Age-Related Macular Degeneration

Age-related macular degeneration, or AMD, is the most common cause of decreased vision in people over 50 in the United States, according to the American Academy of Ophthalmology.

Macular degeneration occurs when part of the retina in your eye, called the macula, is damaged. This affects your vision. In the early stages, you may not notice changes to your eyesight. Macular degeneration can impact your ability to drive and read fine print. However, with treatment – like that available at the Eye Center at The University of Kansas Health System – people rarely go blind from macular degeneration.

There are 2 forms of macular degeneration. Dry macular degeneration is the most common, affecting about 80% of those diagnosed. Patients have thinning in the center of their eye, called the macula, and a buildup of proteins, called drusen. The progression of the disease is slow.

Wet macular degeneration is a more advanced form of the disease. With it, new blood vessels grow within the macula and can start bleeding or leaking other fluids. This damages the photoreceptors and causes decreased vision. Wet macular degeneration can progress rapidly.

There are many symptoms of macular degeneration, but they are all related to changes in your vision, like:

• Blurry or fuzzy vision
• Straight lines look wavy
• Dark, gray or blind spot in the center of your vision
• Loss of central vision
• Colors may look more pale
• Difficulty recognizing faces

You’re more at risk for macular degeneration as you age. If you are 50 or older, you’re at higher risk. Smoking, eating an unhealthy diet, having obesity or high blood pressure, also called hypertension, also increases your risk for developing macular degeneration.

Finally, if you have a genetic relative diagnosed with macular degeneration, you may be at higher risk for developing it, too. The American Academy of Ophthalmology and the American Society of Retina Specialists recognize a genetic correlation but don’t yet know which gene could cause macular degeneration.

If you are concerned about your risk of developing macular degeneration, you should consider screenings after turning 50. In general, screening begins with an eye exam that includes dilating your pupil. These exams are important because doctors can catch macular degeneration before you notice changes to your vision and help stop it from progressing.

Another great tool is the Amsler grid. You can print out a grid and keep it somewhere highly visible at home, like on the refrigerator. If you notice changes in the appearance of the lines on the grid – they look wavy or darker, for example – you should contact an eye doctor.

Optical coherence tomography is also used to diagnose and monitor macular degeneration. This is a noninvasive imaging study that will allow the ophthalmologist to see your retina in more detail.

Dry macular degeneration with geographic atrophy can be treated with intravitreal injections to slow down geographic atrophy. It is also recommended to adopt a healthy diet with leafy greens, colorful vegetables and fish. You should stop smoking. If you have obesity, work with your primary care physician on strategies to decrease your weight. Basically, try to limit any of the risk factors and make sure conditions like high blood pressure or hypertension are well-controlled.

Additionally, the National Institute of Health recommends taking the AREDS vitamin supplement. Talk to your doctor first. Some people will not take all of these due to other health conditions, but the recommended supplements include:

• Vitamin E
• Vitamin C
• Zinc
• Copper
• Lutein
• Zeaxanthin

Wet macular degeneration is treated with intravitreal injections – these are shots directly into the eye. The medication works on the chemical receptors of those sick blood vessels and causes them to shrink and stop bleeding or leaking. Some patients may get injections at regular intervals while others may get one injection and then get gene therapy to create more of those chemicals that control wet macular degeneration.

Watch Denise Johnson get one of these injections at The University of Kansas Health System. Please note the procedure is shown in detail. This graphic content may not be appropriate for all viewers.

The University of Kansas Health System has been a leader in eye care and vision health for more than 100 years. With experts in all subspecialty areas, our team provides a full spectrum of eye care services, from routine vision exams to leading-edge surgical procedures and breakthrough treatments for some of the rarest eye conditions.

Ophthalmologists Radwan Ajlan, MD, and Mary Champion, MD, are fellowship-trained in retinal surgery and experts in the field when it comes to treating macular degeneration.