Age-Related Macular Degeneration
Overview
Age-related macular degeneration (AMD) is a condition that effects the macula—the central area of the retina. There are two types of macular degeneration: dry AMD (or non-neovascular) and wet AMD (or neovascular).
In dry AMD, small yellow deposts called drusen accumulate in the retina, causing damage to the nerve cells. In severe cases, areas of atrophy can develop due to drusen buildup. The most advanced form of dry AMD is called geographic atrophy, where a significant portion of the retina has been damaged and there is loss of central vision.
The more advanced form of macular degeneration is wet AMD, which consists of abnormal new blood vessels growing underneath the retina or retinal pigment epithelium. In early stages of wet AMD, patients may have blurred vision or see wavy lines. If new blood vessels continue to form untreated, scarring can occur which results in loss of central vision.
Diagnosing AMD
Optical coherence tomography (OCT) allows retina specialists to visualize the layers of the retina, including important structures like the macula, fovea, and optic nerve. Additionally, fundus photos provide a more zoomed-out way to visualize these structures.
Treatment
Dry AMD may progress to the wet form, and therefore regular examinations are recommended. An Amsler grid may be used to monitor the vision for changes that may indicate progression from dry to wet macular degeneration. Patients with intermediate risk dry age-related macular degeneration or greater are recommended to take AREDS2 vitamins. AREDS2 vitamins contain 500 mg of vitamin C, 400 IU of vitamin E, 80 mg zinc, 2 mg copper, 10 mg lutein, and 2 mg zeaxanthin. It has been shown that the vitamins can cut the risk of wet AMD development by 25% after five years. It has not been shown that taking AREDS vitamins lowers the risk of developing AMD, so it is only appropriate to take them if there is a confirmed diagnosis of intermediate or advanced dry AMD. For Geographic Atrophy, complement inhibitors such as Izervay may be appropriate.
Wet AMD results from a process called neovascularization, where new blood vessels form under the retina. The growth of these vessels is regulated by a compound in the body called vascular endothelial growth factor (VEGF). Following the discovery of VEGF factors, researchers developed anti-VEGF medications, which halt the growth of new vessels. Marin Retina offers a variety of anti-VEGF drugs, including Avastin, Eylea, Eylea HD, and Vabysmo. These medications are administered intraocularly, or injected into the eye. Dr. Bharadwaj works with patients to develop anti-VEGF treatment plans and works to ensure injections are pain-free.
Learn more about Macular Degeneration from the
American Society of Retina Specialists (ASRS)