Macular Degeneration Diagnosis and Treatment

Macular degeneration can be classified as either dry (non-neovascular) or wet (neovascular). Most Age-related macular degeneration (AMD) starts off as the dry type and in approximately 15% of patients, it progresses into the wet type. While AMD effects both eyes, it doesn’t necessarily progress at the same rate, so there is a possibility to have both wet and dry types of AMD in both eyes.

Dry macular degeneration, also known as atrophic, is the more common diagnosis effecting approximately 85% of all patients with AMD, and is considered to be an early stage of the disease. This form of the disorder usually develops as the macular tissues thin during aging. Deposits of pigment within the macula may also occur.

In 15 percent of patients the condition can progress to the more advanced form of the disease. If this occurs and the patient develops wet macular degeneration, new abnormal blood vessels develop beneath the macula, causing a leakage of blood and fluid. This leakage can lead to the creation of blind spots and permanent damage to central vision.

With either type of macular degeneration, peripheral vision is maintained.

As people age, everyone is at risk for macular degeneration, but some people are at elevated risk due to genetic and/or environmental factors. Some individuals have a genetic variant known as complement factor H that makes them more likely to develop this condition. Nearly half of the cases of blindness associated with macular degeneration are linked to this genetic deficiency.

Macular degeneration is most common in females and people with light skin or eye color, and the risk for all patients increases as they age. Over 30 percent of adults age 75 and older have been diagnosed with advanced or intermediate age-related macular degeneration.

Other factors that may increase the risk of developing macular degeneration include:

• Obesity
• Smoking
• High fat diet
• Elevated cholesterol levels
• Prolonged sun exposure
• High blood pressure
• Certain medications

Patients can minimize their risk of macular degeneration by exercising, eating a diet rich in Omega-3 fatty acids, and getting regular eye examinations.

Patients with dry macular degeneration may notice gradual changes to their vision, including:

• Shadowy areas in the central vision
• Fuzzy and distorted vision
• Difficulty perceiving color
• Difficulty seeing fine details
• Blind spots in central vision

If the disease progresses to the wet form, patients may also perceive straight lines as wavy or crooked, and have larger and larger blind spots, increasingly losing central vision. With wet macular degeneration, central vision loss can occur rapidly, sometimes in as little as a few days or weeks.
Macular degeneration may necessitate many lifestyle changes as it progresses. Patients may lose the ability to drive, have difficulty reading, and have difficulty recognizing faces. Because they retain peripheral vision, however, they usually remain capable of managing independently.

The ophthalmologist may be able to detect early signs of macular degeneration through a regular eye examination while the patient is still asymptomatic. Any signs of this condition can be further confirmed by testing a patient’s central vision with an Amsler grid test. Treating detecting macular degeneration and other serious eye conditions as early as possible can help to prevent permanent loss of vision.

While there is no cure for macular degeneration, there are several treatment options available to help patients manage this condition and preserve their vision. The best treatment option for each patient depends on the severity and type of the condition, as well as how much, if any, permanent vision loss has occurred.

Intraocular injections of vascular endothelial growth factor(anti-VEGF) are often successful in stopping abnormal blood vessel growth in wet macular degeneration. The medications are injected into the vitreous of the eye on a periodic basis to control the damaging effects of wet macular degeneration. Many patients also benefit from vitamin supplements as recommended by their doctor.

It is essential for patients with macular degeneration, wet or dry, to seek continuous medical treatment to manage the condition and prevent permanent vision loss.

Avastin, Eylea, Eylea HD, and Vabysmo represent cutting-edge treatments for wet macular degeneration (AMD), a progressive eye condition characterized by abnormal blood vessel growth beneath the retina. These medications fall under the category of anti-vascular endothelial growth factor (anti-VEGF) therapies, designed to inhibit the growth of these aberrant vessels and prevent the leakage that leads to vision impairment. Regular injections of these drugs, administered by qualified healthcare professionals, work to stabilize and, in some cases, improve vision by reducing retinal swelling and preventing further damage. Patients undergoing these treatments often experience a significant slowdown in the progression of wet AMD, leading to improved visual outcomes and an enhanced quality of life. Close collaboration with eye care specialists ensures optimal treatment plans, contributing to the overall well-being of individuals grappling with this sight-threatening condition.