Age-related macular degeneration (AMD) involves progressive destruction and worsening vision of the macular region of the eye, the central part of the retina responsible for more than 99 percent of the vision. AMD is the leading cause of blindness in people 65 and older in the U.S.
According to the Centers for Disease Control and Prevention, 48 million older Americans had AMD as of November 2020, and it is projected to rise to 88 million by 2050. Studies have shown that people who are white have a higher risk of developing AMD than others.
Risk Factors of AMD
The following groups are at higher risk of developing AMD:
- People who are at least 50 years old.
- People who eat foods high in saturated fat. These include fatty cuts of meat, butter, cheese, sausage and bacon.
- People who are overweight.
- People who smoke cigarettes or use any form of nicotine.
- People who have high, uncontrolled blood pressure.
- People with a family history of AMD.
How AMD is Detected
If you have a risk factor of AMD, you should receive a regular eye exam with a retina specialist. According to BrightFocus Foundation, imaging tests, like fundus photography, fundus fluorescein angiogram, optical coherence tomography or similar tests are required to diagnose and determine how to manage AMD. Patients usually receive an Amsler’s chart to monitor their own vision at home, and any changes in the chart must be reported to the retina specialist immediately.
Types and Treatments
There are different types of AMD that cause varying kinds of destruction to the macular region and require different treatments.
Although AMD is not preventable, you can slow its progression with lifestyle changes. You can eat more green-leafed vegetables, yellow fruits and seafood (fish oils or omega-3 fatty acids) and have a nutrient-rich balanced diet overall. It is also beneficial to get regular exercise and avoid excess sun exposure.
Early AMD is the most common form of AMD. In this form, small yellow deposits called “drusen” form under the retina. This does not cause any visual changes, although people with this form of AMD may have difficulty reading or adjusting from bright to low light.
Wet AMD is a more advanced form of AMD. This form is less common, but it can cause debilitating central vision loss. Wet AMD is caused by the growth of new blood vessels in the macular region, resulting in bleeding and fluid collection. This causes objects’ shapes to appear distorted and causes a sudden onset of blurred vision.
To treat wet AMD, you can receive anti-vascular endothelial growth factor (AntiVEGF) injections. These include Bevacizumab (Avastin®), Ranibizumab (Lucentis®), Aflibercept (Eylea®) and Faricimab (Vabysmo®).
Early treatment reduces eye scarring and can improve vision in some patients. Frequent and multiple injections may be required. It is important to note that vision may not get restored fully due to the damage to central photoreceptors in the eye.
Dry Advanced AMD
Dry advanced AMD is also called “geographic atrophy,” according to BrightFocus Foundation. This stage causes a progressive but crippling loss of central vision due to the central photoreceptors wasting away. This leads to severe visual impairment with the inability to drive or read.
Currently, there is no satisfactory treatment for this stage of AMD. However, recent research trials have suggested that complement factor inhibitors like Pegcetocoplan (Apellis) (now FDA approved) and Avacincaptad (under investigation, Iveric) have shown promising results in slowing progressive atrophy over time in a small number of patients.
Vitamins and Minerals Can Help
Anyone affected by AMD must take multivitamin capsules daily to slow down the progression of this condition. These multivitamin capsules should include vitamin C (500 mg), vitamin E (400 IU), lutein (10 mg), zeaxanthin (2 mg), zinc (80 mg) and copper (2 mg), and these are available as various brands over the counter.
If you are above 50 years of age or if you have any risk factors for AMD, schedule an appointment at UofL Health – Eye Institute by calling 502-588-0550. To learn more about AMD, watch this video from WHAS11: Health expert discusses age-related macular degeneration.