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Age-related macular degeneration (AMD) doesn’t always progress to wet AMD

Good news for those with AMD: only about 10 per cent of cases progress from the less severe dry form to the more serious wet form, which poses greater risks to vision.

Here’s how to reduce your risk…

How AMD affects the retina and macula

Age-related macular degeneration (AMD) is a progressive eye disease wherein the part of the retina called the macula is damaged.[1]

“AMD affects the central part of the retina, an area called the macula, hence the name,” explains Dr. Flavio Rezende, a vitreo retinologist at the Maisonneuve-Rosemont Hospital’s University Ophthalmology Centre and a Professor of Ophthalmology at the University of Montreal. “The disease is an abnormal aging of cells called photoreceptors, which capture the light that goes into the eye and transform it into messaging to the brain.”

These photoreceptors are found in the centralmost region of the macula, the foveola.[2] This part of the eye, and the macula in general, is responsible for the detailed vision necessary for activities such as reading, driving and recognizing people’s faces.[3]

An older woman with short gray hair adjusts her glasses while reading a book, reflecting the impact of age-related macular degeneration (AMD) on daily activities.
A pair of black-framed glasses resting on an open book, with the central area blurred to simulate vision loss.

The Warning Signs: Drusen and Early Indicators of AMD

As the name suggests, AMD develops as the eyes age. “We need vision every minute that we’re awake, so these tissues have to work hard every day,” says Dr. Rezende. “The mix of light and oxygen creates waste products called free radicals, which start to accumulate over the years, and this can eventually damage the cells.”

Early signs of this accumulation of waste products include drusen – deposits of lipids and proteins under the retina.[4] Having drusen is a hallmark of AMD,[4] says Dr. Rezende.

Drusen alone does not account for a AMD diagnosis, but it is, however, a warning sign. Over time, patients with drusen can be more or less likely to advance into AMD depending on a variety of factors, including genetics and lifestyle. Patients who develop AMD may get either or both of its two forms: dry AMD and wet AMD.

“As you advance, you can go into the dry form of AMD, which is usually the natural history of the disease, or the wet form, which happens in about 10 per cent of patients,” says Dr. Rezende. “Dry AMD is the accumulation of drusen. The cells eventually stop functioning – they become atrophic and pretty much die. In some patients, however, before the cells die, they create a stimulus to try to attract new blood vessels toward them, which we call new vascularization, and this is the wet form of AMD. The new vessels don’t have the same capacity as regular blood vessels to keep the blood inside the vessels, so they start leaking, and that’s why we call it the wet form.”[5]

As mentioned, wet AMD is far more serious than the dry version. “When you develop the wet form, there’s a quick drop in vision,” says Dr. Rezende. “All of a sudden you may have a dark spot in the central part of your visual field, which will impact reading and recognizing faces, and you may also have colour deficiencies. It’s a very debilitating disease.” By contrast, dry AMD usually involves slow-progressing vision impairment.

Wet AMD is also associated with a significant treatment burden. “The treatment consists of an eye injection every four to sixteen weeks,” notes Dr. Rezende.

An older man wearing a brown sweater adjusts his glasses while reading a tablet, illustrating the challenges of managing age-related macular degeneration (AMD).

MacuMira Vision Therapy for Dry AMD treatment

Those diagnosed with dry AMD, however, can be treated with MacuMira Vision Therapy which is far more comfortable, and clinically effective, than many of the existing traditional therapies. MacuMira Vision Therapy uses non-invasive eyelid surface neurostimulation to deliver a patented microcurrent through a patient’s closed eyes. This is a quick and easy process that improves visual acuity by an average of 8.8 letters on ETDRS chart.

Patients receive the painless treatment while seated comfortably, and most sessions last an average of 30 minutes.

Dry AMD and Its Progression to Wet AMD

Although all AMD patients start out with dry AMD, not all dry occurrences will progress to wet  – approximately 90 per cent of AMD instances don’t develop into wet AMD. The vascularization that sometimes occurs as a reaction to cells atrophying doesn’t always occur. “The cells that are starving for more food produce this vascular endothelial growth factor, or VEGF, which is supposed to bring blood vessels toward them,” he explains. “If they die before they’re capable of doing this, then there’s no production of the molecule to bring blood vessels, and therefore no progression to wet AMD.”

Certain risk factors have been shown to increase the likelihood of patients developing wet AMD, while other factors may slow AMD’s progression and prevent it from advancing to the wet form. Factors that increase the likelihood include progressing age, family history of AMD, smoking, eating an unhealthy diet, low levels of exercise and high blood pressure.[1]

To prevent or slow the progression to wet AMD, Dr. Rezende recommends smoking cessation, eating a well-balanced and nutritious diet, supplementing with lutein and wearing sunglasses with UVA/UVB protection while outdoors, especially for light-skinned patients.

Screening is also an incredibly important tool. “Go to the optometrist once a year,” advises Dr. Rezende.

By managing the risk factors diligently, AMD patients can help prevent their disease from progressing to the more serious wet form.

Take control of your AMD with MacuMira Vision Therapy and don’t let AMD hold you back from enjoying life. MacuMira Vision Therapy offers a non-invasive, effective, and comfortable solution to improve your vision and prevent progression. Schedule a consultation today with a qualified physician to explore your options for AMD treatment and learn how this innovative therapy can make a difference for you! If you have questions about AMD or MacuMira Vision Therapy as an eyecare professional, don’t hesitate to contact us for more information.

Disclaimer: Always speak to your primary health care provider and/or eye care provider before making any changes to your lifestyle, activities or diet.

References

    1.  https://www.aao.org/eye-health/diseases/amd-macular-degeneration
    2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330894/#:~:text=The%20central%20most%20region%20of,photoreceptor%20cells%20and%20M%C3%BCller%20glia
    3. https://opto.ca/eye-health-library/age-related-macular-degeneration-amd
    4. https://www.aao.org/eye-health/diseases/what-are-drusen
    5. https://www.seethepossibilities.ca/eye-health/age-related-macular-degeneration/