Our eyes are remarkable organs that allow us to experience the world around us, but as we age, certain conditions can affect our vision. One such condition is dry age-related macular degeneration (AMD). In this blog post, we’ll delve into what dry AMD is, its causes, symptoms, and available treatments, all in simple and easy-to-understand terms.

What is Dry Age-Related Macular Degeneration?

Dry AMD is a common eye condition that primarily affects older adults. It occurs when the macula, a small, central part of the retina deteriorates over time.  The macula is responsible for detailed vision and is essential for activities including reading, driving and recognizing faces.  AMD is the leading cause of significant vision loss in people over age 50 in developed countries.

Causes and Risk Factors:

While the exact cause of dry AMD isn’t fully understood, several factors contribute to its development.  Age is the strongest risk factor.  Genetics and family history of AMD also play a role.  Caucasian race and cigarette smoking are also risk factors for developing AMD.

States of Dry AMD:

Dry AMD can be divided into early, intermediate and late/advanced stages.  Early stage Dry AMD is characterized by small deposits under the retina called drusen.  Intermediate stage dry AMD is characterized by growth of drusen and areas of atrophy or thinning of the retina.  Late stage Dry AMD, also known as geographic atrophy (GA), occurs when there is significant atrophy to the retina.  GA typically starts developing in the region next to the center of the macula and as the geographic atrophy increases in size vision loss may occur.

Symptoms:

Early stages of dry AMD might not produce noticeable symptoms, but as the condition progresses, patients might experience:

1. Blurred or distorted central vision: Straight lines might appear wavy, and objects may seem blurry.
2. Decreased color perception: Colors might appear less vibrant or faded.
3. Difficulty reading or recognizing faces: The central vision loss affects activities that require sharp, detailed vision.
4. Need for brighter light: As AMD progresses, patients may require more light for reading or other close-up tasks.
5. Dark or empty spots: Patients might notice dark or empty areas in their central vision.

Diagnosis:

If you experience any of these symptoms, it’s crucial to visit an eye specialist. An eye specialist can conduct a comprehensive eye exam, including a visual acuity test and dilated eye exam. If necessary you may be referred to a retina specialist. Additionally, several types of non-invasive imaging tests may be performed to diagnose AMD including optical coherence tomography (OCT) and Fundus Auto Fluorescence imaging (FAF). Early detection is key to managing the progression of AMD.

Treatment and Management:

While there is currently no cure for dry AMD, there are several strategies to help manage the condition and slow geographic atrophy progression.

1. Nutritional supplements: Studies have shown that certain vitamins and minerals can slow the progression of AMD.  The AREDS2 formula is available over the counter and contains Vitamin C, Vitamin E, Zinc, Copper, Zeaxanthin, and Lutein.  Consult your doctor before starting any supplements.
2. Healthy lifestyle choices: Quitting smoking and maintaining a balanced diet rich in antioxidants and omega-3 fatty acids can lower your risk for progression.
3. Complement Factor Inhibitors are new treatment options for Geographic Atrophy. Pegetacoplan (Syfovre) was approved by the FDA for the treatment of Geographic Atrophy in February 2023. Avacincaptad Pegol (Izervay) was approved by the FDA for the treatment of Geographic Atrophy in August 2023.  Both medications are given as an injection into the eye every 1-2 months and have been shown to slow the progression of geographic atrophy.
4. Low vision aids: Devices such as magnifiers, special glasses, and smartphone apps can help improve daily tasks affected by central vision loss.

Conclusion:

Dry age-related macular degeneration is a common eye condition that affects many older adults. While it can lead to central vision loss and impact daily activities, early detection and proper management can significantly slow its progression. By making healthy lifestyle choices, seeking regular eye check-ups, and following your doctor’s recommendations, you can take control of your eye health and maintain a high quality of life even in the presence of dry AMD. Remember, your eyes are invaluable, and taking care of them is a step towards a brighter future.

Arjun B. Sood, MD