

1. Dry AMD (Atrophic AMD)
   • Most common form (about 80–90% of cases).
   • Occurs when the macula gradually thins and deposits called drusen accumulate beneath it.
2. Wet AMD (Neovascular AMD)
   • Less common but more severe.
   • Caused by abnormal blood vessels growing under the retina and leaking fluid or blood, leading to rapid vision loss. 

Causes and Risk Factors

The exact cause is not fully understood, but several factors increase the risk:

• Aging (most important risk factor) 
• Family history and genetics 
• Smoking 
• High blood pressure 
• High cholesterol and cardiovascular disease 
• Obesity 
• Diet high in saturated fats
• Being over 50 years old 

Symptoms

Symptoms often develop gradually in dry AMD but may occur suddenly in wet AMD.

Early Symptoms

• No symptoms (common in early stages) 
• Mild blurring of central vision 
• Difficulty seeing in dim light 

Advanced Symptoms

• Blurred or distorted central vision 
• Straight lines appearing wavy or crooked (metamorphopsia) 
• Dark, blurry, or blank spots in the center of vision 
• Difficulty reading and recognizing faces 
• Reduced ability to see fine detail

Treatment

Dry AMD

There is no cure, but progression may be slowed by:

• AREDS2 vitamin supplements for patients with intermediate AMD or advanced AMD in one eye. These supplements can reduce the risk of progression to advanced AMD by about 25%.
• Smoking cessation
• Healthy diet rich in fruits, vegetables, and fish 
• Regular eye examinations 
• Low-vision aids for patients with significant vision loss 

Wet AMD

Treatment aims to stop abnormal blood vessel growth and preserve vision:

• Anti-VEGF eye injections (standard treatment) to reduce leakage and slow vision loss. 
• Photodynamic therapy (light-activated treatment) in selected patients. 
• Laser therapy in certain cases. 

Prevention

Although AMD cannot always be prevented, the risk may be reduced by:

• Not smoking 
• Maintaining healthy blood pressure and cholesterol levels 
• Eating a balanced diet rich in leafy green vegetables and fish
• Exercising regularly and maintaining a healthy weight
• Having regular dilated eye examinations, especially after age 50

Summary

Macular degeneration is a common age-related retinal disease that causes progressive loss of central vision. The two forms are dry AMD (more common, slower progression) and wet AMD (less common, faster vision loss). Early detection, lifestyle modifications, AREDS2 supplements (when appropriate), and treatments such as anti-VEGF injections can help preserve vision.