Diabetic Retinopathy

What is macular degeneration?

Age-related macular degeneration (AMD) is a problem with your retina. It happens when a part of the retina called the macula is damaged. AMD is very common. It is a leading cause of vision loss in people 50 years or older.

What are the symptoms?

With AMD you lose your central vision. You cannot see fine details, whether you are looking at something close or far. But your peripheral (side) vision will still be normal. For instance, imagine you are looking at a clock with hands. With AMD, you might see the clock's numbers but not the hands. Many people don't realize they haveAMD until their vision is very blurry. This is why it is important to have regular visits to an ophthalmologist. They can look for early signs of AMD before you have any vision problems.

Who is at risk for getting AMD?

You are more likely to develop AMD if you:

• Eat a diet high in saturated fat (found in foods like meat, butter, and cheese)
• Are overweight
• Smoke cigarettes
• Are over 50 years old
• Have hypertension (high blood pressure)
• Have a family history of AMD

Having heart disease is another risk factor for AMD, as is having high cholesterol levels. Caucasians also have an elevated risk of getting AMD.

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What are the two types of AMD?

Dry AMD

This form is quite common. About 80% (8 out of 10) of people who have AMD have the dry form. Dry AMD is when parts of the macula get thinner with age and tiny clumps of protein called drusen grow. People with dry AMD may have drusen, pigment abnormalities, or geographic atrophy (an area of cell loss in the retina). You slowly lose central vision.

Wet AMD

This form is less common but much more serious. Wet AMD is when new, abnormal blood vessels grow under the retina. These vessels may leak blood or other fluids, causing scarring of the macula. You lose vision faster with wet AMD than with dry AMD.

Treatment Options

Right now, only dry AMD with geographic atrophy can be treated. Two new medications are available: pegcetacoplan and avacincaptad pegol. One of these will be injected into your eye to slow the atrophy. Hopefully, this will delay vision loss.

There is no treatment for drusen. However people with lots of drusen or serious vision loss might benefit from taking a certain combination of nutritional supplements. A large study (AREDS and the later AREDS 2 study) found people with certain drusen may slow their dry AMD by taking these vitamins and minerals daily:

• Vitamin C (500 mg)
• Vitamin E (400 IU)
• Lutein (10 mg)
• Zeaxanthin (2 mg)
• Zinc (80 mg)
• Copper (2 mg)

Your ophthalmologist can tell you if vitamins and minerals are recommended for your dry AMD, as not all forms will benefit from the AREDS supplements. Beta caroten should not be used by smokers as it raised the risk of lung cancer.