Macular Degeneration
Understanding Macular Degeneration:
Age-related macular degeneration (AMD) is a progressive degenerative disease of the retina. It is currently the leading cause of vision loss in the elderly1. Clinically, the beginnings of AMD can be characterized by a degree of lipid- and protein-rich deposits in the center of the retina (the macula) called drusen. These deposits can eventually lead to retinal damage seen as atrophic or scarring changes in the retina. In the early stages of disease, most patients have no visual symptoms. As symptoms develop, these can vary from difficulty seeing in low-lights, difficulty transitioning from light to dark, central or “patchy” blurred vision, or distortion.
Macular degeneration is also categorized into both a “dry” or “wet” type. Dry AMD is typically limited to slowly progressive macular scarring that can eventually become confluent, referred to a “geographic” atrophy. Patients can develop wet-type AMD at any point along the course of the disease and is characterized by abnormal blood vessels that develop in and around the macula. These aberrant vessels often lead to plasma leakage, hemorrhages, and fibrosis in the retina that can lead to more rapidly progressive vision loss.
Risk factors for AMD include advancing age, smoking, female gender, Caucasian race, obesity, hypertension, cardiovascular disease, and hyperlipidemia2. Preventative and treatment modalities in macular degeneration are currently focused on decreasing blood vessel formation in wet AMD and decreasing risks of destructive inflammation that leads to retinal deposits and scarring.
We recommend that all adults older than age 50 have a yearly dilated fundus exam to screen for signs of macular degeneration. These exams aid in early diagnosis and can prompt treatment to prevent permanent vision loss.
Resources:
- Wang Y, Wang VM, Chan CC. The role of anti-inflammatory agents in age-related macular degeneration (AMD) treatment. Eye. 2011;25:127-39.
- Holz FG, Strauss EC, Schmitz-Valckenberg S. et al. Geographic atrophy: clinical features and potential therapeutic approaches. Ophthalmol. 2014;121:1079-91.
- Mettu PS. Dry AMD Pathobiology: Role for Antiinflammatory Therapies?. Topics in ocular anti-inflammatories. 2018; 25:4-7.
