Focusing on macular degeneration

Learn how to spot a troubling and common age-related eye affliction known as AMD . . .

For many older people, age-related macular degeneration (AMD) is the leading cause of vision loss and may be the likely culprit of blurred vision, difficulty recognizing faces, and straight lines that appear wavy. AMD gradually destroys the sharp, central vision needed to see objects clearly, making common daily tasks such as driving nearly impossible.

There are two types of AMD: “dry” and “wet.” Dry AMD accounts for 85-90% of cases and occurs when light-sensitive cells in the macula slowly break down. It typically progresses slowly and individuals who have the condition can lead relatively normal and productive lives. However, at any time dry AMD can develop into the more severe form of macular degeneration known as wet AMD.

Wet macular degeneration occurs when abnormal blood vessels behind the retina start to grow under the macula. These vessels often leak blood and fluid and can damage the macula rapidly, causing a quick loss of central vision. Wet AMD does not have stages; all are considered advanced.

Treatment options differ for wet and dry AMD. If you are diagnosed with dry AMD, treatments may delay the advancement of the disease. The Age-Related Eye Disease Study (AREDS) from the National Eye Institute found that a specific high-dose formulation of antioxidants and zinc significantly reduced the progression from the intermediate stage to the advanced stage of AMD.

Although there are several treatment options for wet AMD, there is no cure and vision loss may progress despite treatment. One should discuss treatment options with an ophthalmologist.

Dr. Neil Bressler

I talked to world-renowned ophthalmologist, Neil Bressler, MD, chief of the Wilmer Eye Institute’s Retina Division at Johns Hopkins Hospital.*

Can people with an early stage of AMD take the AREDS formulation to help prevent the disease from progressing to an intermediate stage?

The AREDS formulation has only been shown to reduce the risk of progression from the intermediate stage of AMD to an advanced stage. If one has no AMD or only an early stage of AMD, regardless of one’s family history, the strongest evidence suggests that the AREDS formulation will not reduce one’s risk from developing an intermediate stage of AMD.

Does quitting smoking significantly reduce the risk of AMD?

There is strong evidence to suggest that cigarette smoking is associated with the development or progression of AMD. Since there is strong evidence that when one quits smoking, one reduces the risk of progression of other diseases, one should consider quitting smoking. It’s not known how long one must quit to reduce the risk.

Do you recommend any alternative medicine techniques?

The strongest scientific evidence would not suggest that one should take any complementary or alternative medicine technique for AMD at this time.

*Bressler’s participation in this article does not constitute or imply endorsement by the Johns Hopkins University, the Johns Hopkins Hospital or the Johns Hopkins Health System. Healthnetwork partners with over 30 top-tier medical institutions. If you have questions about AMD or if you’re interested in scheduling an appointment with an ophthalmologist, contact Healthnetwork today.

Susan Locke, MD, is Healthnetwork’s medical director.

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