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 the most common cause of destruction of the macula in older adults. 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.
Adult, or age-related macular degeneration (AMD), is classified as:
The cause of AMD is not known. It may be related to a combination of genetics and environmental exposures over the course of a lifetime.
The risk of AMD increases with age. AMD is most commonly seen in women and in people who are Caucasian. Other factors that may increase your chance of getting AMD include:
In some people, AMD advances slowly. It has little effect on their vision. In others, the disease moves faster. It may lead to significant vision loss. AMD does not cause pain.
Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done. AMD may be suspected if you are older and have had recent changes in your central vision. A specialist will look for signs of the disease with an eye exam. Eye drops will be used 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.
Imaging tests may be used in some cases. These may include:
Treatment depends on the stage of AMD. In general, lifestyle changes will help slow disease progression for early, intermediate, and late (dry) stages:
Your doctor will schedule regular exams to monitor any changes or progression in AMD.
Vision loss at this stage can be severe. Options to slow vision loss include:
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 than newer treatments.
This procedure involves injecting a light-sensitive dye into your blood. The affected areas in the back of the eye are then treated with a special laser light. The light activates the dye to destroy certain blood vessels. It takes less than 30 minutes. You may need to have additional treatments.
Another way to treat wet AMD is an injection of a special medication. It is called a vascular endothelial growth factor (VEGF) inhibitor. The medication is injected into the vitreous (fluid) in the back of the eye. It usually needs to be repeated multiple times.
To help reduce your chance of AMD:
American Macular Degeneration Foundation
Macular Degeneration Foundation
AMD Alliance International
Canadian Association of Optometrists
Adult macular degeneration. Macular Degeneration Foundation website. Available at: http://www.eyesight.org/Macular_Degeneration/Adult_MD/adult_md.html. Accessed November 29, 2016.
Age-related macular degeneration (AMD). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114486/Age-related-macular-degeneration-AMD. Updated May 7, 2015. Accessed November 28, 2016.
Age-related macular degeneration (AMD). National Eye Institute (NEI) website. Available at: https://nei.nih.gov/health/maculardegen. Updated September 2015. Accessed November 28, 2016.
Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355(14):1419-1431.
What is macular degeneration? American Academy of Ophthalmology website. Available at: http://www.aao.org/eye-health/diseases/amd-macular-degeneration. Accessed November 29, 2016.
What is macular degeneration? American Macular Degeneration Foundation website. Available at: https://www.macular.org/what-macular-degeneration. Accessed November 29, 2016.
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Last reviewed May 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.