Age-Related Macular Degeneration

At least 10% of elderly Americans have irreversible central vision loss from age-related macular degeneration. Two primary forms include the atrophic (also called the involutional or dry) form, which accounts for about 70% of cases, and the exudative (also called the hemorrhagic or wet) form of macular degeneration.

AMD occurs when the macula, which is located in the center of the retina and provides us with sight in the center of our field of vision, begins to degenerate. With less of the macula working, central vision - which is necessary for driving, reading, recognizing faces, and performing close-up work - begins to deteriorate.

Macular degeneration commonly affects both eyes and is a leading cause of blindness in the United States.

Causes

Age-related macular degeneration results from hardening and obstruction of the retinal arteries, usually associated with age-related degenerative changes. As a result, new blood vessels form (neovascularization) in the macular area and totally obscure central vision. The disorder may also be genetic in origin or may result from an injury, inflammation, or infection.

Symptoms

The main symptom of age-related macular degeneration is blurred central vision, which looks like a blind spot right in the middle of your vision. You might first notice it when reading, driving, or watching TV. Macular degeneration does not affect peripheral (side) vision or the ability to see colors. Dry age-related macular degeneration usually begins in one eye, but may affect the other eye at a later time, or it can occur in both eyes at the same time. The dry type progresses slowly until central vision is very poor. Wet age-related macular degeneration causes the same symptoms, but they occur more rapidly. Lines that should be straight may also look wavy or distorted.

Diagnostic tests

Eye physicians usually diagnose AMD. Vision testing, Amsler grid test, ophthalmoscopy, fundus photography and fluorescein angiography are some common tests performed during a retinal exam.

Treatment

No cure currently exists for the atrophic form of macular degeneration. In patients with the exudative form, argon laser photocoagulation may slow the progression of severe visual loss in 5% to 10% of cases.

Prevention

At the present time, no cure has been discovered for macular degeneration. Likewise, no treatment has been found to restore central sight that has been lost to the condition.

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