age related macular degeneration

Age-related Macular Degeneration (AMD): A Comprehensive Overview

Age-related macular degeneration (AMD) is a progressive eye disease that affects the central vision, leading to significant visual impairment in older adults. The condition occurs when the macula, a small area at the back of the retina responsible for sharp, central vision, deteriorates due to age-related changes.

Types of AMD

There are two primary types of AMD: dry (atrophic) and wet (exudative). Dry AMD is characterized by a gradual deterioration of the macula, while wet AMD involves the growth of abnormal blood vessels under the retina, leading to rapid vision loss.

• Dry AMD: This type accounts for 90% of all AMD cases. It progresses slowly over time, causing blurred vision and distorted colors.
• Wet AMD: This type is more aggressive and can cause sudden, severe vision loss. Abnormal blood vessels grow under the retina, leaking fluid and leading to scarring.

Symptoms of AMD

The most common symptoms of AMD include:

• Blurred vision
• Distorted colors
• Difficulty reading or performing daily tasks
• Central vision loss

Causes and Risk Factors

While the exact causes of AMD are still unknown, several risk factors have been identified:

• Age: The likelihood of developing AMD increases with age.
• Family history: A person's risk is higher if they have a family history of AMD.
• Smoking: Smoking has been linked to an increased risk of AMD.
• Obesity: Being overweight or obese may increase the risk of AMD.

Prevention and Treatment

While there is no cure for AMD, several treatments can slow its progression:

• Lifestyle modifications: Quitting smoking, maintaining a healthy weight, and exercising regularly can help reduce the risk of AMD.
• Vitamin supplements: Certain vitamins, such as vitamin A and E, may help prevent or slow the progression of AMD.
• Medications: Treatments like anti-VEGF injections can help manage wet AMD.

References

1. [2] Age-related macular degeneration (AMD) is a problem with your retina. It happens when a part of the retina called the macula is damaged.
2. [3] Macular degeneration is primarily an age-related retinal condition. There are two types of macular degeneration — wet and dry. You may lose central vision, ...
3. [5] Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older.
4. [6] Age-related macular degeneration (AMD) is an eye condition causing central vision loss, mostly affecting those older than 50.
5. [9] Age-related macular degeneration is a chronic but painless disease. It affects a special layer of cells in the eye called the retinal pigment epithelium, ...

Age-related Macular Degeneration (AMD) Signs and Symptoms

Age-related macular degeneration (AMD) is a condition that affects the macula, the part of the retina responsible for central vision. The symptoms of AMD can vary from person to person, but here are some common signs and symptoms:

• Visual Distortions: Straight lines may appear bent or distorted [3].
• Reduced Central Vision: You may experience a loss of central vision in one or both eyes, making it difficult to see details straight ahead [2].
• Blurred or Distorted Area: The first symptom is often a blurred or distorted area in your vision, which can progress to affect the entire central part of your vision [4].
• Loss of Central Vision: Some early signs can be loss of central vision, making it difficult to read, watch TV, or perform other daily activities that require clear central vision [5].
• Gaps or Dark Spots: Gaps or dark spots (like a smudge on glasses) may appear in your vision, especially first thing in the morning [6].
• Colours Fading: Colours can fade, making it difficult to distinguish between different shades and hues.
• Dark or Blurred Patches: Dark or blurred patches in the centre of your vision can be a symptom of AMD [7].

It's essential to note that some people with AMD may not experience any symptoms at all, especially in the early stages. If you're experiencing any of these symptoms, it's crucial to consult an eye care professional for a proper diagnosis and treatment plan.

References: [1] Not applicable (this is the start of the response) [2] Context 2 [3] Context 3 [4] Context 4 [5] Context 5 [6] Context 6 [7] Context 7

Diagnostic Tests for Age-related Macular Degeneration

Age-related macular degeneration (AMD) can be diagnosed through various tests and exams performed by an eye doctor, such as an ophthalmologist or optometrist. Here are some of the diagnostic tests used to detect AMD:

• Optical Coherence Tomography (OCT): This is a non-invasive imaging test that takes high-resolution photographs of the retina, allowing doctors to visualize the macula and detect any abnormalities [1][2].
• Eye Angiogram: This test uses a special dye to highlight blood vessels in the eye, helping doctors identify any abnormal growths or leakage beneath the macula [3].
• Comprehensive Eye Exam: A thorough eye exam may include tests such as visual acuity testing, refraction, and a dilated pupil examination to assess the overall health of the eyes [4][5].
• Genetic Testing: For young onset AMD, genetic testing can help identify any inherited factors that may contribute to the condition [6].
• Imaging Tests: Some optometrists use photography or other imaging tests to detect early signs of macular degeneration, such as OCT scans [7].

These diagnostic tests can help doctors confirm a diagnosis of age-related macular degeneration and determine the best course of treatment.

References:

[1] Context 1: Optical coherence tomography (OCT) is a special photograph that shows a detailed image of the retina. [2] Context 5: To help diagnose macular degeneration, an ophthalmologist or optometrist will perform a comprehensive eye exam that may include the following tests. [3] Context 3: An eye angiogram or an optical coherence tomography (OCT) may be given to find out if abnormal blood vessels are growing beneath the macula. [4] Context 6: Feb 21, 2023 — Your eye doctor reviews your medical and family history and conduct a complete eye exam. To confirm a diagnosis of macular degeneration, ... [5] Context 9: NYU Langone ophthalmologists use vision and imaging tests to diagnose macular degeneration, also known as age-related macular degeneration, or AMD. [6] Context 4: Genetic Testing. Another diagnostic for young onset macular degeneration is genetic testing ... [7] Context 8: Some optometrists use photography or other imaging to detect early signs of macular degeneration. These might include optical coherence tomography (OCT) scans.

Age-related Macular Degeneration (AMD) Treatment Options

Age-related macular degeneration (AMD) is a condition that affects the macula, the part of the retina responsible for central vision. There are two types of AMD: dry and wet. While there is no cure for AMD, various treatment options can help manage the condition.

Wet AMD Treatment

Wet AMD is characterized by the growth of abnormal blood vessels in the retina, leading to bleeding and damage to the macula. The main treatment for wet AMD is the injection of medications called anti-vascular endothelial growth factor (anti-VEGF) agents [8][9]. These drugs block the production of vascular endothelial growth factor (VEGF), a protein that promotes blood vessel growth.

Some common anti-VEGF agents used to treat wet AMD include:

• Aflibercept (Eylea)
• Ranibizumab (Lucentis)
• Faricimab (Vabysmo) [7]
• Bevacizumab (Avastin)

These medications can help stabilize or improve vision in people with wet AMD.

Dry AMD Treatment

Dry AMD, also known as atrophic AMD, is characterized by the thinning of the macula. While there is no cure for dry AMD, researchers have identified several treatment options that may slow its progression.

• Syfovre (pegcetacoplan) and Izervay (avacincaptad pegol) are approved to treat geographic atrophy, also known as late-stage "dry" age-related macular degeneration [6].

Other Treatment Options

In addition to medication injections, other treatment options for AMD include:

• Photodynamic therapy (PDT)
• Laser surgery
• Brolucizumab-dbll (Beovu)

It's essential to note that these treatments may not cure AMD but can help manage the condition and slow its progression.

References:

[1] May 23, 2024 — These drugs — including aflibercept (Eylea), ranibizumab (Lucentis), faricimab (Vabysmo) and bevacizumab (Avastin) — stabilize or improve vision ...

[2] Sep 18, 2023 — Wet AMD is most commonly treated with injections of angiogenesis inhibitors into the eye, photodynamic therapy (PDT), or laser surgery, which ...

[3] Feb 20, 2024 — Treatment options for Wet AMD include brolucizumab-dbll (Beovu), aflibercept (Eylea and Eylea HD), ranibizumab (Lucentis), faricimab-svoa (...

[4] Feb 21, 2023 — Medications · Bevacizumab (Avastin). · Ranibizumab (Lucentis). · Aflibercept (Eylea). · Brolucizumab (Beovu). · Faricimab-svoa (Vabysmo).

[5] Feb 21, 2023 — FDA approves Syfovre, the first-ever treatment for dry age-related macular degeneration (AMD) in the US. It is now available for use in ...

[6] Dec 12, 2023 — Syfovre (pegcetacoplan) and Izervay (avacincaptad pegol) are approved to treat geographic atrophy, also known as late-stage "dry" age-related macular degeneration.

[7] Vabysmo (Faricimab) is the most recently approved medication for treatment of wet AMD. It is the first dual action drug and tackles two biological pathways ...

[8] The main treatment for wet AMD is the injection of medications called anti-VEGF agents. VEGF stands for vascular endothelial growth factor. A high level of VEGF ...

[9] There are drugs that treat but don't cure wet AMD. They include anti-vascular endothelial growth factor (anti-VEGF) injections. They block the production of ...

Differential Diagnosis of Age-related Macular Degeneration (AMD)

Age-related macular degeneration (AMD) is a complex disease with various differential diagnoses, especially when choroidal neovascularization (CNV) is present. The differential diagnosis can be broadly categorized into two types: non-exudative and exudative ARMD.

Non-Exudative ARMD

• Other genetic macular diseases, such as Stargardt disease, Best disease, and pattern dystrophy [1]
• Central serous chorioretinopathy (CSC) [5]
• Cuticular drusen and pseudo-vitelliform maculopathy [4]

Exudative ARMD

• Wet AMD, also known as exudative or neovascular AMD, is the most common cause of central visual impairment and blindness among older individuals in developed countries [15]
• Choroidal melanoma [3]
• Angioid streaks
• Central serous chorioretinopathy (CSC) [5]

Key Considerations

• The differential diagnosis between macular lesions and wet AMD can be challenging when it occurs [4]
• Reticular pseudodrusen should be differentiated from drusen, as they are deposits above the retinal pigment epithelium (RPE) in the subretinal plane [13]

References

[1] Other genetic macular disease: Stargardt disease, Best disease, pattern dystrophy [3] Choroidal Melanoma [4] Cuticular Drusen, Pseudo-Vitelliform Maculopathy [5] Central Serous Chorioretinopathy (CSC) [13] Reticular pseudodrusen vs. drusen [15] Wet age-related macular degeneration (AMD)