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Macular degeneration - age-related

  • Alternative Names

    Age-related macular degeneration (ARMD); AMD; senile macular degeneration (SMD) is an older name that is no longer in common use.


    Treatment

    Once dry macular degeneration becomes advanced or severe, no treatment can restore lost vision.

    A special combination of vitamins, antioxidants, and zinc may prevent the disease from getting worse if the macular degeneration is not yet severe. It will not bring vision that has been lost, however. This combination is often called the "AREDS" formula.

    AREDS may also benefit people with a family history and risk factors for AMD before they have any signs of the disease.

    Only take this vitamin combination if your doctor recommends it. Make sure your doctor knows about any other vitamins or supplements you are taking. Smokers should not use this treatment.

    The recommended supplements contain:

    • 500 milligrams of vitamin C
    • 400 international units of beta-carotene
    • 80 milligrams of zinc
    • 2 milligrams of copper

    Other supplements called lutein and zeaxanthin may also be helpful, although they are not part of the AREDS formula. If you have wet AMD, your doctor may recommend the following treatments:

    • Laser surgery (laser photocoagulation) -- a small beam of light destroys the leaking, abnormal blood vessels.
    • Photodynamic therapy -- a light activates a drug that is injected into your body to destroy leaking blood vessels.
    • Special medications that prevent new blood vessels from forming in the eye (anti-angiogenesis, anti-VEGF therapy) -- drugs such as bevacizumab (Avastin) and ranibizumab (Lucentis) are injected into the eye. This is a painless process.

    Low-vision aids (such as special lenses) and therapy can help you use the vision that you have more effectively, and improve your quality of life.

    Close follow-up is important.

    • For dry AMD, a complete eye exam should be performed by an eye specialist at least once a year.
    • After getting treated for wet AMD, you will need frequent, perhaps monthly, follow-up visits.

    In AMD, early detection of vision changes is very important. Early detection leads to earlier treatment and often, a better outcome.

    The best way to detect changes is by self-testing at home with an Amsler grid. Test each eye individually with the vision correction you normally wear for reading.


    Support Groups

    AMD Alliance International -- (877) AMD-7171 -- www.amdalliance.org.


    Expectations (prognosis)

    Most people with mild dry macular degeneration will not have disabling central vision loss. However, there is no way to predict who will progress to a more severe form of the disease.

    The wet form of macular degeneration often leads to significant vision loss.

    Although macular degeneration can cause people to lose the ability to read, drive a car, and recognize faces at a distance, it never causes complete blindness. This disorder results in the loss of central vision only -- macular degeneration cannot cause side (peripheral) vision loss.

    Nearly everyone with macular degeneration can get around, eat, perform personal hygiene, and do other routine activities without too much difficulty.


    Complications

    Loss of central vision may interfere with many daily activities, such as reading, working on the computer, or driving. You may need extra light or magnification to perform many of your normal activities.


    Calling your health care provider

    If you have AMD, your health care provider may recommend that you check your vision every day on an Amsler grid. Call your provider immediately if the lines appear wavy, or you notice any other changes in your vision.