Age-Related Macular Degeneration (ARMD): Symptoms, Causes, Tests, & Treatments

What is Age-Related Macular Degeneration (ARMD)?

Age-Related Macular Degeneration (ARMD) is a progressive eye condition that primarily affects older individuals and can lead to severe vision impairment or blindness.

The macula is a small, central portion of the retina at the back of the eye. It’s responsible for sharp central vision, allowing us to see fine details and perform tasks like reading and recognizing faces.

ARMD occurs when the macula deteriorates or is damaged, leading to a loss of central vision. The main causes are age, genetics, smoking, and obesity.

There are treatments available to slow its progression and manage its effects, especially for the wet form of the disease. These treatments often involve using medications injected into the eye to inhibit abnormal blood vessel growth or specific vitamins and minerals to support eye health in cases of dry AMD.

Types of ARMD

There are two main types of ARMD:

Dry AMD (Non-Neovascular or Atrophic AMD): This is the more common form of AMD, accounting for about 80-90% of cases. It is characterized by the gradual breakdown or atrophy of the macular cells and the accumulation of drusen, which are small yellow deposits beneath the retina. Dry AMD progresses slowly and may cause a gradual loss of central vision over time.
Wet AMD (Neovascular or Exudative AMD): Although less common, wet AMD is more severe. It involves the growth of abnormal blood vessels (choroidal neovascularization) beneath the macula. These fragile blood vessels can leak blood and fluid, causing rapid and significant damage to the macula and leading to sudden and severe vision loss.

Symptoms of Age-Related Macular Degeneration (ARMD)

Age-Related Macular Degeneration (ARMD) often progresses gradually, and symptoms may not be noticeable in the early stages. However, as the condition advances, individuals may experience the following symptoms:

Blurred or Distorted Central Vision: One of the most common early signs of ARMD is a gradual loss of central vision, which can make it challenging to see fine details, read, recognize faces, or perform tasks that require sharp vision.
Straight Lines Appear Wavy: A classic symptom of wet AMD is the distortion of straight lines. The lines may appear wavy or crooked when looking at a grid or checkerboard pattern.
Dark or Empty Areas in Vision: Individuals with ARMD may develop dark or blank spots in their central vision as the disease progresses. These blind spots can make seeing objects directly in front of them difficult.
Difficulty Recognizing Faces: People with ARMD may have trouble recognizing faces, even those of close family members or friends, due to the loss of central vision.
Decreased Color Perception: Some individuals may notice changes in their ability to perceive colors, making colors appear less vivid or distinct.
Difficulty Reading or Performing Close-up Tasks: Reading, sewing, or performing any activity that requires clear central vision may become increasingly challenging.
Increased Sensitivity to Light: Some individuals with ARMD may become more sensitive to bright light or glare, worsening their visual difficulties.

What Experts Say?

Dr. Anshul Goyal

Retina Surgeon (CEO)

“Regular retina exam every 6 months can detect early conversion of DRY ARMD to WET ARMD. With the use of injections the damage due to ARMD can be well contained and even reversed in many cases.”

Causes of Age-Related Macular Degeneration (ARMD)

Age: The risk increases significantly with advancing age. Most people diagnosed with ARMD are over the age of 50.
Genetics: If you have close relatives, such as parents or siblings, diagnosed with ARMD, your risk of developing the condition may be higher.
Smoking: Smokers have a significantly increased risk of developing both dry and wet forms of the disease.
Heredity: Specific genetic factors and variations in certain genes have been linked to an increased risk of ARMD.
Race and Ethnicity: It is more common among Caucasians than other racial and ethnic groups.
High Blood Pressure: Hypertension has been associated with an increased risk of ARMD. Managing blood pressure can be an important preventive measure.
Diet and Nutrition: Diets high in saturated fats and processed foods may increase the risk of contracting the disease.
Obesity: Obesity is another risk factor for ARMD.
Sunlight Exposure: Prolonged exposure to ultraviolet (UV) light can cause such conditions.
Cardiovascular Health: Conditions that affect cardiovascular health, such as atherosclerosis and high cholesterol, may increase the risk of ARMD.

Diagnostic Tests for Age-Related Macular Degeneration (ARMD)

Visual Acuity Test: This is a standard eye chart test where you read letters or numbers from a chart at various distances.
Dilated Eye Examination: During this exam, eye drops enlarge the pupil, allowing the eye care professional to examine the retina and macula more thoroughly.
Amsler Grid Test: This test is designed to help individuals monitor their central vision for any changes or abnormalities through a grid pattern.
Fluorescein Angiography: This test involves injecting a fluorescent dye into a vein in your arm. The dye travels through the bloodstream and into the blood vessels in your retina.
Optical Coherence Tomography (OCT): OCT is a non-invasive imaging test that provides high-resolution cross-sectional images of the retina.
Fundus Photography: High-resolution color photographs of the back of the eye, including the macula, are taken to document and monitor changes over time.
Electroretinography (ERG): In some cases, an ERG test may be used to measure the retina's electrical activity, which can help evaluate the health of the retinal cells.

Treatment for Age-Related Macular Degeneration (ARMD)

1. Dry Age-Related Macular Degeneration (Dry ARMD):

Lifestyle Modifications: Managing dry ARMD often involves making healthy lifestyle changes, including a diet rich in antioxidants, vitamins (especially vitamins C and E), and minerals (such as zinc and copper).
Vitamin and Mineral Supplements: Some individuals with intermediate or advanced dry AMD may benefit from specific vitamin and mineral supplements known as AREDS (Age-Related Eye Disease Study) or AREDS2 supplements.
Low Vision Aids: In cases where vision loss has already occurred, low vision aids such as magnifiers, telescopic lenses, and special reading glasses can help individuals with ARMD make the most of their remaining vision.

2. Wet Age-Related Macular Degeneration (Wet ARMD):

Anti-VEGF Injections: Wet ARMD is often treated with anti-vascular endothelial growth factor (anti-VEGF) injections.
Photodynamic Therapy (PDT): PDT is sometimes an option. It involves a light-sensitive drug injected into a vein, which is then activated by laser light to destroy abnormal blood vessels selectively.
Laser Therapy: It is less commonly used today but may be considered for specific cases when the abnormal blood vessels are located away from the macula.
Combination Therapy: In some situations, a combination of treatments may be employed to manage wet ARMD, such as anti-VEGF injections along with PDT or laser therapy.

FAQs for Age-Related Macular Degeneration

What is the main cause of ARMD?

The primary causes of ARMD are aging, genetics, and factors like smoking and diet.

Can ARMD be cured?

There is no cure for ARMD, but treatments can help manage the condition and slow its progression.

What are the early signs of ARMD?

Early signs may include blurred central vision, distorted lines, and difficulty recognizing faces.

How is ARMD diagnosed?

Diagnosis involves eye exams, visual acuity tests, and imaging tests like OCT and fluorescein angiography.

What lifestyle changes can help prevent ARMD?

Quitting smoking, maintaining a healthy diet, protecting your eyes from UV light, and managing blood pressure are some key preventive measures.

Is there hope for people with ARMD to maintain their vision?

Yes, early detection, lifestyle changes, and appropriate treatments can help preserve vision and improve the quality of life for individuals with ARMD.

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