Macular Degeneration


Age-related macular degeneration (AMD) is a chronic condition that causes central vision loss in one or both eyes. The Centers for Disease Control and Prevention estimate that 1.8 million Americans over the age of 50 have AMD, and another 7.3 million are at substantial risk of vision loss from macular degeneration.

That’s the bad news. The good news is that, if discovered and treated early, the progression of AMD can be slowed down significantly. Researchers have even discovered that a healthy diet rich in leafy green vegetables and fish can prevent or delay the onset of AMD.

Macular degeneration causes a breakdown in that part of the eye known as the macula. The macula is a small part of the retina that we use to see fine details. People with AMD may notice distorted vision or a loss in their ability to see objects clearly. Those with the more advanced form of the disease may experience blurriness, a blind spot in the center of their vision, or notice that doorframes and blinds seem wavy or crooked.

There are two forms of Age-Related Macular Degeneration: dry (non-exudative) and wet (exudative). Dry AMD occurs when the light-sensitive cells in the macula gradually break down. Upon examination of patients with dry AMD, an ophthalmologist may also be able to detect the presence of drusen, which are creamy yellow spots under the pigment layer of the macula. These drusen are indicative of a defective metabolism, and serve as a marker for those at risk of developing advanced macular degeneration.

  • Early dry AMD—Patients may have just a few small drusen or one medium-sized drusen.
  • Intermediate dry AMD—Patients may have many medium-sized drusen or one large drusen.
  • Advanced dry AMD—In addition to many large drusen, patients may experience blurred central vision.

Patients who have large drusen in both eyes have a 30 percent chance of developing wet AMD within 10 years. Once the first eye is affected, the risk of the second eye developing a “wet” macula within the next 10 years increases to 50 percent.

Wet macular degeneration occurs when abnormal blood vessels behind the retina start to grow under the macula. These blood vessels can leak blood and fluid, causing the macula to swell and causing rapid damage to the retina.

Wet AMD is the leading cause of severe vision loss among adults age 65 and older. Approximately 200,000 new cases are diagnosed each year. As the baby boomer population ages—the first of the 76 million boomers turned 65 in January 2011—we can expect to see a dramatic increase in the number of patients at risk of developing wet AMD.

Over the years, amazing progress has been made in treating AMD. Just a few years ago, the best we could do for patients with wet AMD was to try to limit visual damage using laser photocoagulation or photodynamic therapy.

All that changed in 2005 with the availability of Avastin and the subsequent FDA approval of Lucentis in 2006. When either medication is injected into the eye, the leakage or growth of the abnormal blood vessels behind the retina stops quickly. Both Avastin and Lucentis are given once a month until the leakage stops and the macula is considered “dry.”

These medications are effective for almost any patient with macular degeneration and they have changed the lives of many of my patients. We can now reassure every patient that there is a 90 percent chance they will maintain the baseline vision they had when they started treatment. There is also a 40 percent chance these medications can even improve their vision.

Early detection and timely treatment are critical for preserving vision. Identifying and monitoring patients with drusen can go a long way toward alleviating suffering from macular degeneration.

For an appointment, please call the offices of retinal specialist Joseph “Jack” Timmes, M.D., 703-560-7797.



***This post is for information purposes only. This posting does not offer medical advice, so nothing in it should be construed as medical advice. The information on this blog/post is only offered for informational purposes. You shouldn’t act or rely on anything in this blog or posting or use it as a substitute for medical advice from a licensed professional. The content of this posting may quickly become outdated, especially due to the nature of the topics covered, which are constantly evolving. The materials and information on this posting/blog are not guaranteed to be correct, complete, or timely. Nothing in this posting/blog and nothing you or I do creates a doctor-patient relationship between you and the blog; between you and me; or between you and Joseph J. Timmes, Jr., M.D., F.A.C.S. or Even if you try to contact me through the blog or post a comment on the blog you are still not creating a doctor-patient relationship. Although, I am a doctor, I’m not YOUR doctor until and unless there is a written agreement specifically providing for a doctor-patient relationship.***
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