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Macular Degeneration Q&A

What is Macular Degeneration?

Macular Degeneration (AMD) is the foremost cause of vision loss. AMD is not curable. It is caused by a breakdown of the central section of the retina, which is the inside rearmost layer of the eye. The retina registers the images a person sees and transmits them to the brain through the optic nerve. The central portion of the retina, referred to as the macula, focuses central vision in the eye and regulates our ability to recognize faces or colors, read, drive a car, and see items in minute detail. To understand the condition, think of the eye as a camera. The macula is the centermost and highly sensitive area of the “camera’s film.” When cells in the macula break down, images are not collected properly. As the disease progresses, individuals can experience blurred or wavy vision. Left untreated, central vision can be entirely lost. Peripheral vision, however, remains intact, but peripheral vision is not as sharp or detailed as central vision. Stargardt disease is a type of MD found in younger people and is the result of a recessive gene.

What is the Difference Between Wet and Dry AMD?

There are two types of AMD, each affecting the eyes in different ways:

• Dry AMD = This form accounts for 85-90% of cases. Layers of the macula, including photoreceptors and retinal pigment epithelium, become increasingly thin, functioning less and less.
• Wet AMD = In this type of AMD, blood vessels begin to grow in the choroid layer behind the retina. This is called choroidal neovascularization, or CNV. These new vessels are fragile and leak fluid, lipids, and blood. The fluids spill into the layers of the retina and macula, causing scar tissue to form and retinal cells to cease functioning.

What Treatments Are Used for AMD?

When dry AMD progresses, treatment centers on nutritional therapy and the support of supplements used to increase the quantities of vitamins and minerals which in turn can support healthy pigment levels and cell structure. For Wet AMD the most common treatment is anti-VEGF (vascular endothelial growth factor) therapy. This involves periodic eye injections of a chemical called an "anti-VEGF.”  Normally, VEGF supports the growth of new blood vessels, but with MD VEGF is unhealthy because the new vessels grow in weak and leak. An intraocular shot of an anti-VEGF medication impedes the development of new blood vessels behind the retina and can keep it free of seepage.  An injection in the eye may seem disconcerting, but the shot is typically not painful as the eye is anesthetized first. The procedure takes about 15 minutes and the effects can last around a month and occasionally longer.

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