Which Macular Degeneration is Treatable?

Age-related macular degeneration (AMD) is a major cause of vision loss among older adults in the United States. This condition affects the macula, which is the central part of the retina responsible for sharp vision. AMD exists in two main forms: dry (atrophic) and wet (neovascular). Understanding these forms is essential to determine the treatment options available.

What is Macular Degeneration?

Age-related macular degeneration (AMD) is a progressive eye disease that primarily affects individuals over the age of 50. It impacts the macula, the central part of the retina, which is crucial for clear, central vision.

Dry Macular Degeneration

Dry AMD is the more common form, accounting for about 80-90% of all AMD cases. It progresses slowly and is marked by the thinning of the macula and the buildup of drusen—tiny yellow deposits under the retina. Key features of dry AMD include:

Gradual Vision Loss: Vision deteriorates slowly over time, affecting the ability to see fine details.
Drusen Deposits: These deposits can be detected during an eye exam before significant vision loss occurs.
Geographic Atrophy: In advanced stages, dry AMD can lead to geographic atrophy, where large areas of the retinal cells waste away, causing severe vision impairment.

Wet Macular Degeneration

Wet AMD is less common but more severe, accounting for about 10-15% of all AMD cases. It progresses rapidly and is characterized by the growth of abnormal blood vessels under the retina and macula. These vessels can leak fluid or blood, leading to significant vision loss. Key features of wet AMD include:

Rapid Vision Loss: Vision can decline quickly, sometimes within days or weeks.
Abnormal Blood Vessels: The growth of new, fragile blood vessels under the retina, known as choroidal neovascularization, is the hallmark of wet AMD.
Fluid and Blood Leakage: These vessels can leak, causing swelling and damage to the retina.

Which Type of AMD is Treatable?

While there is currently no cure for either form of AMD, wet AMD is considered more treatable than dry AMD. Primary treatment options for wet AMD include:

Anti-VEGF Injections: Medications such as Beovu, Eylea, and Lucentis inhibit vascular endothelial growth factor (VEGF), a protein that promotes the growth of abnormal blood vessels. Regular injections can reduce fluid leakage, slow vision loss, and, in some cases, improve vision (BrightFocus) (AMDF).
Photodynamic Therapy: This treatment uses a light-activated drug to destroy abnormal blood vessels, often used in conjunction with anti-VEGF therapy.
Laser Surgery: High-energy laser light can seal off abnormal blood vessels to prevent further leakage and damage.

For dry AMD, treatment focuses on slowing disease progression and managing symptoms:

AREDS2 Supplements: The Age-Related Eye Disease Study 2 (AREDS2) formulation includes vitamins C and E, zinc, copper, lutein, and zeaxanthin. These supplements can reduce the risk of progression to advanced AMD in people with intermediate or advanced dry AMD in one eye (BrightFocus). Saffron 2020 supplements combine these vitamins and minerals found in the AREDS formula with saffron and resveratrol for synergistic properties, helping people with AMD preserve their eyesight and achieve clearer vision.
Healthy Lifestyle Choices: Maintaining a diet rich in leafy greens, fish, and other antioxidant-rich foods, avoiding smoking, and controlling cardiovascular risk factors can help manage dry AMD.

Conclusion

Both forms of macular degeneration can lead to significant vision loss, but wet AMD has more direct treatment options available. Early detection through regular eye exams is crucial for effective management of both types of AMD. Understanding the differences between dry and wet AMD and staying informed about the latest treatments can help individuals manage their condition and maintain their quality of life.

For more detailed information and support, consider visiting resources like the American Macular Degeneration Foundation (AMDF), the BrightFocus Foundation, and the National Eye Institute (NEI).