Age-Related Macular Degeneration

AMD

Age-Related Macular Degeneration (AMD): Overview

Age-related macular degeneration (AMD) is a chronic, progressive eye disease that affects the macula, the central area of ​​the retina responsible for detailed vision and color perception. It is the leading cause of irreversible vision loss in people over 60 years of age in developed countries.

What is the Macula and Why is it Important?

Macula: A small area in the center of the retina that allows us to clearly see fine details, read, recognize faces, and drive.

When damaged, central vision becomes blurred or a dark spot appears, while peripheral vision is usually preserved..

Types of AMD

1. Dry (or Atrophic) AMD

Most common form (90% of cases).

Cause: Accumulation of yellow deposits (drusen) and progressive thinning of the macula.

Progression: Slow (may take years to affect vision).

Symptoms:

Blurred central vision.

Difficulty reading or recognizing faces.

Need for more light for daily activities.

2. Wet AMD (or Exudative/Neovascular)

Most severe form (10% of cases, but causes 90% of legal AMD blindness).

Cause: Abnormal growth of blood vessels under the retina that bleed and leak fluid.

Progression: Rapid (vision loss in weeks or months if untreated).

Symptoms:

Distortion of straight lines (metamorphopsia).

Central dark spot (scotoma).

Abrupt loss of vision.

Risk Factors

Age (over 50 years, risk increases with age).

Genetics (family history).

Smoking (triples the risk).

Prolonged exposure to unprotected sunlight.

Cardiovascular disease (hypertension, high cholesterol).

Diet low in antioxidants (vitamins C, E, lutein, zinc).

Diagnosis

Fundoscopy (ophthalmoscopy).

Optical coherence tomography (OCT): Detailed images of the retina.

Fluorescein or indocyanine green angiography: To detect blood vessel leaks (wet AMD).

Amsler grid: Home test to detect visual distortions.

Available Treatments

For Dry AMD

Vitamin supplements (AREDS2: vitamins C, E, zinc, copper, lutein, zeaxanthin) to slow progression.

UV protection (blue-filtering sunglasses).

A diet rich in omega-3s and antioxidants (fish, green leafy vegetables).

For Wet AMD

Intravitreal injections (anti-VEGF: Lucentis, Eylea, Beovu): Reduce the formation of abnormal vessels.

Photodynamic therapy (in selected cases).

Thermal laser (rarely used today).

Prevention

✔ Don't smoke.

✔ Wear sunglasses with UV and blue light protection.

✔ Control blood pressure and cholesterol.

✔ Follow a Mediterranean diet (fruits, vegetables, fish).

✔ Have annual eye exams after age 50.

Prognosis

Dry AMD: Slow progression; some patients maintain good vision for years.

Wet AMD: Without treatment, it can cause central blindness within months. With injections, many patients stabilize or improve their vision.