Understanding age-related macular degeneration (AMD)

As February marks Age-Related Macular Degeneration (AMD) Awareness Month, we’re shining a light on this challenging condition that affects so many around the world.

Dr. Alex Kaplan, who co-leads the Medical Retina Clinic at the Donald K. Johnson Eye Institute, shares his valuable insights about AMD and the innovative treatments available right here at UHN.

As we age, our vision can play tricks on us, especially when it comes to age-related macular degeneration, or AMD. An eye disease that can blur your central vision, AMD is a leading cause of vision loss for older adults and can make daily activities like reading, driving, and even recognizing familiar faces a constant challenge.

There are two types of AMD:

1. Dry AMD (also called atrophic AMD) is the most common form of the disease, and usually progresses slowly over several years.

2. Wet AMD (also called neovascular AMD) is less common, usually causing sudden vision loss due to the growth of abnormal blood vessels in the back of the eye. Any stage of dry AMD can turn into wet AMD.

AMD is the leading cause of serious, permanent vision loss in people over 50. Affecting more than 200 million worldwide, this number is expected to increase to 288 million by 2040. As the prevalence of age-related macular degeneration rises with age, women face a higher risk than men in part due to their longer life expectancy.

AMD results from a combination of genetic, environmental, and lifestyle factors that damage the macula – the central part of the retina responsible for sharp, detailed vision. While aging is the primary risk factor, certain lifestyle choices can significantly increase the likelihood of developing AMD.

A diet high in saturated fats, excess weight, smoking, and uncontrolled high blood pressure can all contribute to the condition. However, the good news is that many of these risk factors are within your control. Adopting a healthier lifestyle – such as eating a nutrient-rich diet with plenty of leafy greens, staying physically active, and managing blood sugar, blood pressure, and cholesterol – can help protect your vision and slow the progression of AMD.

Annual eye exams are essential for detecting macular degeneration, as the condition can progress silently without noticeable symptoms in its early stages. Regular screenings allow eye care professionals to identify changes early, when interventions are most effective.

However, if you experience sudden visual disturbances – such as straight lines appearing wavy or unexpected blurriness – it is important to seek immediate evaluation by an eye specialist rather than waiting for your next scheduled appointment.

The treatment for age-related macular degeneration (AMD) depends on the type and stage of the disease.

For dry AMD, there is no cure, but lifestyle changes and certain nutritional supplements (such as the AREDS2 formula) may help slow progression. These supplements contain antioxidants, zinc, and lutein, which support retinal health. Regular monitoring and healthy habits, including a Mediterranean diet and smoking cessation, are also recommended.

For wet AMD, treatment focuses on halting or reversing vision loss. The primary approach involves anti-VEGF injections, which reduce abnormal blood vessel growth and leakage in the retina. These injections, administered directly into the eye, can help preserve vision and, in some cases, improve it.

Early detection and timely intervention are critical for maintaining vision and slowing disease progression.

The Donald K. Johnson Eye Institute at UHN is a national leader in both clinical care and research, providing patients with the latest diagnostic tools and treatments for retinal diseases.

The service brings together an exceptional team of physicians, surgeons, researchers, fellows, residents and medical students that makes it a leading force in ophthalmology. In addition to delivering exceptional patient care, we are actively engaged in ground breaking research. One exciting study, for which we are currently recruiting patients, explores a new method for monitoring and treating wet AMD. This study is testing whether using a home monitoring device for daily eye scans can help personalize treatment and improve vision outcomes compared to the standard in-clinic treatment schedule. If successful, this approach could reduce the number of injections needed while still keeping the disease under control.

For more information on current research and treatment options, please visit the Donald K. Johnson Eye Institute website. If you or someone you know has wet AMD and is interested in participating, please reach out to the Donald K. Johnson Eye Institute at [email protected] for more details and information about the referral process.