- Wet age-related macular degeneration (AMD) causes rapid and progressive central vision loss due to leaking blood vessels in the eyes.
- Early treatment can reduce the amount of vision loss you experience.
- By closely monitoring the condition, you can identify early changes, which will help you benefit from prompt treatment.
You’ve likely heard of the retina before. It’s the surface at the back of each eye that captures images and sends them along the optic nerve to your brain.
At the center of each retina is an area called the macula. Your macula processes your central vision and helps you focus on tasks like driving, seeing fine detail, recognizing faces, and reading this article.
If you have macular degeneration, the cells in your macula are degrading. This can affect your vision.
At first, you may not be aware of any vision loss, but your eye doctor will be able to see changes to your retina. As macular degeneration progresses, you will begin to notice vision loss.
Macular degeneration is caused by a combination of environmental and genetic factors. It’s usually referred to as age-related macular degeneration (AMD) when it’s found in people over 55 years of age.
According to the American Macular Degeneration Foundation, about 85 to 90 percent of AMD diagnoses are dry (atrophic) AMD. Atrophic refers to the macula’s decrease in size. The remaining 10 to 15 percent are wet (exudative) AMD. Exudative means leaking fluid.
With dry AMD, the photoreceptor and retinal pigmented epithelial (RPE) cells in the macula deteriorate and die. This can progress to wet AMD when cell death causes an abnormal growth of blood vessels in the area. When these vessels leak and bleed, they damage your central vision.
Both wet and dry AMD cause deterioration in central vision, but this change happens faster with wet AMD. Wet AMD can affect your vision within a few weeks, unlike dry AMD, which can take years before it causes vision loss.
With wet AMD, you might have a blank or blurry area in the middle of your field of vision. You may also experience visual distortions like straight lines or surfaces appearing to be bent or wavy.
Low light may cause visual challenges, and you may not be able to recognize faces as easily as you have in the past.
You might even experience a visual hallucination called Charles Bonnet syndrome. This happens when your brain tries to compensate for your vision interruption by inserting images that aren’t real, such as flowers or animals. It’s important to remember that this type of hallucination is part of vision loss and doesn’t indicate reduced mental capacity.
Wet AMD has no cure, but prompt treatment can slow its progression and help relieve symptoms.
Lifestyle changes can protect your vision. Exercise regularly, maintain a healthy weight for your body size, eat nutritious food like dark, leafy greens, manage your blood pressure and cholesterol, and avoid smoking. Protect your eyes from sunlight with hats and sunglasses that offer 100 percent ultraviolet protection.
Vitamins can help prevent dry AMD from becoming wet AMD. Two large studies, the Age-Related Eye Disease Studies (AREDS/AREDS2), revealed that nutrients like vitamins C, and D, copper, and zinc can slow the progression of early and mid-stage dry AMD so that it doesn’t become wet AMD.
For example, in the AREDS study, researchers found that people at high risk for developing advanced AMD reduced their progression risk by about 25 percent when treated with the combination of antioxidants, zinc, and copper. However, there was no benefit for people with early AMD or those without AMD.
Anti-vascular endothelial growth factor (anti-VEGF) injections into the eye can reduce abnormal blood vessel formation. Usually, these injections are given every 4 to 8 weeks.
Most patients treated with anti-VEGF medication — such as Avastin, Beovu, Eylea, and Lucentis — keep their eyesight and may even regain some of the vision that was previously lost.
Laser treatments can reduce the number of abnormal blood vessels in the eye and help minimize the amount they leak.
An intraocular lens (IOL) can also be surgically implanted into the eye to redirect incoming images to an undamaged area of the retina. Several different types of IOLs can be used, including an implantable miniature telescope (IMT).
Slowing progression from dry to wet AMD
If you have dry AMD, ask your doctor how to self-monitor for signs that your condition is progressing to wet AMD. If identified early, treatment can reduce vision damage.
Your doctor may recommend that you perform a daily vision check using an Amsler grid. This grid helps you check for vision changes that indicate you may benefit from treatment.
Without treatment, wet AMD causes rapid, progressive central vision loss. Even though wet AMD makes up only about 10 percent of macular degeneration diagnoses, it accounts for around 90 percent of the significant loss of vision from this condition.
If you’ve already experienced some vision loss, occupational therapy can help you learn strategies to live with reduced vision. A therapist can teach you how to modify your environment and make use of your peripheral vision in your daily activities.
You may feel anxiety or depression, a common occurrence with vision loss. A mental health professional can help you explore therapy options that can help.
Ongoing research aims to increase treatment effectiveness for wet AMD. Areas of investigation include gene therapy to help your eyes make their own anti-VEGF medication.
Other promising ideas include an implantable port that slowly releases medication into the eye and injectable medications that last longer and require fewer injections.
Currently, there is no cure for wet AMD, but treatments can help reduce the amount of vision loss you experience. There are also some lifestyle changes, medications, and surgical procedures you can try.
Without treatment, wet AMD causes rapid, progressive central vision loss.