Age-Related Macular Degeneration FAQ

What Is Age-Related Macular Degeneration?

Age-Related Macular Degeneration or AMD is a progressive disease of the macula.  The macula is the special part of the blood vessel layer in the back of the eye called the retina.  The macula is responsible for our central vision, which is critical for normal, functional vision.  When this tissue begins to deteriorate, it leads to permanent vision loss if left untreated.  AMD is the leading cause for blindness in people over 65 years of age in the U.S.


Who Gets AMD?

AMD is multifactorial which means there are a lot of factors that contribute to the disease but it's not entirely clear why some people get it and others don't.  Studies have shown that heredity does play a part, so if you have any blood relatives with AMD, you should get checked out when you reach your 60s.  Other risk factors include a history for tobacco smoking, caucasian race, blue eyes, among others.  Studies have shown that cataract surgery does not increase the risk for getting AMD.

Can I Do Anything To Prevent Getting AMD?

There is no sure way to prevent AMD but there are some steps you can take.  Quit tobacco use.  Start taking omega-3 fatty acids such as fish oil supplements.  Eat a diet rich in green leafy vegetables as long as your primary doctor permits it.  There are also special eye vitamins (AREDS formula) that are designed to protect the eye from disease, but studies so far have shown they are more effective at slowing down AMD once it develops.  There is yet no evidence that vitamins can actually prevent the development of AMD.  Lastly, protecting the eyes from ultraviolet (UV) sunlight by wearing sunglasses is an easy and safe way to prevent your maculas from being exposed to harmful UV radiation.

Once I Am Diagnosed With AMD, What Should I Expect?

AMD comes in two forms: dry and wet.  Dry AMD is the more common and less severe form.  Early forms of dry AMD may only be detectable with an eye examination thus you can have signs for AMD and still have good vision.  Dry AMD is usually associated with mild and slow vision loss but it may take years for vision to deteriorate.  But if the vision worsens, it may become permanent and untreatable.  Eye vitamins (AREDS formula) and fish oil (omega-3s) are used to help slow the progression of dry AMD.  Studies looking at lutein and zeaxanthine (AREDS 2) are still in progress and may be beneficial as well.

Wet AMD, in contrast, is less common but is the more severe form.  The vision can be lost almost instantaneously because it occurs from bleeding in the blood vessels deep to the retina called the choroid.  This leads to a choroidal neovascular membrane which causes sudden, painless vision loss.  Unlike dry AMD, wet AMD has available treatments in the form of anti-VEGF (Vascular Endothelial Growth Factor) therapy.  The most commonly performed treatments are Avastin and Lucentis.  These medications are administered by injecting the medicine directly into the eye.  This allows for direct exposure of the macula to the medicines which help resolve the blood as well as any associated swelling of tissue.  Sometimes the vision improves by reducing bleeding and swelling, but residual vision loss can occur from permanent damage to the macular tissue.

The recommendations above as well as using an Amsler grid to monitor the vision is important to detect any visual changes.  Your eye doctor can tell you about the Amsler grid in more detail.

Do Intravitreal Injections Hurt?

No.  Although the idea of having a medication injected into the eye sounds scary, most patients say that the thought of it is far worse than the injection itself.  Most patients feel nothing or may feel a little pin prick for a moment.  There is typically little to no pain or discomfort afterward.

How Often Do I Need the Shots?

Anti-VEGF therapy is wonderful because prior to its development, treatments were not very effective at slowing the disease process.  Anti-VEGF therapy effectively slows the disease progression and in some cases reverses vision loss from wet AMD.  However, the medication only lasts in the eye for a short period of time and thus repeated injections are necessary to maintain and sustain the effect of the treatment.  Dr. Tim O'Boyle and Dr. Brian Kim have performed hundreds of Intravitreal injections for Macular Degeneration.  Call our office for a consultation today.