Macular Degeneration
Our Arizona retina specialists diagnose and manage macular degeneration using advanced imaging and evidence-based treatments to help preserve vision and quality of life. Give us a call to schedule a retina evaluation.
What Is Macular Degeneration?
Macular degeneration is a common eye condition that most often develops with age and affects your central vision. It makes everyday tasks like reading, driving, and recognizing faces more difficult.
At the back of your eye is the retina, a light-sensitive layer that sends visual information to your brain. In the center of the retina is the macula, which provides sharp, detailed vision straight ahead. When the macula becomes damaged, central vision begins to deteriorate.
Age-related macular degeneration (AMD) is a broad term used to describe degenerative changes that occur in the macula over time. AMD develops due to a combination of aging, genetics, and environmental factors. There are two primary forms of AMD: dry AMD and wet AMD.
Types of Age-related Macular Degeneration (AMD)
Dry AMD
Dry AMD is the more common form of macular degeneration, and accounts for the majority of AMD cases. It occurs when the pigment-forming cells of the macula gradually break down, and waste deposits called drusen accumulate, impairing healthy retinal function. This type of AMD progresses slowly over the years, and many people may not notice vision changes in the early stages. However, as the condition advances, your central vision may become noticeably blurry or distorted, or blind spots may develop. Dry AMD can sometimes be a precursor to wet AMD.
Wet AMD
Wet AMD is less common than dry AMD, but more severe and sudden in onset. In this type of AMD, abnormal blood vessels grow under the macula and leak fluid or blood, leading to rapid vision distortion and loss. Wet AMD can occur spontaneously, but often evolves from dry AMD. Because wet AMD progresses quickly, early detection and treatment are essential to preserve as much vision as possible.
Symptoms of AMD
In the earliest stages of AMD, your eye doctor may observe small drusen, or waste deposits, on the surface of the retina. Subtle changes in the color (pigment) of the macula may also be present. However, if macular degeneration advances beyond the early stage, symptoms may begin to affect central vision.
Common symptoms of macular degeneration include:
- Blurred or fuzzy central vision
- Straight lines appearing wavy or distorted, such as door frames or text on a page
- Objects appearing smaller than they actually are
- A gray, dark, or empty spot in the center of the visual field
- Colors appearing less vivid or noticeably faded
Treating Macular Degeneration
Currently, there is no cure for macular degeneration, but treatment options have advanced significantly over the past two decades. As Dr. Jordan Graff, Retina Surgeon at Barnet Dulaney Perkins Eye Center, explains in this video, early detection and comprehensive eye exams are critical. Genetics, aging, and environmental factors can all contribute to changes in the eye that, if left untreated, can lead to vision loss.
Treatment is tailored to the type and stage of macular degeneration and may include medications that help reduce leaking and bleeding in the eye. These treatments can slow disease progression, stabilize vision, and, in many cases, improve vision that has already been affected. Dr. Graff also notes that newer, longer-lasting medications and sustained-delivery devices are helping reduce the frequency of treatment, making care more manageable while preserving sight.
Treatment for Dry AMD
Though dry AMD cannot be reversed, its progression can be slowed by taking vitamins and supplements, making lifestyle changes, and regular monitoring.
Vitamins and Supplements
The Age-Related Eye Disease Study (AREDS) and AREDS 2 identified a blend of vitamins and minerals that can slow the progression of macular degeneration and prevent dry AMD from turning into wet AMD. This blend includes:
- 500 milligrams of Vitamin C
- 400 international units of Vitamin E
- 2 milligrams of copper
- 80 milligrams of zinc
- 10 milligrams of lutein
- 2 milligrams of zeaxanthin
Earlier versions of the supplement blend included beta-carotene. This ingredient has been removed as beta-carotene can increase the risk of lung cancer in smokers or people who used to smoke.
Lifestyle Changes
Maintaining a healthy lifestyle is one of the best ways to keep your eyes healthy. Things you can do to take care of your eyes include:
- Don’t smoke: Smoking is damaging to your overall health and is a significant contributor to the development of macular degeneration. If you smoke, speak with your healthcare provider about finding a method of quitting that works for you. If you aren’t a smoker, try to limit the time you spend around cigarette smoke.
- Eat healthy. Nutrient-rich foods, especially those high in omega-3 fatty acids, protein, and zinc, can benefit people with macular degeneration. Avoid foods high in saturated fat, as these can increase your risk of developing macular degeneration.
- Exercise regularly. Studies have shown that regular exercise offers numerous benefits for your body, including lowering your cholesterol and blood pressure, which can impact your eye health.
- Maintain a healthy weight. Excess weight can put unnecessary strain on your body, damaging your eyes. If you need help reaching a healthy weight safely, speak with your healthcare provider.
Regular Monitoring
Routine eye exams with a retina specialist are essential for tracking changes in your AMD and adjusting your care as needed. Your retina specialist may also be able to recommend tools to help you adjust to and cope with your reduced vision.
Treatment for Wet AMD
There are several different treatment options for wet AMD. These treatments may not restore your vision, but they can preserve the vision you still have by slowing the progression of your AMD.
Anti-VEGF Injections
Anti-vascular endothelial growth factor (anti-VEGF) medications are typically the first treatment option for wet AMD. These medications work by blocking signals the body sends to form new blood vessels, preventing your body from growing new blood vessels under the retina.
Your doctor must inject the anti-VEGF medication into your eye. You’ll need to get these macular degeneration treatment injections every 4 to 6 weeks. Some patients regain some of their vision lost to wet AMD with these treatments. Side effects of these injections include infection, intraocular hemorrhage, and retinal detachment, so speak with your doctor about the risks and benefits.
Photocoagulation Therapy
Photocoagulation therapy is a much less common treatment method for macular degeneration. For this type of treatment, your doctor will use a laser beam to seal up leaking blood vessels under the retina and macula. However, this treatment does not stop new blood vessels from forming and may lead to scarring that creates a blind spot.
Not everyone is eligible for photocoagulation therapy. It depends on how damaged your macula is and where the leaking blood vessels are located beneath it.
Photodynamic Therapy
Photodynamic therapy is another type of laser treatment and, like photocoagulation therapy, is used much less often than medication. Your doctor will inject a medication called verteporfin (Visudyne) into one of your arm veins. This medication will then travel to your eyes. Your doctor will use a special laser on the damaged blood vessels to activate verteporfin. The activated verteporfin then blocks leaking blood vessels, closing them. This treatment may reduce the vision loss caused by your leaking blood vessels.
Because the closed blood vessels may reopen and begin leaking again, you may need repeated treatments. You will need to avoid bright lights and direct sunlight for a few days after each treatment.
SUSVIMO
SUSVIMO offers the first alternative to regular eye injections (currently the standard of care for wet AMD). Unlike traditional monthly injections, SUSVIMO uses a small implant placed in the eye during a minor procedure that continuously releases ranibizumab, a trusted anti-VEGF medication, over an extended period. This can reduce the frequency of treatments to as few as two per year, significantly lowering the treatment burden for many patients.
Our Macular Degeneration Specialists
Suhail Alam, MD
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Mahmood El Gasim, MD
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Brendan Girschek MD, FRCSC, FACS
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Jordan Graff, MD, FACS
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Brian Horsman, MD
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Delu Song, MD, PhD, MTR
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Jack Sipperley, MD
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Macular Degeneration: Frequently Asked Questions
What is the difference between wet AMD and dry AMD?
Dry AMD progresses slowly and involves drusen buildup and gradual macula deterioration. Wet AMD involves abnormal blood vessel growth under the macula and can cause rapid vision loss.
Are there ways to prevent AMD from worsening?
Yes. Quitting smoking, using supplements as recommended by your eye doctor, and attending regular eye exams can all help slow the process of AMD.
Is treatment for AMD painful?
Most treatments, including injections and implant placements like SUSVIMO, are performed under local anesthesia to minimize discomfort. Many patients tolerate them well with mild or brief sensations.
How long does it take to lose vision with dry macular degeneration?
Dry macular degeneration usually causes slow, gradual vision loss over the years, not sudden changes. Many people maintain functional vision for a long time with regular monitoring and care.
What percentage of people with macular degeneration go blind?
Total blindness is rare because macular degeneration affects central vision, not peripheral (side) vision. Less than 5% of patients develop severe vision loss that significantly limits central vision.