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Age Related Macular Degeneration

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Age-related macular degeneration (AMD) is the leading cause of vision loss in people over the age of 50, affecting approximately 1.4 million Canadians. The disease is “macular” because it damages the macula, which is the small, central portion of the retina, the light-sensitive tissue at the back of the eye that facilitates the cellular interactions that make sight possible. The macula is responsible for detailed, central vision, and is important for activities such as reading, driving, and distinguishing faces. While the disease is most commonly associated with ageing—hence “age-related”—there are some forms that can affect younger people and are caused by genetic, environmental, nutritional, and other factors, often simply called “macular degeneration.” In fact, the age-related form of the disease (AMD) involves risk factors outside of age that should be taken into account as well, including smoking, diet/nutrition, race (AMD is more common among Caucasians than African-Americans or Hispanics/Latinos), genetics, and family history of the disease.

A cross-section of the retina showing its different layers, including the layer of RPE cells. The photoreceptors are the elongated shapes standing vertically at the top, which are nourished by the RPE cells below them.

There are two kinds of AMD: dry AMD and wet AMD. The dry form is more common and less severe. It occurs when the macula becomes thinner and, as a result, less capable of supporting the retina’s photoreceptors, the cells that convert light into visual signals. Vision loss occurs as these cells die off.

The wet form of the disease is less common, affecting approximately one in ten people with AMD [1], and is a negative progression from dry AMD. In other words, dry AMD has the potential to develop into wet AMD. In the wet form, blood vessels below the thinning macula swell and begin to grow abnormally; if left untreated, they also begin to leak blood and fluid into the eye (hence “wet”). The cells directly affected by leaking vessels are called retinal pigment epithelial (RPE) cells, which nourish and sustain the sheet of light-sensitive photoreceptors above them. Since RPE cells play such a crucial role, their damage and loss during the advanced stages of wet AMD can entail rapid and severe vision loss. In AMD, such vision loss does not lead to blindness, but in the worst cases it causes significant loss of sight.

The below video provides a basic summary of wet AMD:

Content on this page was written by Dr. Chad Andrews and Dr. Mary Sunderland, and was most recently updated on August 23, 2018.

Do You Have Age-Related Macular Degeneration (AMD)?

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