It can begin with a barely perceptible loss of vision. Threading a needle may seem more difficult than before. The squares of a crossword puzzle may be harder to see. Eventually, nearly all central vision may be gone.
It’s a very common condition that affects many older adults: age-related macular degeneration (AMD).
Awareness of AMD has grown and so has the search for treatments, including at Scripps. No treatment can reverse AMD, but it can prevent the condition from worsening.
“If you experience blurry vision or difficulty recognizing familiar faces, seek help right away. An eye doctor can check for AMD as part of an eye exam,” says Anne Hanneken, MD, an ophthalmologist at Scripps. “Treatment for AMD depends on stage and type.”
AMD is the leading cause of severe vision loss in older adults. The number of cases is expected to increase as people continue to live longer.
AMD is an eye disease of the retina that causes the loss of central vision needed to see clearly straight ahead. “Losing your central vision can affect daily activities, such as reading, driving and watching television,” Hanneken says. “While living with AMD can be challenging, there is help.”
AMD may develop in one or both eyes. AMD doesn’t affect peripheral vision, so complete vision loss is rare.
AMD affects the macula, which is part of the retina, the light-sensitive tissue in the back of the eye. It helps the eyes focus on things that require close, concentrated vision. AMD happens when aging causes damage to the macula and develops in stages.
In early stages, small protein deposits build up under the cells that nourish the retina. Because these deposits cause no symptoms, patients are not aware of them. Straight lines looking wavy is a warning sign for AMD.
There are two forms of macular degeneration: dry and wet form.
Dry AMD accounts for most cases. Light-sensitive cells in the macula slowly break down. Vision loss progresses slowly, and vision can remain stable for years.
Wet AMD is less common but can cause more rapid vision loss than dry AMD. Vision may change suddenly, with marked distortions and wavy lines. It happens when abnormal blood vessels grow under the retina and leak, causing scarring of the macula.
Risk for AMD increases with age. People 55 and older are at higher risk for AMD. The risk is also higher for people who:
- Have a family history of AMD
- Are Caucasian
- Have high blood pressure
- Have a diet high on saturated fat
There is no treatment for dry AMD, but help is available in case of vision loss, including low vision devices and vision rehab services to learn skills to live with low vision. Not everyone who has AMD experiences significant vision loss.
Standard treatments for wet AMD include medications called anti-VEGF drugs that block development of new blood vessels in the eye.
Studies show certain nutrients, taken through foods or supplements, may help slow AMD, including:
- Vitamin C
- Vitamin E
Green leafy vegetables, including spinach, have large amounts of many of these vitamins.
“Even after a diagnosis, you can take steps that may help slow vision loss. Among these are a healthy diet, keeping a healthy weight and exercising regularly,” Dr. Hannaken says.
“These are like recommendations that would be made for cardiovascular disease. In fact, we think of dry age-related macular degeneration as sharing similar risk factors to cardiovascular disease.”