Dry Macular Degeneration

Dry age-related macular degeneration (AMD) is the most common form of macular degeneration characterized by thinning and drying of retina.

The central area of vision is limited and the patient may have fluctuating vision. It often starts in one eye and then proceeds to the other.

Dry AMD progresses slowly in three different phases – early, immediate, and advanced. This form of macular degeneration may lead to vision loss.

It is more commonly seen in people above 65 years. As the disease progresses, it starts affecting the ability to read and recognize faces.

Early detection and treatment are very important in preventing vision loss.

Dry age-related macular degeneration (AMD) may remain asymptomatic during the early stages. Symptoms start appearing when it affects both the eyes. The healthy eye often makes up for the loss, when only one eye is affected by AMD. The first sign of dry AMD is the formation of dim, blurry spot in the middle of vision. Retinal degeneration may also affect the color perception considerably.

Deterioration of retina due to macular degeneration is associated with formation of yellow deposits called drusen. These small deposits are formed under the macula, leading to thinning and drying of the retina. This affects the central vision, and the loss of function depends on the location and extent of retinal thinning.

Some other symptoms include:

• Blurred vision
• Distortions in vision – straight lines are seen as bent
• Difficulty to read in low light levels
• Reduced intensity of colors

Dry macular degeneration may develop into wet macular degeneration over a period of time.

The actual cause of dry age-related macular degeneration (AMD) is not known. Both hereditary and environmental factors are implied in the development of this condition.

It is more commonly found in older adults. It is the leading cause of vision loss as it progresses. It is seen to run in families, passing from parents to children.

Some other risk factors for dry AMD are:

• Smoking
• Hypertension
• High cholesterol
• Obesity
• Fair skin
• Cardiovascular disease
• Light eye color

Complete eye examination is the first step in diagnosis of dry age-related macular degeneration (AMD). Review of medical and family history helps in assessing the risk factors.

Presence of drusen at the back of eye is indicative of dry AMD. These yellow spots are revealed by examining the eye after dilation of pupil.

Amsler grid test helps to check for issues in the central vision.

Patients with AMD see the straight lines of the grid as distorted or bent. Retinal changes are noted with fluorescein angiography. In this procedure, colored dye is injected to trace the blood vessels of the eye. Images of the eye with the dye reveal the changes in retina and blood vessels.

Another dye-based diagnostic technique is indocyanine green angiography. This procedure is used to confirm the diagnosis or to detect specific types of macular degeneration. Cross-sectional images of retina are produced by optical coherence tomography. These images show thinning and swelling of the retinal layer.

There is no cure for dry age-related macular degeneration (AMD). Treatment aids in slowing down the progression of the disease. The disease progresses slowly, and most of the patients are able to lead a normal life without much distress. 

Dry AMD affects the central vision, leading to issues in reading, driving, and recognizing faces. Peripheral vision often remains the same without changes. Vision rehabilitation specialist helps in adapting to the changes in vision.

Surgical implantation of telescopic lens is another much sought after treatment option for dry AMD. Telescopic lens helps to improve the field of vision, both close and long distance vision.

High dose formulations of antioxidants and zinc helps to reducing vision loss.

There is no way to prevent dry age-related macular degeneration (AMD).

Disease progression can be slowed down by:

• Quitting smoking
• Eating plenty of green leafy vegetables
• Taking multivitamin supplements
• Taking fish oil supplements
• Maintaining healthy weight
• Keeping levels of cholesterol and blood pressure under control
• Having regular eye checkups

Diet high in carotenoids, blue berries, cherries, and fiber are alternative remedies used for dry macular degeneration.

Antioxidants, astaxanthin, and zeaxanthin are also suggested for preventing degenerative damage by AMD.

Lifestyle changes help to control the progression of dry macular degeneration.

Healthy diet with plenty of fruits and vegetables, unsaturated fats, whole grains, and omega-3 fatty acids are also helpful.

Try out ways for using the remaining vision. Counselling can also help in living with limited vision due to AMD.

The main complication of dry macular degeneration is the progression to more severe wet AMD.

Wet form of AMD cause rapid loss of vision.