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Age-Related Macular Degeneration (AMD) - Types, Stages, Causes, Symptoms, and Treatment

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Age-Related Macular Degeneration (AMD) - Types, Stages, Causes, Symptoms, and Treatment

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Macular degeneration is the leading cause of vision loss in adults? Read about its types, stages, causes, symptoms, and treatment.

Medically reviewed by

Dr. Prashant Koranmath

Published At December 20, 2019
Reviewed AtAugust 8, 2023

Introduction

Vision loss can be due to various causes and the most commonly encountered is age-related macular degeneration. Currently, it is considered to be a non-curable disease and happens with aging. The eye has a back layer called the retina, which is responsible for the images that we see. The central portion of the retina is called the macula, which is responsible for central vision focus in the eye that ultimately controls the reading ability, driving, face or color recognition, and fine detailing of the objects.

It can be divided into two basic types:

Dry or Non exudative AMD - Most of the cases fall into the category of dry AMD, which is atrophic type and the rest fall into wet or exudative type AMD. Dry form happens when the macular parts get thin with age and tiny clumps of protein called Drusen grow. The central vision is slowly lost, and there is no cure for it yet.

Wet or Exudative AMD form happens when there is a growth of new abnormal blood vessels under the retina. These may lead to scarring of the retina due to blood or fluid leakage. In this type, the vision is lost faster. Sometimes, due to the recessive gene, young people face macular degeneration and is called Stargardt disease.

What Are the Stages of The Disease?

There are basically three stages of this disease which are as follows:

Early: There is no vision loss in this stage and the deformity can be examined only through an eye examination.

Intermediate: There can be a minimal vision loss in this stage but still not many noticeable symptoms are there. Again, an eye examination is necessary to diagnose the condition.

Late: This is the stage where vision loss is noticeable.

How Is It Caused?

Mostly, it is age-related and hence, can be seen in people above 60 years of age. As mentioned earlier, it can be related to genes also. Some of the risk factors include smoking, hypertension, increased cholesterol, obesity, family history of AMD, light-colored eye, female, light-skinned people,family history of AMD, etc.

What Are the Symptoms?

Symptoms are mainly dependant on the stages. But some of the alarming symptoms include:

  • Less clear vision or blurred visionary distorted vision. It might make reading or driving difficult.
  • Dark, blurry areas are visible in the center of the vision.
  • Changes in color perception.

If you notice any of the above-mentioned symptoms, it is advisable to consult an eye specialist as soon as possible. Also, it is important to get regular eye examinations done in order to diagnose the condition in its early stages which improves the prognosis.

How Can It Be Diagnosed?

This disease can be diagnosed in its early stages with regular eye examinations. One of the common early signs includes small yellow spots below the retina.

Another way to check for it is by using the Amsler grid, which is nothing but straight lines making a pattern of a checkerboard. People suffering from this condition may notice that some of the straight lines will appear wavy and some may be missing.

Apart from these tests, some examinations like Fundus Fluorescein Angiography (FFA), OCT will be done to check for fluids or blood under the retina.

How Can It Be Managed or Treated?

As for now, there is no treatment for curing macular degeneration. Treatment given for it may slow down the progression of the disease and decrease the worsening of the symptoms. Some of the management options include:

For Dry AMD-

1.Antioxidant vitamins minerals like Vitamin C (500 mg), Vitamin E (400 IU), Lutein (10 mg), Zeaxanthin (2 mg), Zinc (80 mg), Copper (2 mg).

2.Cessation of smoking.

3.Healthy diet Like consuming green leafy vegetables, multi colored fruits.

4.Exercise.

Wet or Exudative AMD Treatment-

1) Anti-VEGF drugs injection inside the eye(intravitreal)- They stop the creation of new blood and also prevent the leakage of fluids in the eye. It has to be noted that studies have shown that those who took these medications and were suffering from wet form got back their vision.

2) Laser therapy- High-energy containing laser light may help in the destruction of abnormal blood vessels or new vessels.

3) Photodynamic laser therapy- Injecting light-sensitive drugs followed by laser treatment.

4) Low vision aids- Devices containing special lenses or electronic systems that help in the creation of larger images of things that are nearby.

Some of the treatment options that are under study include submacular surgery, retinal translocation, etc.

Losing the vision is one of the nightmares coming true. Most of the time, when the symptoms start to appear, the disease would already have reached a late stage. Hence, a routine eye check-up is mandatory for eye health maintenance. With the help of online medical platforms, it has become easy to consult a physician or specialist at the ease of home whenever there is a health-related crisis or doubt. Hence, it is advisable to stay updated by consulting them.

Conclusion

Macular degeneration is an age related condition which affects the retina. The central vision is lost in this condition. It most commonly affects people over the age of 50 years. There are treatment for this condition, but it cannot be cured completely.

Frequently Asked Questions

1.

What Can One Do to Cope With Macular Degeneration?

Vision loss can be frustrating and stressful as the condition progresses. The patient may be required to talk to a psychologist, counselor, or social worker to support them and develop coping skills to deal with the condition. Avoiding smoking, protecting the eyes from ultraviolet rays, and eating a balanced diet are some of the ways that may help one deal with the degenerative condition.

2.

What Is a New Treatment Modality Available for Macular Degeneration?

The researchers are exploring new treatments, such as injecting stem cells directly into the retina (the innermost light-sensitive layer of the eye). The injected cells can help to repair and promote new retinal tissue growth. However, these treatments are yet to be approved by federal regulators.

3.

Does Age-Related Macular Degeneration Progress Fast?

Macular degeneration is an irreversible damage condition that progresses significantly over the years, usually within ten years from its early diagnosis to total loss of vision. The progression of the condition can be slowed by early diagnosis and necessary care, such as eating healthy, taking vitamin supplements, and avoiding smoking.

4.

What Are the Three Phases of Macular Degeneration?

Macular degeneration progresses slowly over the years in three stages, including early, intermediate, and late stages.
- Early - The initial stages of macular degeneration do not exhibit any symptoms and are difficult to detect. However, once developed the degeneration progresses.
- Intermediate - Mild symptoms may be visible in some patients, including blurry central vision or inability to see properly at night. 
- Late - It is the most severe stage when the person develops blurriness in the central vision that may enlarge into black spots, difficulty in seeing straight lines, and inability to recognize colors. It is also known as dry degeneration.

5.

How to Slow the Progression of Macular Degeneration?

Taking a few steps can help people to slow vision loss, like
- Maintaining a healthy life by exercising regularly and keeping a healthy weight.
- Choosing a healthy diet that is high in omega-3 fatty acids, low in saturated fats and cholesterol, and vitamins (A, C, and E).
- Avoid smoking, as it can increase the risk.
- Getting regular eye check-ups.

6.

What Activities Can Aggravate Macular Degeneration?

Certain activities can worsen macular degeneration, such as smoking cigarettes regularly, eating processed foods, and exposure to blue rays in the spectrum, or bright sunlight. Failure to get regular eye exams and manage other medical conditions, like obesity, high blood sugar, and hypertension can make the degeneration progress faster.

7.

Which Vitamins Work Best for Macular Degeneration?

Research supports that a healthy diet and nutrition promote good health. Taking vitamins A, C, and E can reduce the risk of macular degeneration. Vitamin A supplementation is vital for human retinal pigment, while vitamin C acts as an antioxidant.

8.

What Is the Main Cause of Macular Degeneration?

No exact cause of macular degeneration is known. It is indicated that macular degeneration is in family genes and is aggravated by environmental factors, like smoking, unhealthy diet, and increased weight or obesity.

9.

Does Macular Degeneration Affect Normal Life?

Macular degeneration can affect carrying out daily activities. People with age-related macular degeneration can lose their central vision and may require to make certain changes in their lifestyle. However, most people continue to live independently in their houses.

10.

Does Macular Degeneration Always Lead To Blindness?

Macular degeneration rarely progresses to blindness. Initial diagnosis can significantly slow the progress of the degeneration. Change in diet and a healthy lifestyle can reduce the risk of complete loss of central vision, but can make it difficult for one to carry out daily activities, such as reading or driving.

11.

What Is the Last Stage of AMD?

Wet age-related macular usually causes fast vision loss. However, it is rare and happens when there is an abnormal growth of blood vessels in the eye. During the end stage, the person loses complete vision loss of both eyes and is unable to do daily activities, as it progresses fast.

12.

What Happens When Wet AMD Is Left Untreated?

Untreated wet AMD progresses fast and accounts for 90 percent of vision loss from this condition. The degeneration can make it difficult for a person to read, write, drive, or perform daily tasks. It usually happens over several years, often within ten years.

13.

Can Wearing Glasses Help With Macular Degeneration?

Glasses and visual aids can help a person carry out daily tasks and may improve vision. Wearing yellow-tinted glasses helps to increase contrast and can protect one from harmful ultraviolet rays.
Dr. Prashant Koranmath
Dr. Prashant Koranmath

Ophthalmology (Eye Care)

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