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What are the types of age-related macular degeneration? [ 08/30/13 ]

There are two forms of AMD: dry and wet. It is possible for a person to suffer from both forms and for the disease to progress slowly or rapidly.

Dry macular degeneration is the most common type of AMD. This form, in which the photosensitive cells of the macula slowly break down, is diagnosed in 85 to 90 percent of cases. Yellow deposits called drusen (waste products from metabolism) form and accumulate under the retina, between the retinal pigmented epithelium (RPE) layer and the Bruch's membrane, the blood-retina barrier which supports the retina. Drusen are often found in the eyes of older people, but an increase in the size and number of these deposits is frequently the first sign of macular degeneration. Over time, drusen are associated with deterioration of the macula and the death of RPE and photoreceptor cells, resulting in blurring or a spotty loss of clear, straight-ahead vision.

Dry AMD may advance and cause loss of vision without turning into the wet form of the disease. It is also possible for early-stage dry AMD to change into the wet form of the disease.

Wet macular degeneration is usually preceded by the dry form of the disease. This wet form occurs when the Bruch's membrane begins to break down, usually near drusen deposits, and new blood vessels grow. This growth is called neovascularization. These vessels are very fragile and can leak fluid and blood, resulting in scarring of the macula and the potential for rapid, severe damage. The neovascularization disturbs the natural organization of the light-detecting photoreceptor cells and their associated RPE cells, eventually leading to their death. Straight-ahead vision can become distorted or be lost entirely in a short period of time, sometimes within days or weeks. The wet form accounts for approximately 10 percent of all cases of AMD, but it results in 90 percent of the cases of legal blindness. All wet AMD is considered advanced.

Can younger people get macular degeneration? [ 08/30/13 ]

Yes, there are several forms of juvenile macular degeneration (JMD), and all are inherited. The most common form of JMD is Stargardt's disease, also called fundus flavimaculatus or macular dystrophy, which normally develops in the childhood or teen years. Best disease or vitelliform macular degeneration is the second most common form of JMD; symptoms usually occur between birth and age 7. People in their thirties or forties can develop genetic forms of macular disease such as Sorsby's fundus dystrophy, Behr's dystrophy and Doyne's honeycomb retinal dystrophy. Finally, myopic macular degeneration can occur in people who are severely near-sighted due to extreme elongation of the eyeball. This condition can result in macula tears and bleeding beneath the retina.

Do wet and dry age-related macular degeneration (AMD) have early, intermediate and advanced stages? [ 08/30/13 ]

All wet AMD is considered advanced; however, the dry form of AMD has three stages:

  • Early AMD - patients have several small drusen or a few medium-sized drusen. There is no vision loss or symptoms at this stage.
  • Intermediate AMD - patients have many medium-sized drusen or one or more large drusen. Some people may need more light for tasks such as reading. A blurry spot may appear in the center of the visual field.
  • Advanced AMD - patients exhibit a large number of drusen deposits and a breakdown of RPE and photoreceptor (light sensitive) cells and supporting tissue in the retina. A large blurry spot occurs in the center of the visual field and can become larger and darker, eventually causing a complete loss of central vision.
What is an Amsler grid? [ 08/30/13 ]

To discover any changes to your vision as early as possible, your eye care professional will probably have you test your own vision on a regular schedule using a small, hand-held Amsler grid.  He or she may also do this at the office. At home, you will hold the chart at reading distance in good light, cover one eye, and focus on a black dot in the middle of the grid, then repeat with the other eye. If the lines of the grid appear dim, irregular, wavy, or fuzzy, you should schedule an eye exam immediately.

You can download an Amsler grid at www.brightfocus.org/amsler.

What potential vision-related symptoms should I be aware of and mention to my eye doctor if they arise? [ 08/30/13 ]
  • More light is needed for tasks such as reading
  • A blurry spot appears in the center of the visual field
  • A blurry spot becomes larger and darker
  • Straight lines may appear wavy
  • Straight-ahead vision becomes distorted or lost entirely in a short period of time
Where can I find more information about macular degeneration? [ 08/30/13 ]

The BrightFocus Macular Degeneration Research website goes into greater depth on many of the above topics and covers additional areas of concern, both medical and social. You can learn where to get help and access to resources, as well as download free publications. And explore our Ask an Expert section where you can read or post queries to doctors.

Visit www.childrenscorner.org for information for all members of the family, with stories, games, and other interactive learning tools.

For more information dealing with the topics below, please visit the helpful organizations section of our website. 

  • Clinical Trials
  • Organizations of Eye-care Professionals
  • Federal Government Programs and Services
  • General Information, Resources and Referrals
  • Legal Assistance
  • Low Vision Aid Resources
  • Low Vision Organizations
  • Print and Audio Materials for the Visually Impaired
  • Senior Housing
  • State and Local Resources
Do people with macular degeneration ever have visual hallucinations? [ 08/30/13 ]

Yes, some people with macular degeneration also develop Charles Bonnet Syndrome (CBS) and hallucinate. Some eye diseases prevent normal nerve impulses from reaching the brain, and it is believed that spontaneous, brain-generated nerve activity may cause visual hallucinations. CBS appears to be more common in women than men and is more likely to occur if both eyes are affected by disease. The hallucinations are normally complex and can include detailed patterns or fully formed images such as animals, people, faces or scenery. Patients know that the hallucinations are not real. These images are not associated with any other sensory (e.g., sound or odor) hallucinations, nor are they delusions. The hallucinations may last for seconds or for most of the day. They tend to disappear when people close their eyes. CBS may last for days or even years, but can be managed by educating the patient and reassuring him or her that the images are a result of eye disease, not a mental disorder.

Can vitamin supplements help treat dry age-related macular degeneration? [ 08/30/13 ]

Once dry age-related macular degeneration reaches the advanced stage, there is no form of treatment at present to prevent further vision loss. However, there is an intervention measure that could delay and possibly prevent intermediate age-related macular degeneration from progressing to the advanced stage in which vision loss occurs.

The National Eye Institute’s Age-Related Eye Disease Study (AREDS) found that taking nutritional supplements with a specific high-dose formulation of antioxidants (vitamins C and E and beta-carotene), zinc, and copper delayed or prevented the progression of age-related macular degeneration from the intermediate to the advanced stage.

A follow-up trial, called AREDS2, was completed in May 2013. In that study, researchers found that the addition of omega-3 fatty acids to the supplements did not improve the formula’s success. The antioxidants lutein and zeaxanthin proved safer than beta-carotene, which increases the risk of lung cancer for smokers or ex-smokers. Thus, the AREDS2 recommendation for the supplement formula is 500 milligrams of vitamin C, 400 international units of vitamin E, 10 milligrams of lutein, 2 milligrams of zeaxanthin, 80 milligrams of zinc, and 2 milligrams of copper.

What is age-related macular degeneration (AMD)? [ 08/30/13 ]

AMD is a common eye disease associated with aging that gradually destroys sharp, central vision. The retina is the very thin tissue that lines the back of the eye and contains the light-sensing cells that send visual signals to the brain. Sharp, clear, 'straight ahead' vision is processed by the macula, which is the central part of the retina. When the macula is damaged, many daily activities such as driving, reading and recognizing faces become increasingly difficult.

How many people are estimated to have age-related macular degeneration (AMD)? [ 08/30/13 ]

Age-related macular degeneration (AMD) is a major cause of visual impairment in the U.S. Age-related macular degeneration (AMD) is a major cause of visual impairment in the United States. As many as 11 million Americans have some form of macular degeneration, including both early and later stages of the wet and dry forms. More than two million people, aged 50 and older, are living with the most advanced forms of the disease.

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Disclaimer: The information provided in this section is a public service of the BrightFocus Foundation, and should not in any way substitute for the advice of a qualified healthcare professional and is not intended to constitute medical advice. Although we take efforts to keep the medical information on our website updated, we cannot guarantee that the information on our website reflects the most up-to-date research. Please consult your physician for personalized medical advice; all medications and supplements should only be taken under medical supervision. The BrightFocus Foundation does not endorse any medical product or therapy.

Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.

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