Macular degeneration | |
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Other names | Age-related macular degeneration |
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Picture of the back of the eye showing intermediate age-related macular degeneration | |
Specialty | Ophthalmology, optometry |
Symptoms | Blurred or no vision in the center of the visual field[1] |
Complications | Visual hallucinations[1] |
Usual onset | Older people[1] |
Types | Early, intermediate, late[1] |
Causes | Damage to the macula of the retina[1] |
Risk factors | Genetics, smoking[1] |
Diagnostic method | Eye examination[1] |
Prevention | Exercising, eating well, not smoking[1] |
Treatment | Anti-VEGF medication injected into the eye, laser coagulation, photodynamic therapy[1] |
Frequency | 8.7% global prevalence in 2020[2] |
Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred or no vision in the center of the visual field.[1] Early on there are often no symptoms.[1] Over time, however, some people experience a gradual worsening of vision that may affect one or both eyes.[1] While it does not result in complete blindness, loss of central vision can make it hard to recognize faces, drive, read, or perform other activities of daily life.[1] Visual hallucinations may also occur.[1]
Macular degeneration typically occurs in older people,[1] and is caused by damage to the macula of the retina.[1] Genetic factors and smoking may play a role.[1] The condition is diagnosed through a complete eye exam.[1] Severity is divided into early, intermediate, and late types.[1] The late type is additionally divided into "dry" and "wet" forms, with the dry form making up 90% of cases.[1][3]
The difference between the two forms is categorized by the change in the macula. Those with dry form AMD have drusen, cellular debris in their macula that gradually damages light-sensitive cells and leads to vision loss. In wet form AMD, blood vessels grow under the macula, causing blood and fluid to leak into the retina.[4]
Exercising, eating well, and not smoking may reduce the risk of macular degeneration.[1] There is no cure or treatment that restores the vision already lost.[1] In the wet form, anti-VEGF medication injected into the eye or, less commonly, laser coagulation or photodynamic therapy may slow worsening.[1] Dietary antioxidant vitamins, minerals, and carotenoids do not appear to affect the onset;[5] however, dietary supplements may slow the progression in those who already have the disease.[5]
Age-related macular degeneration is a main cause of central blindness among the working-aged population worldwide.[6] As of 2022, it affects more than 200 million people globally with the prevalence expected to increase to 300 million people by 2040 as the proportion of elderly persons in the population increases.[2][7] It affects females more frequently than males, and it is more common in those of European or North American ancestry.[2][8] In 2013, it was the fourth most common cause of blindness, after cataracts, preterm birth, and glaucoma.[9] It most commonly occurs in people over the age of fifty and in the United States is the most common cause of vision loss in this age group.[1][3] About 0.4% of people between 50 and 60 have the disease, while it occurs in 0.7% of people 60 to 70, 2.3% of those 70 to 80, and nearly 12% of people over 80 years old.[3]