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Macular Degeneration

What Is Macular Degeneration?

The diagnosis of macular degeneration is becoming increasingly more common due to patient awareness, physician access, and improvements in tools for detection. Additionally, because of the increase in our elderly population, there has been an increase in the percentage of the population at risk for this condition. Macular degeneration is a formidable challenge to patients, their doctors, and our society as the costs for delivering state-of-the-art care increase.

Macular degeneration, also called age-related macular degeneration (AMD or ARMD), affects the macula, which is the central portion of the retina of the eye. Our central vision (what you see directly in front of you rather than what you see at the side [or periphery] of your vision) is dependent on a healthy macula.

The retina is a layer of tissue inside the eye consisting of the receptors and nerves that sense and transmit light signals from the eye to the optic nerve. From there, the optic nerve sends the information to the brain for interpretation as our sense of vision. The macula is the very central portion of the retina and is responsible for the detailed vision that we use to read, thread a needle, sign a check, or recognize faces.

Age-related macular degeneration is the leading cause of blindness in people older than 55 years in the United States affecting more than 2 million people. Because overall life expectancy continues to increase, age-related macular degeneration has become a major public-health concern.

There are two types of age-related macular degeneration:

  • Dry form: This type results from the gradual breakdown of cells in the macula, which can result in a gradual blurring of central vision. Small, round, yellow-white spots called drusen accumulate under the macula in the dry type. Drusen can be seen by your doctor using standard eye exam equipment. Drusen can become visible at any age but are much more common in people over the age of 55. Many people with drusen alone have excellent vision and no symptoms. However a small percentage of people will go on to develop an advanced form of dry AMD known as geographic atrophy (GA), in which the macular tissue gradually thins. When this occurs, there can be vision loss ranging from mild to profound.
  • Wet (exudative or neovascular) form: In the wet form of AMD, abnormal blood vessels grow under the macula. These blood vessels may leak fluid or blood, distorting or diminishing central vision. Wet AMD usually starts in one eye and may affect the other eye later. In contrast to the dry type, vision loss may be rapid.
    • Wet macular degeneration affects only 10%-15% of people who have AMD but accounts for the majority of people who have significant visual loss.

Juvenile macular degenerations (for example, Stargardt disease) are uncommon inherited macular diseases of childhood that are not discussed here.

Last Reviewed 11/20/2017

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Read What Your Physician is Reading on Medscape

ARMD, Nonexudative »

Age-related macular degeneration (AMD) is the most common cause of irreversible visionloss in the developed world.

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