Learn About
about Age-related Macular Degeneration
What is Age-related Macular Degeneration (AMD)?
Age-related macular degeneration (AMD) is deterioration of the center of the retina, called the macula. There are two types of AMD: dry AMD and wet AMD.1 In the dry type of AMD, deposits, called drusen, develop under the macula. In the wet type of AMD, abnormal blood vessels develop under the macula. 1
AMD is a leading cause of severe vision loss. 1, 2 In people with AMD, about 85-90% of have dry AMD and 10-15% have wet AMD. 3 The majority of severe vision loss from AMD is caused by wet AMD. 3
AMD Patient Checklist
There are 3 Stages of AMD: 4
Early AMD
Intermediate AMD
Severe AMD: severe AMD can be characterized in two ways: severe dry AMD (also called geographic atrophy) and wet AMD (also called neovascular AMD)
It is possible to have AMD without any symptoms. People with early and intermediate stages of AMD rarely have symptoms; in comparison, people with severe or wet AMD usually do have symptoms. 5 Earlier diagnosis and appropriate treatment helps maintain better vision. 6
Understanding AMD
National Institue of Health (NIH) 7
Symptoms: 8
Reduced vision
A blind or blurry spot in the vision
Difficulty with low light situations
(Example: reading a menu in a dimly lit restaurant)
Faded color vision
Visual distortion
(Example: a straight line appearing bent)
The visual experience of AMD
Know your risk factors for AMD
Age: People over age 50 are at increased risk. 2
Genetics (family history). 9
Obesity: Speak with your PCP if you’d like help losing weight. 11
Northern European ancestry. 2, 16
Smoking or history of smoking: Speak with your eye care provider or primary care provider (PCP) if you would like help quitting. 10
Dilated eye exams are especially important for people age 40 and over, people of Northern European decent and people with a family history of AMD.
3 myths about age-related macular degeneration
MYTH
I’ll notice if something is wrong with my vision.
FACT
Even with the most severe form of AMD, wet AMD, some people have no symptoms. 1
MYTH
I should take AMD vitamins (AREDS or AREDS2 formulation) to prevent macular degeneration
FACT
The AREDS formulation of vitamins is only effective when you have an intermediate or severe stage of AMD. 12, 13 Studies show these vitamins have no value in prevention of AMD or in people with early AMD.
MYTH
I had my eyes tested when I got my new driver’s license. I passed, so I must have healthy eyes.
FACT
The eye check for a driver’s license is not sufficient to detect eye disease. A dilated eye exam is still necessary.
Maintaining healthy eyes and vision
Get a dilated eye exam at age 40 if you have never had one before 1
Contact your eye doctor if you experience vision changes
Stop smoking 10
Daily vitamins, if recommended by your eye care provider: AREDS or AREDS 2 formulation. This is only appropriate for intermediate and severe stages of AMD 12, 13
Maintain a healthy weight 11
Know how often your eye doctor wants to see you for follow up and stick to the schedule
Daily use of an Amsler grid or electronic home monitored machine 14
Printable Amsler grid with instructions
Eat a well-balanced diet- A Mediterranean diet and intake of omega-3 fatty acids, like fish, may decrease the risk of progression for AMD 15, 16
Your primary care provider (PCP) can help you quit smoking, recommend a nutritionist or help you maintain a healthy weight. Your care team for AMD will include your PCP and eye care provider and may also include a retinal specialist, low vision specialist, and nutritionist.
Common treatments for AMD
It is possible to have a different stage of AMD in each eye. 1 Treatment will be tailored specifically for each person and each eye.
Stages and Treatments:
Early AMD
Lifestyle modifications: quit smoking, maintain a healthy weight and eat a healthy diet (Mediterranean diet). 10, 11, 15, 16
Intermediate AMD
Lifestyle modifications: quit smoking, maintain a healthy weight and eat a healthy diet (Mediterranean diet). 10, 11, 15, 16
Vitamins: AREDS or AREDS2 formulation vitamins as recommended by your doctor. 12, 13
Severe AMD - Dry
Lifestyle modifications: quit smoking, maintain a healthy weight and eat a healthy diet (Mediterranean diet). 10, 11, 15, 16
Vitamins: AREDS or AREDS2 formulation vitamins as recommended by your doctor. 12, 13
Severe AMD - Wet
Anti-VEGF medication: This medication is injected into the eye to prevent abnormal blood vessel growth. 1
Laser: A laser may be used to treat leaking blood vessels. 1
Treating AMD
AMD & Anti-VEGF Therapy
App for mobile devices
Barriers to eye care 17
Limited knowledge of AMD: Not all people with AMD are aware of the importance of dilated eye exams beginning at age 40, even if a person has no symptoms.
Cost of care: Ask your eye doctor what programs are available to reduce your cost.
Difficulty buying and locating vitamins (AREDS or AREDS2): Ask your eye doctor what vitamin is right for you, take a picture of the bottle or enroll in a subscription service that sends vitamins directly to your home.
Fear of treatment: Speak with your doctor before your appointment if fear may prevent you from going to the appointment. Pain with eye injection is mild for the majority of people.
Meet Cherie, who explains her experience with anti-VEGF injections for AMD
Download a Patient Question Checklist
DownloadReferences:
1 Flaxel CJ, Adelman RA, Bailey ST, et al. Age-related macular degeneration preferred practice pattern®. Ophthalmology. 2020;127:P1-P65.
2 Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology. 1992;99:933-943.
3 Ambati J, Fowler BJ. Mechanisms of age-related macular degeneration. Neuron. 2012;75:26-39.
4 Ferris FL 3rd, Wilkinson CP, Bird A, et al. Clinical classification of age-related macular degeneration. Ophthalmology. 2013;120:844-851.
5 Ayoub T, Patel N. Age-related macular degeneration. J R Soc Med. 2009;102:56-61.
6 Rauch R, Weingessel B, Maca SM, Vecsei-Marlovits PV. Time to first treatment: The significance of early treatment of exudative age-related macular degeneration. Retina. 2012;32:1260-1264.
7 National Institutes of Health (NIH). National Eye Institute . Animation: Age Related Macular Degeneration. Feb 21, 2014. Accessed December 29, 2020. Available from: https://www.youtube.com/watch?v=hZe7VxtuQB0
8 National Institutes of Health (NIH). National Eye Institute. Age-Related Macular Degeneration. Last updated August 17, 2020. Accessed December 26, 2020. Available from: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration
9 Warwick A, Lotery A. Genetics and genetic testing for age-related macular degeneration. Eye (Lond). 2018;32:849–857.
10 Tomany SC, Wang JJ, Van Leeuwen R, et al. Risk factors for incident age-related macular degeneration: Pooled findings from 3 continents. Ophthalmology. 2004;111:1280-1287.
11 Adams MKM, Simpson JA, Aung KZ, et al. Abdominal obesity and age related macular degeneration. Am J Epidemiol. 2011;173:1246-1255.
12 Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene and zinc for age-related macular degeneration and vision loss: AREDS report number 8. Arch Ophthalmol. 2001;119:1417-1436.
13 Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013;309:2005-2015.
14 AREDS2-HOME Study Research Group. Randomized trial of a home monitoring system for early detection of choroidal neovascularization home monitoring of the Eye (HOME) study. Ophthalmology. 2014;121:535-544.
15 Chong EW, Kreis AJ, Wong TY, et al. Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: A systematic review and meta-analysis. Arch Ophthalmol. 2008;126:826-833.
16 Merle BMJ, Colijn JM, Cougnard-Grégoire A, et al. Mediterranean diet and incidence of advanced age-related macular degeneration: The EYE-RISK consortium. Ophthalmology. 2019; 126:381-390.
17 Hall, LB. Barriers to eye care among patients with age-related macular degeneration in the Yale Eye Center. 2014. Yale Medicine Thesis Digital Library. 1885.