Macular Degeneration

The highly skilled ophthalmologists at The Center for Retinal and Macular Diseases and Surgery at University Hospitals Eye Institute offer expert diagnosis and treatment of macular degeneration. Also called age-related macular degeneration (AMD), this condition is the leading cause of vision loss in the U.S. for adults over 60. About 1 in 10 Americans over age 50 have macular degeneration.

Macular degeneration causes loss of central vision. The disease affects the macula: a small round area in the center of the retina, which is the thin, light-sensitive layer of nerve tissue that lines the inside of the back of the eye. The macula maintains the sharpness of your central vision, allowing you to see fine details when you look at something directly in front of you. Although it rarely causes total blindness, macular degeneration can make driving, reading, recognizing faces and doing close-up work difficult.

Macular Degeneration Symptoms

Symptoms of macular degeneration may include:

• Objects appearing smaller than they really are
• Straight lines appearing wavy
• Colors appearing paler than normal
• A dark, empty area or blind spot at the center of your vision
• Reduced vision in low light
• Blurred vision

Symptoms of macular degeneration may resemble those of other eye conditions. An eye care provider can determine if your symptoms are due to macular degeneration or another condition.

Types of Macular Degeneration

There are two main types of age-related macular degeneration, each of which has different causes:

• Dry: The more common of the two types, dry (or atrophic) macular degeneration occurs when the light-sensitive cells in the macula slowly deteriorate. This type usually affects both eyes. Age-related thickening of the tissue beneath the retina may lead to dry macular degeneration. In some people, dry macular degeneration develops into geographic atrophy (GA), which is an advanced form of the disease.
• Wet: Less common than dry macular degeneration, wet (or exudative) macular degeneration causes the most severe eyesight loss caused by macular degeneration. Wet macular degeneration occurs when abnormal blood vessels develop under the retina and macula. These new vessels leak blood and fluid, creating a bulge in the macula that can cause people to see dark spots in their central vision.

Who Is at Risk for Macular Degeneration?

Macular degeneration is more likely to occur as you get older. However, some younger people develop macular degeneration. Aside from age, risk factors for macular degeneration include:

• Having a family history of macular degeneration
• Being overweight
• Having high blood pressure (hypertension)
• Smoking
• Eating a diet high in saturated fats
• Being white

How Is Macular Degeneration Diagnosed?

Your eye care provider will give you an eye exam and review your health history. You may also have additional testing, including:

• Visual acuity test: The common eye chart test to measure the clarity and sharpness of your vision.
• Pupil dilation: Using special eye drops, the pupil is widened (dilated) to allow close-up examination of the retina.
• Amsler grid: Used to identify wet AMD, you’re asked to look at a grid and see if straight lines in the grid are missing or look wavy.
• Fluorescein angiography: Used in the diagnosis of wet AMD, a dye is injected into the arm to visualize blood vessels in the retina and determine if they’re leaking.

A common early sign of macular degeneration is the presence of tiny yellow deposits called drusen in the retina. Visible during an eye exam, the presence of drusen may mean you’re at risk for developing more severe macular degeneration.

How Is Macular Degeneration Treated?

The vision damage caused dry macular degeneration can’t be reversed. If the disease is diagnosed early, you can take measures to slow its progression, such as eating healthy, taking vitamin supplements and not smoking.

For wet macular degeneration, treatment options include:

• Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Injections: These injections work by blocking the production of VEGF, the protein that stimulates the growth of new blood vessels. After numbing the eyes, the anti-VEGF medication is injected. Anti-VEGF shots can sometimes improve your vision.
• Photodynamic therapy (PDT): A combination of an injectable, light-sensitive drug and a laser destroy extra blood vessels that have formed behind the macula.
• Laser photocoagulation: A laser seals and destroys leaky blood vessels.

Living With Macular Degeneration

If you already have reduced vision caused by macular degeneration, talk to your healthcare provider about services for people with low vision. Also ask about devices that may assist you with your daily tasks.