Macular degeneration causes, symptoms and treatments

Older man squinting to read a magazine

Macular degeneration is a common eye condition that affects millions of people worldwide. It is a progressive disease that causes damage to the macula, which is at the center of the retina and responsible for central vision.

According to ophthalmologist Steven Yeh, MD, the condition is commonly referred to as age-related macular degeneration, or AMD, as it is most often seen in people aged 50 and older. While it can range from mild and asymptomatic to severe – causing small areas of vision to go missing — researchers have come a long way in treating AMD.

“We are fortunate to live in a time where we have treatments that can help restore and improve vision and prevent vision loss,” Dr. Yeh says.

Causes

The exact cause of AMD is unknown. However, several factors can increase your risk of developing it, including:

  • Age: AMD is more common in people over 50 years old
  • Genetics: If you have a family history of AMD, you are more likely to develop this condition
  • Smoking: Smoking can increase your risk of developing AMD

Symptoms

The symptoms of macular degeneration can vary depending on the type you have. There are two types of macular degeneration: dry and wet.

  • Dry macular degeneration: This type of AMD is more common and has less severe symptoms, including:
    • Blurred vision
    • Difficulty reading
    • Visual distortions, such as straight lines seeming bent
  • Wet macular degeneration: This type of AMD is less common and has more severe symptoms, including:
    • Distorted vision
    • Blind spots in your central vision
    • Rapid loss of central vision

Treatment

There are several treatment options that can help slow down the progression of macular degeneration and improve vision. These include:

  • Nutrition: Certain vitamins and minerals, such as antioxidants and zinc, as well as foods that are high in omega-3 fatty acids, such as fresh fish (and particularly salmon), can help slow the progression of macular degeneration
  • AREDS 2: A dietary supplement called AREDS 2 can help slow the progression of dry macular degeneration and make it less likely to progress to wet macular degeneration
  • Pegcetacoplan: This drug was approved in February 2023, the first of its kind to reduce the rate of progression of a form of advanced dry macular degeneration called geographic atrophy
  • Anti-VEGF drugs: Used to treat wet macular degeneration, these drugs are regularly injected to slow or stop damage and may even improve vision

A reason for optimism

Advancements continue in the treatment of AMD. A University of Nebraska Medical Center clinical trial is currently studying the effect of gene therapy on wet macular degeneration.

“If a patient has wet macular degeneration, they’ll often need injections monthly or every two months,” Dr. Yeh says. “In this trial, we’re looking at whether we can introduce the gene that makes this medication so that the eye makes the medication within the eye itself. That reduces the number of injections they need over long-term follow-up, which we're excited about.”

Dr. Yeh says the advent of new therapies for AMD and the willingness of funders to support research, can provide hope to patients.

“Sometimes they hear the term macular degeneration, and may think, ‘How long do I have to see?’ It's a very scary place to be,” Dr. Yeh says. “I find that sometimes it can be therapeutic to know there are things they can do to reduce the risk of progression, treatments available and research studying treatment on the horizon. There are reasons to be optimistic about the direction of this field.”

Early detection and treatment are important in managing AMD. If you have vision concerns, call 402.559.2020 to schedule an appointment today. Evaluation and treatment options are available through the Truhlsen Eye Institute with a retina service provided by Dr. Yeh; Chris Conrady, MD, PhD; Martin Worrall, MD; Courtney Hellman, MD, and Pukhraj Rishi, MBBS, MS, FASRS.

Patients who have a history of wet macular degeneration and are interested in participating in the clinical trial can email Clinical Research Supervisor Tolulope Fashina, MD, MPH at tfashina@unmc.edu.