Age-related macular degeneration (AMD) is one of the leading causes of blindness in patients over the age of 50 years old. It leads to a loss of vision centrally, whereby patients may be able to see the world around them, only they will lose the central vision responsible for many of our activities of daily living. This is because this disease affects the central portion of the retina known as the macula which is responsible for our central vision that we rely on for the majority of our visual needs such as reading, driving, and recognizing details directly in front of us.

There are 2 main types of AMD- the dry form and the wet form. “Dry AMD” is more common and refers to a group of disorders that demonstrate the presence of deposits underneath the retina, absence of retinal tissue, and/or pigment clumping. These deposits can cause damage to that under layer and over time, this damage can lead to the growth of blood vessels under the retina. The presence of blood vessels and the leaked components of the blood under the retina is known as “wet AMD”. Loss of central vision can occur in both types of AMD, but the most common form of acute loss of vision is from “wet AMD.” Currently there are effective treatments for “wet AMD”, but we are still awaiting effective treatments for “dry AMD.”

Treatment strategies for dry AMD revolve around preventing progression to wet AMD. These include altering modifiable risk factors such as smoking cessation, maximizing treatment of hypertension and atherosclerosis, and making dietary modifications along with vitamins described in the AREDS-2 formulation.

Treatment for “wet AMD” is designed to stop the leakage and growth of new blood vessels under the retina. This is accomplished with medications injected into the eye. These medications are a class of medicines known as VEGF (Vascular Endothelial Growth Factor) inhibitors with trade names Avastin, Lucentis, and Eylea. These drugs interfere with signaling that promotes the growth of the abnormal vessels and causes them to involute. These injections typically need to be repeated every 4 weeks at first and decrease in frequency once the process responds to treatment.

Regardless of the type of AMD, patients with this diagnosis need to be followed closely as well as educated on the symptoms of progression and the need for prompt treatment. This can be accomplished with Amsler grid monitoring at home and regular visits with an eye care specialist.