Age-Related Macular Degeneration (AMD) – Minimizing Its Symptoms

When left untreated, age-related macular degeneration can lead to blindness. We provide options for patients to help control their symptoms.

Age-related macular degeneration (AMD) is the leading cause of visual impairment in older people. AMD is a condition of the eye that carries the risk of blindness in advanced forms of the disease. AMD occurs when the macula, the central portion of the retina, gradually deteriorates. The retina is the membrane at the back of the eye that transmits signals to the brain through the optic nerve. The macula is an organ that’s filled with thousands of cells that can sense light and is responsible for central vision. Macular degeneration can rob a person of their central vision. This loss can make it difficult to perform day-to-day tasks like reading, sewing or driving.

Two Forms of Macular Degeneration

Age-related macular degeneration can come in two forms: wet AMD and dry AMD. Dry macular degeneration is also known as Central Geographic Atrophy. It has a slower onset than wet AMD, but can cause significant vision loss. Wet macular degeneration is also called neovascular/exudative AMD. It happens when there’s an abnormal growth of blood vessels beneath the center of the retina. These blood vessels can leak blood and protein below the macula and injure it. In this case vision loss is rapid.

People with dry AMD can suffer from blurry or distorted vision and a slow loss of their central vision. They can also see letters that seem broken or missing when they read. When people have wet AMD, they have these symptoms along with shadows and areas of their visual field that are missing. They can also see curvy, wavy or missing letters, lines or objects. They can have trouble distinguishing different colors and don’t recover well after they’ve been exposed to very bright lights. AMD doesn’t cause any pain and symptoms are subtle, thus it’s a good idea to schedule an appointment with an ophthalmologist or eye doctor if you feel your vision is impaired in any way.

Who is at Risk for Age-Related Macular Degeneration?

Age is one of the biggest risk factors for getting AMD. It can start in middle age but becomes more common in people who are over 60. Women tend to suffer from AMD more than men and Caucasians are more prone to it than other races. Smoking can also put a person at more risk for AMD. It also seems to have a genetic basis.

Treatment Options

Once an ophthalmologist diagnoses your condition as age-related macular degeneration, a series of treatment avenues will be suggested. Your ophthalmologist will monitor your vision and central vision field with an Amber grid. A variety of drugs and procedures are used to delay progression of vision loss, but until recently there was no treatment available to restore lost vision.

The new CentraSight treatment involves implanting a miniature telescope (IMT) into the eye. The device is smaller than a pea and can restore vision in people affected by AMD. A study of 76 individuals reported that on average the patients’ vision improved by more than or equal to 2 lines. Although 2 lines doesn’t sound very good, the change made a major difference in the patients’ lives. They went from seeing blurry outlines and shadows to being able to recognize people’s faces. Most of the participants in the study went from complete dependency to being able to perform activities of daily living on their own.

The IMT is implanted in one eye only. The lens of the eye is removed and replaced by the telescope in a procedure that is very similar to the common procedure used to treat cataracts. The other eye is left as-is to provide peripheral vision. In the eye with the telescope, the device captures visual input aimed at the non-functioning central portion of the retina, magnifies it, and diverts it to the functional retina surrounding the damaged central portion. Thus, the patient uses one eye to see what is directly ahead, and the other eye to see the surrounding area. There is a 6 to 12 week adjustment period during which the patient’s brain adapts to the altered method of visual input. An occupational therapist may work with the patient to help the patient adjust to the new way of seeing.

IMTs were approved in 2010 by the FDA for limited use. Only patients who met very strict criteria were allowed to receive them at first, because the FDA wanted to perform a five-year study on the safety of the devices. IMTs are now becoming more widely available.

The Costs of the Surgery are Covered by Medicare

Candidates for IMTs have the following characteristics:

  • Irreversible end-stage AMD, either wet or dry
  • Not responding to drug treatments for AMD
  • Have not had cataract surgery in at least one eye
  • Meet requirements for general health and cornea health

In the News

The following are stories about Dr. Jack Abrams and his team’s treatment of age-related macular degeneration:

Dr. Abrams helps a woman named Yakkar see again (David Magazine): Read the story
Dr. Jack Abrams details technology used to treat retinal disorders (Eyeworld): Read more
A story about the technology Dr. Abrams uses (NBC News)

If you or someone you know are suffering from conditions related to age-related macular degeneration, set up a consultation with Dr. Jack Abrams immediately.