Age-Related Macular Degeneration / AMD
If you’re over the age of 50, you may be at risk for age-related macular degeneration (AMD). The nation’s leading cause of irreversible vision impairment, more than 18 million adults ages 40 and older have early-stage AMD. It is one of the most commonly treated conditions at Retina Consultants of Charleston.
An Overview of Age-Related Macular Degeneration
AMD is an incurable, degenerative disease that targets the retina, the thin, photosensitive tissue layer located in the back of the eye. As light enters through the eye’s lens, the retina transforms them into electrical signals that travel to the brain via the optic nerve, allowing you to see.
However, AMD targets the retina’s central portion, known as the macula, which contains cells that enable your eye to perform various advanced central vision tasks. Over time, your macular tissue gradually weakens and loses its functionality.
What Are Age-Related Macular Degeneration Symptoms?
Depending on the AMD type and severity, there may be no apparent symptoms early on, or they may develop quickly or slowly. Among the more common symptoms are blurriness, visual distortions, like straight lines appearing wavy, and darkened areas within your central field of vision. Typically, your peripheral vision isn't affected, and you won’t experience complete blindness. But you may notice issues with your sharp, straight-ahead central vision, such as with reading, driving, or seeing faces.
Are There Different Types of Age-Related Macular Degeneration?
Dry Age-Related Macular Degeneration
The more common type, dry AMD, or atrophic AMD, develops in about 90% of all patients. A normal part of aging, dry AMD is not usually harmful or painful, and may not affect your vision. But should vision loss occur, it may affect one or both eyes, and develop gradually. Dry AMD can make it difficult to see in the dark and make out contrasts.
Dry AMD is usually detected during a regular dilated eye exam. If diagnosed, your ophthalmologist will need to regularly monitor your vision. Generally, you can expect to do well without treatment. But if any vision changes become noticeable, you must alert your ophthalmologist immediately, as this may indicate the development of wet AMD.
What Are Drusen? Can They Help Diagnose AMD?
During your eye exam, your ophthalmologist may notice small, yellow, cholesterol-like deposits known as drusen, which accumulate under the retina. Drusen are normal with aging, but when they multiply and grow in size, retinal specialists can use them to measure AMD progression. While typically not harmful, if they grow too large or there are too many, drusen can cause the macula to become thinner and stop working, leading to visual distortions.
Wet Age-Related Macular Degeneration
A more serious condition, wet AMD, also known as exudative AMD, only develops in about 10% of all AMD cases. Vision loss develops much quicker and is more noticeable than dry AMD. Wet AMD is characterized by the development of choroidal neovascularization (CNV), which is when irregular, fragile, weed-like blood vessels form under the retina. When they break, blood and other fluids can leak into the macular area. You may experience swelling and bleeding, central vision blurriness and distortions, and worsening vision loss.
What Are AMD Risk Factors?
With dry AMD, the main risk factor is being over the age of 50. But there are specific risk factors, including conditions and lifestyle factors, which may increase your likelihood, including:
- A family history of AMD
- Underlying conditions, such as diabetes, high blood pressure, or high cholesterol
- Having light-colored irises in your eyes
- Obesity
- Smoking
- Consuming a poor diet, such as one heavy in saturated fats
- Long-term, unprotected exposure to sunlight
Can I Reduce My Chances of Developing AMD?
We recommend that you schedule regular dilated eye exams to detect the earliest signs of AMD. If you’re between 40 and 54, you should visit our retina specialists at least every 2-4 years, depending on your health needs. If over 55, schedule an eye exam at least every 1-2 years. For wet AMD, certain preventive measures may slow its progression and preserve your central vision, including:
- Ensuring any underlying conditions are properly managed
- Engaging in daily physical activity
- Avoiding smoking
- Maintaining a healthy body mass index (BMI)
- Shielding your eyes from harmful UV ray exposure with sunglasses and hats
- Monitoring your vision daily by using an Amsler grid
What Is An Amsler Grid?
With dry AMD, you need to monitor your vision daily to quickly detect any changes. An Amsler grid, a simple paper chart, may be helpful, and if used regularly, it can help detect visual distortions. It consists of horizontal and vertical lines that form a grid pattern, with a dot in the center. Here are the directions:
- Wear your normal reading glasses.
- Make sure your grid’s located in an area with good lighting.
- Hold it about 12-15 inches away from your face.
- Cover one eye and focus your uncovered eye on the center dot.
- Look to see if the grid’s lines look straight or if there are any distortions, like wavy lines, blurred areas, darkened areas, or blank spots.
- Repeat these steps with the other eye.
- Contact your ophthalmologist immediately if you notice any changes or distortions.
The Benefits of a Healthy Diet for AMD
Consuming a diet with foods rich in certain nutrients may promote eye and vision health. Your doctor may recommend that you follow the Mediterranean Diet, as it’s associated with lower AMD rates. With it, you eat more fruits, vegetables, legumes, nuts, whole grains, fish, and olive oil, and less dairy and red meat. In addition, it delivers essential antioxidants, which are nutrients shown to defend against free radicals (i.e. harmful molecules that cause cellular damage).
Which Nutrients Impart Properties For AMD?
Research suggests that certain nutrients, including vitamins, minerals, and antioxidants, may benefit vision health, and slow AMD’s progression of vision loss, especially when combined. Among these nutrients are:
- Vitamin C, an antioxidant, may benefit AMD and other retinal conditions.
- Vitamin E, an antioxidant, may improve retinal blood flow.
- Lutein, a carotenoid, or organic pigment, may improve or even prevent AMD, and also filters light and protects tissues from sunlight damage.
- Zeaxanthin, a carotenoid and antioxidant, may help lower AMD risks.
- Essential fatty acids, such as omega-3 fatty acids, promote proper visual development and retinal function.
- Beta-carotene, a carotenoid, naturally produces vitamin A, which the retina uses to detect light and convert it into electrical signals.
- Zinc, a mineral and antioxidant, may slow blindness and help the retina produce melanin, a protective eye pigment.
- Copper, a mineral, may help to balance zinc’s effects.