Age-Related Macular Degeneration

Degeneration of the central retina in older adults

Overview

Age related macular degeneration, AMD, is a degenerative disease of the macula, the central part of the retina responsible for detailed vision such as reading and recognizing faces. It is a leading cause of central vision loss in older adults in high income countries. The dry, or non neovascular, form is the more common and is marked by yellow deposits called drusen and gradual thinning of the retina, which in late stages is called geographic atrophy. The wet, or neovascular, form is less common but responsible for much of the severe vision loss, as abnormal blood vessels grow from the choroid beneath the retina, leak, bleed, and scar, causing rapid distortion in which straight lines appear wavy. The introduction of anti VEGF drugs injected into the eye in the 2000s transformed the outlook of wet AMD. The Age Related Eye Disease Studies, AREDS and AREDS2, evaluated antioxidant and zinc supplement formulations in intermediate disease. Smoking is the strongest modifiable risk factor, and variants in genes such as CFH and ARMS2 account for much of the inherited risk.