Age-Related Macular Degeneration (AMD)

Macular degeneration is widespread. As many as 11 million people in the United States have some form of age-related macular degeneration. This number is expected to double to nearly 22 million by 2050.[3]

What is AMD?

AMD is a common eye condition and a leading cause of vision loss among people age 50 and older. The risk of getting advanced age-related macular degeneration increases from 2% for those ages 50-59 to nearly 30% for those over the age of 75.[3]

It causes damage to the macula, a small spot near the center of the retina and the part of the eye needed for sharp, central vision, which lets us see objects that are straight ahead.[1]

In some people, AMD advances so slowly that vision loss does not occur for a long time. In others, the disease progresses faster and may lead to a loss of vision in one or both eyes. As AMD progresses, a blurred area near the center of vision is a common symptom. Over time, the blurred area may grow larger or you may develop blank spots in your central vision. Objects also may not appear to be as bright as they used to be. [1]

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HOW IS AMD DETECED? [1]

The early and intermediate stages of AMD usually start without symptoms. Only a comprehensive dilated eye exam can detect AMD. The eye exam may include the following:
AMD detection Visual Acuity Test

Visual acuity test

This eye chart measures how well you see at distances.
AMD detection Dilated Eye Exam

Dilated eye exam

Your eye care professional places drops in your eyes to widen or dilate the pupils. This provides a better view of the back of your eye. Using a special magnifying lens, your eye care professional then looks at your retina and optic nerve for signs of AMD and other eye problems.
AMD detection Amsler Grid
Your eye care professional also may ask you to look at an AMSLER grid. Changes in your central vision may cause the lines in the grid to disappear or appear wavy, which is a sign of AMD.
AMD detection Fluorescein Angiogram

Fluorescein angiogram

In this test, which is performed by an ophthalmologist, a fluorescent dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your eye. This makes it possible to see leaking blood vessels, which occur in a severe, rapidly progressive type of AMD.
AMD detection Optical Coherence Tomography

Optical Coherence Tomography

You have probably heard of ultrasound, which uses sound waves to capture images of living tissues. OCT is similar except that it uses light waves and can achieve very high-resolution images of any tissues that can be penetrated by light—such as the eyes. After your eyes are dilated, you’ll be asked to place your head on a chin rest and hold still for several seconds while the images are obtained. The light beam is painless.

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WHAT ARE THE STAGES OF AMD? [1]

There are three stages of AMD defined in part by the size and number of drusen under the retina. It is possible to have AMD in one eye only, or to have one eye with a later stage of AMD than the other. 

Early AMD. Early AMD is diagnosed by the presence of medium-sized drusen, which are about the width of an average human hair. People with early AMD typically do not have vision loss. 

Intermediate AMD. People with intermediate AMD typically have large drusen, pigment changes in the retina, or both. These changes can only be detected during an eye exam. Intermediate AMD may cause some vision loss, but most people will not experience any symptoms. 

Late AMD. In addition to drusen, people with late AMD have vision loss from damage to the macula. There are two types of late AMD: 

In geographic atrophy (also called dry AMD), there is a gradual breakdown of the light-sensitive cells in the macula that convey visual information to the brain, and of the supporting tissue beneath the macula. These changes cause vision loss. 

In neovascular AMD (also called wet AMD), abnormal blood vessels grow underneath the retina. (“Neovascular” literally means “new vessels.”) These vessels can leak fluid and blood, which may lead to swelling and damage of the macula. The damage may be rapid and severe, unlike the more gradual course of geographic atrophy. It is possible to have both geographic atrophy and neovascular AMD in the same eye, and either condition can appear first. 

RISK FACTORS FOR AMD INCLUDE: [1,2]

  • OVER 50 YEARS OF AGE
  • SMOKING
  • FAMILY HISTORY OF AMD
  • RACE(CAUCASIANS HAVE A HIGHER OCCURANCE OF AMD)
  • FARSIGHTEDNESS
  • LIGHT COLORED EYES
  • OBESITY
  • GENDER(FEMALES ARE MORE LIKELY TO DEVELOP AMD)
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TREATMENT/REDUCTION OF AMD: [11]

Early AMD.Currently, only preventative treatment exists for early AMD, which in many people can have no symptoms or loss of vision.  Preventative treatment includes but is not limited to supplements that utilize the AREDS 2 formulation. (TOZAL is a supplement that goes beyond the AREDS 2 formulation for complete eye health.) In addition, your eye care professional may recommend that you get a comprehensive dilated eye exam at least once a year. The exam will help determine if your condition is advancing. 

Intermediate and Late AMD. Researchers at the National Eye Institute tested whether taking nutritional supplements could protect against AMD in the Age-Related Eye Disease Studies. They found that daily intake of certain high-dose vitamins and minerals can slow progression of the disease in people who have intermediate AMD, and those who have late AMD in one eye. 

 

REDUCE THE RISK: [1,2]
  • AVOID SMOKING
  • EXERCISE REGULARLY
  • HEALTHY DIET- MAINTAIN A HEALTHY WEIGHT 
  • MAINTAIN BLOOD PRESSURE AND CHOLESTEROL
  • WEAR SUNGLASSES
  • REGULAR EYE EXAMS
  • TAKE SUPPLEMENTS THAT MEET AREDS 2 STANDARDS

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Resources: 

[1] Facts About Age-Related Macular Degeneration. (2018, November 01). Retrieved from https://nei.nih.gov/health/maculardegen/armd_facts

[2] Macular Degeneration: Prevention & Risk Factors. (2018, November 13). Retrieved from https://www.brightfocus.org/macular/prevention-and-risk-factors

[3](2018, April 10). Age-Related Macular Degeneration: Facts & Figures. Retrieved from https://www.brightfocus.org/macular/article/age-related-macular-facts-figures