Macular Degeneration

Age-related macular degeneration (AMD) is a chronic disease where the macula, the central portion of the retina, deteriorates, leading to loss of sharp central vision. The retina lines the back of the eye and converts light into signals sent to the brain; when the macula is damaged, tasks like reading, driving and recognizing faces become difficult. AMD is the leading cause of significant vision loss in people over fifty. It affects central, not peripheral, vision, so most patients retain some usable sight.

Types and Stages

Dry (non-neovasular) AMD

Dry (non-neovascular) AMD is more common and involves the buildup of drusen (yellow deposits) under the retina and thinning of the macular tissue. Over time, drusen enlarge and regions of atrophy called geographic atrophy form, causing progressive central vision loss.

Wet (neovascular) AMD

Wet (neovascular) AMD occurs when abnormal blood vessels grow under the retina (choroidal neovascularization) and leak blood or fluid, causing sudden vision changes. Dry AMD sometimes converts to wet AMD, so regular monitoring is important.

Symptoms in Detail

Early dry AMD may not cause noticeable symptoms. As the disease advances, patients might notice distortion of straight lines (metamorphopsia), decreased brightness or intensity of colors, or blank spots in central vision. Wet AMD often leads to a sudden or gradual decrease in central vision, blind spots or dark, blurry areas. It is recommended to use an Amsler grid, a simple grid of straight lines at home to detect distortion, and report any changes promptly. AMD does not typically cause pain, and peripheral vision usually remains intact.

Risk Factors and Causes

The exact cause is unknown, but several factors increase risk. Age is the strongest predictor; prevalence increases greatly after fifty. Genetics play a role: people with a family history of AMD are at higher risk. Smoking significantly increases both risk and progression. Other factors include Caucasian race, high cholesterol, high blood pressure, cardiovascular disease, obesity, diets low in antioxidants or fish, and high body mass index. Having these factors does not guarantee you will develop AMD, and some people develop AMD without obvious risk factors.

Diagnostic Evaluation

Diagnosis begins with a comprehensive, dilated eye exam. A retina specialist uses a slit lamp to look for drusen, pigment changes or fluid. Imaging tests such as fluorescein angiography (a dye study of the retina’s blood vessels), indocyanine green angiography and optical coherence tomography (OCT) help distinguish dry from wet AMD and measure damage. OCT is particularly valuable for monitoring subtle fluid accumulation.

Treatment Options for Macular Degeneration

Anti-VEGF Injections (Wet AMD)

Anti-VEGF medications block the signals that cause abnormal blood vessels to grow and leak under the retina. They help stabilize or slow vision loss and are typically given monthly or on a treat-and-extend schedule.

Bevacizumab (Avastin)

A commonly used anti-VEGF drug that reduces abnormal blood vessel growth. It is injected into the eye at regular intervals to help control wet AMD.

Ranibizumab (Lucentis)

A targeted anti-VEGF therapy designed specifically for eye conditions. It helps slow leakage and growth of abnormal vessels in wet AMD.

Aflibercept (Eylea)

An anti-VEGF medication that often allows for longer intervals between injections after the initial treatment phase. It helps maintain stable vision in many wet AMD patients.

Faricimab (Vabysmo)

A newer injection that blocks both VEGF and another pathway involved in inflammation and vessel growth. Many patients are able to extend injection intervals with this treatment.

Pegcetacoplan (Syfovre)

An injectable treatment for geographic atrophy that slows the progression of retinal cell loss. It does not restore vision but may delay further decline.

Avacincaptad Pegol (Izervay)

This monthly injection targets the complement system to slow the spread of geographic atrophy. It can help preserve remaining vision for a longer period.

Lifestyle Modification and Nutritional Supplements

The Age-Related Eye Disease Studies (AREDS) showed that a specific high-dose formulation of antioxidants and minerals, vitamin C, vitamin E, zinc, copper, lutein and zeaxanthin, can reduce the risk of intermediate dry AMD progressing to advanced disease. Note that these supplements do not prevent AMD in people without it but may benefit those with intermediate or advanced dry AMD when recommended by a physician. Lifestyle changes can support eye health. Quitting smoking, eating a diet rich in leafy greens and omega-3 fatty acids, exercising regularly and controlling blood pressure and cholesterol are recommended lifestyle changes. It is also advised to wear sunglasses and wide-brimmed hats to protect eyes from ultraviolet light, another suspected risk factor.

Living With AMD and Low-Vision Support

Macular degeneration requires lifelong monitoring. Even with treatment, patients should schedule follow-up visits as recommended and contact their doctor if they notice vision changes. Low-vision services and devices such as magnifiers, special reading lights and large-print materials help people adapt. Vision rehabilitation specialists and support groups offer training and emotional support. AMD rarely causes complete blindness and many people maintain independence through adaptive strategies and timely care.

When to Seek Care

It is recommended for adults over fifty to have yearly dilated eye exams. Patients with known AMD should watch for sudden changes in vision, use an Amsler grid and notify their specialist if straight lines appear wavy or if dark spots develop. Early detection of wet AMD can preserve sight; missed injections may allow irreversible damage.

Our Practice Locations and Physicians

With six locations across the upstate, our team is able to conveniently serve you in treating your macular degeneration.
Learn more about our locations and the physicians serving at each practice.

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