1. 1 AMD Jane Warren
Macular Degeneration: An Overview
Jim is a 75-year-old retired welder who is an avid ballroom dancer. He dances at least 4 times a week
and does a killer Paso Doble in front of an audience. But he cannot drive to the dance studio himself.
Therefore, his dance partner, his wife of 46 years, does the driving. Now if he can spin her around the
floor while doing a Waltz or a Foxtrot, he can certainly drive. Right? Well, not exactly.
Jim cannot drive because he has macular degeneration.
Description of Macular Degeneration
Macular degeneration is an eye condition that affects the macula, which is the central portion of the retina
that enables us to see clearly with detail, color, and sharpness. The most sensitive part of the retina, the
macula is composed of millions of light-sensing cells and is responsible for our central vision, or what we
see in front of us. It lets us read, drive a car, and look at someone face to face. The retina, a layer of
tissue located in the back of the eye, contains receptors and nerves that assemble and conduct light
signals from the eye into the optic nerve. These signals then travel to the brain, which translates the
signals into images that we see.
Commonly known as age-related macular degeneration (AMD), macular degeneration affects adults older
than 55 years and is the leading cause of legal blindness in older people. It does not lead to total
blindness because the peripheral, or side, vision is still intact. Instead, the condition destroys the central
vision. This is why people like Jim can still dance but can no longer drive. Unfortunately, AMD is
progressive.
Types of AMD
The condition presents itself as either dry AMD or wet AMD. Dry AMD is more common than its wet
counterpart and occurs in roughly 90% of people. Also known as atrophic AMD, it arises when the cells of
the macula break down. Vision loss is more gradual in people with dry AMD. Wet (neovascular) AMD is
the more serious form in which new, abnormal blood vessels grow into the macula and leak blood and
fluid. The blood and fluid then jostle the macula from its usual position, causing the central vision to blur.
In this case, vision loss is quicker and more severe. Wet AMD occurs in 10% to 15% of people. Dry AMD
can progress to wet AMD.
Symptoms
Both forms of AMD are painless, and symptoms are more gradual in dry AMD. There may be no
symptoms in the early stages of dry AMD, but blurred vision, the most common symptom, appears later
on. Also, people with the condition need more light because objects may not seem as bright as before.
Objects may appear smaller in one eye than in the other, which may indicate swelling of the macula.
People with AMD also have difficulty recognizing faces, start seeing straight lines as blurry, and have
blind spots.
Another sign of dry AMD is yellow deposits under the retina called drusen. Your ophthalmologist can see
them while performing a dilated eye examination.
Causes and Risk Factors
Macular Degeneration: An Overview

2. 2 AMD Jane Warren
Jim is a 75-year-old retired welder who is an avid ballroom dancer. He dances at least 4 times a week
and does a killer Paso Doble in front of an audience. But he cannot drive to the dance studio himself.
Therefore, his dance partner, his wife of 46 years, does the driving. Now if he can spin her around the
floor while doing a Waltz or a Foxtrot, he can certainly drive. Right? Well, not exactly.
Jim cannot drive because he has macular degeneration.
Description of Macular Degeneration
Macular degeneration is an eye condition that affects the macula, which is the central portion of the retina
that enables us to see clearly with detail, color, and sharpness. The most sensitive part of the retina, the
macula is composed of millions of light-sensing cells and is responsible for our central vision, or what we
see in front of us. It lets us read, drive a car, and look at someone face to face. The retina, a layer of
tissue located in the back of the eye, contains receptors and nerves that assemble and conduct light
signals from the eye into the optic nerve. These signals then travel to the brain, which translates the
signals into images that we see.
Commonly known as age-related macular degeneration (AMD), macular degeneration affects adults older
than 55 years and is the leading cause of legal blindness in older people. It does not lead to total
blindness because the peripheral, or side, vision is still intact. Instead, the condition destroys the central
vision. This is why people like Jim can still dance but can no longer drive. Unfortunately, AMD is
progressive.
Types of AMD
The condition presents itself as either dry AMD or wet AMD. Dry AMD is more common than its wet
counterpart and occurs in roughly 90% of people. Also known as atrophic AMD, it arises when the cells of
the macula break down. Vision loss is more gradual in people with dry AMD. Wet (neovascular) AMD is
the more serious form in which new, abnormal blood vessels grow into the macula and leak blood and
fluid. The blood and fluid then jostle the macula from its usual position, causing the central vision to blur.
In this case, vision loss is quicker and more severe. Wet AMD occurs in 10% to 15% of people. Dry AMD
can progress to wet AMD.
Symptoms
Both forms of AMD are painless, and symptoms are more gradual in dry AMD. There may be no
symptoms in the early stages of dry AMD, but blurred vision, the most common symptom, appears later
on. Also, people with the condition need more light because objects may not seem as bright as before.
Objects may appear smaller in one eye than in the other, which may indicate swelling of the macula.
People with AMD also have difficulty recognizing faces, start seeing straight lines as blurry, and have
blind spots.
Another sign of dry AMD is yellow deposits under the retina called drusen. Your ophthalmologist can see
them while performing a dilated eye examination.
Causes and Risk Factors
Causes of AMD are unknown, but the condition runs in families. For example, studies of twins have
suggested hereditary factors.

3. 3 AMD Jane Warren
The primary risk factor for AMD is age, followed by family history. Also, AMD is more common in women
than in men and is more common in whites but can occur in any race. Smoking is another important risk
factor. Obesity, sleep apnea, intense exposure to sunlight, and even near-sightedness are linked with
AMD.
Treatments
There is no cure for both dry and wet AMD, but certain treatments and changes in lifestyle might keep the
condition from getting worse and preserve some vision.
Dry AMD
No treatment is available for dry AMD, but studies show that a diet high in green, leafy vegetables; high
doses of supplements such as vitamins C and E; and zinc may stave off the progressive effects of the
condition. Also, quitting smoking and keeping regular visits with your ophthalmologist can help.
Wet AMD
Drugs called vascular endothelial growth factor (VEGF) inhibitors can keep wet AMD at bay. People with
wet AMD have elevated levels of VEGF, a protein that causes abnormal blood vessels to grow.
Therefore, VEGF inhibitors block these effects and keep new vessels from forming in the eye. Your
ophthalmologist administers this drug by injecting it into the eye, usually once a month.
Other treatments of wet AMD involve lasers, which actually destroy the abnormal blood vessels in the
eye. These can be given in the ophthalmologist's office.
Living With AMD: What's Next?
Despite experiencing vision loss, people with both forms of AMD can still live full lives. Support groups
and counseling can be very helpful, especially for those newly diagnosed with AMD. Family and friends
are valuable, but talking with someone who also has AMD can be invaluable. You can find a like-eyed
person either in your community, over the telephone, or online. For online support, or to find a local
support group, visit WebRN-MacularDegeneration.com. To seek support over the phone, call ILVSG
[International Low Vision Support Group] TeleSupport at 1-816-761-7080 if you live in North America. If
you live outside of North America, dial your "exit country code" (found in your phone book) + 1* + 816-
761-7080.
References
1. Foster, CS. Pivotal Age-Related Macular Degeneration Treatment Studies Update. Available at:
http://www.medscape.com/viewarticle/767568. Visited September 19, 2012.
2. National Eye Institute, National Institute of Health. Facts About Age-Related Macular Degeneration.
Available at: http://www.nei.nih.gov/health/maculardegen/armd_facts.asp. Visited September 18, 2012.
3. Sheppard, JD. Macular Degeneration. Available at:
http://www.emedicinehealth.com/macular_degeneration/article_em.htm#macular_degeneration_overview.
Visited September 19, 2012.