Macular Degeneration

The macula is the centermost part of the retina and involved in central vision. When the macula is damaged, as in age related macular degeneration (AMD), the central vision is slowly lost.

Damage is due to loss of integrity of the layers of the retina as well as irregular deposits of protein, called drusen, in the lower layers of the retina causing light and images not to focus properly.

Top left: In this fundus photo, drusen is initially seen in the central part of the retina, the macula.

Top right: Years later, drusen has been replaced by geographic atrophy, which can cause significant vision loss.

Photo credit: www.eyerounds.org

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Who is at highest risk for developing AMD?

There are risk factors that are not modifiable and those that are. We encourage you to modify the risk factors you can to minimize your risk and slow down/prevent the onset of disease.

Risk factors for AMD:

Eating a diet high in saturated fat (cheese, butter, red meat)
Smoking
Family history
Caucasian race
High blood pressure, heart disease

What is Wet vs Dry AMD?

Dry AMD is the most common form and 80% of patients who have AMD have the dry form. This leads to very slow, progressive vision loss over 10-20 years.

The wet form is much rarer, but can result in sudden vision loss. In wet AMD, abnormal blood vessels begin to grow in the choroid, the vascular layer surrounding the retina. These vessels can leak blood and other fluid, causing scarring and vision loss in the macula.

What is the Treatment for Dry AMD?

Studies known as AREDS (Age Related Eye Disease Study) and AREDS2 (Age Related Eye Disease Study 2) were completed in 2001 and 2013, respectively.

These studies looked at patients with early, intermediate, and advanced AMD, and concluded that adding anti-oxidants and zinc supplementation reduced progression to advanced AMD by 25% in patients who had intermediate AMD or advanced disease in one eye.

The AREDS2 formulation includes:

Vitamin C (500 mg)
Vitamin E (400 IU)
Lutein (10mg) and Zeaxanthin (2 mg)
Zinc (80 mg)
Copper (2 mg)

Smokers taking beta carotene, which is the carotenoid used in the initial AREDS study, had higher risk of developing lung cancer, and the AREDS2 study showed that Lutein (10 mg) and Zeaxanthin (2 mg) can safely replace beta carotene and did not have increased cancer risk. Therefore, it is a good option for everyone with AMD.

What is the Treatment for Wet AMD?

Wet AMD is treated with anti-VEGF (vascular endothelial growth factor) drugs. These drugs are administered as monthly injections in the eye. Dr. Ali will discuss the risks, benefits, and frequency of these injections with you to optimize your treatment.

Maximizing Vision with Low Vision Aids

With advanced macular degeneration, even with best glasses at times vision can be impaired to the point where it is difficult to read.

This page has been put together based on feedback from our actual patients. We do not benefit or obtain revenue from any of these products. It is not meant for marketing, but a forum for patients to share best practices.

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- Recommended as a useful reading aid by Dr. Ali's patient with advanced dry AMD with geographic atrophy and vision of 20/400 in one eye and 20/50 in the other eye.