Macular Degeneration (AMD)

Understanding Macular Degeneration

The macula is the central part of the retina responsible for sharp, detailed, central vision. It has the highest concentration of cone cells and allows you to read, drive, and recognize faces. When you’re reading this page, you’re using your macula.

As we age, some people develop damage or thinning of the macula — this is called age-related macular degeneration (AMD). Aging, genetics, oxidative stress, poor diet, smoking, UV light exposure, and reduced circulation can all contribute to this condition.

Types of Macular Degeneration: Dry vs. Wet

Dry (Non-Neovascular) AMD

• Accounts for 85–90% of cases.

• Caused by gradual damage to the retinal pigment epithelium (RPE) — the cells that support the macula.

• Changes may include:

  • Drusen (yellow deposits under the retina),

  • Pigment changes, or

  • Geographic atrophy (GA) — areas where RPE cells and photoreceptors are lost.

These changes develop gradually over years and can cause slow vision loss.

AREDS2 Supplements

Large clinical trials called AREDS (Age-Related Eye Disease Study) and AREDS2 proved that specific vitamins can help reduce progression in certain types of moderate to advanced dry AMD.
AREDS2 formula includes:

• Vitamin C

• Vitamin E

• Zinc and copper

• Lutein and zeaxanthin (replaced beta-carotene due to lung cancer risk in smokers)
  Omega-3 supplements did not show significant benefit except in a small group.

New Treatment for Advanced Dry AMD (Geographic Atrophy)

Until recently, no treatments could slow geographic atrophy. Now, FDA-approved therapies can help:

• SYFOVRE® (pegcetacoplan) – an injectable treatment that slows the progression of GA by targeting the complement system in the retina.

• Additional therapies like Izervay® (avacincaptad pegol) are also available in certain cases.

These treatments do not restore lost vision but can help preserve what remains by slowing the disease.

Wet (Neovascular) AMD

Wet AMD occurs when abnormal blood vessels grow under the retina and leak blood or fluid, leading to faster and more severe vision loss.

• About 10–15% of patients with dry AMD progress to wet AMD.

• Symptoms include sudden blurry vision, wavy lines, or dark/blank spots (often noticed on an Amsler grid or while reading).

Treatment for Wet AMD

Prompt referral to a retinal specialist is essential. Treatment involves anti-VEGF injections that stop abnormal blood vessels from leaking.

Current options include:

• Avastin®, Lucentis®, Eylea® (aflibercept)

• Eylea HD (8 mg) – a newer, higher-dose formulation that may allow fewer injections while maintaining effectiveness

• Biosimilars, such as Byooviz® (ranibizumab-nuna), are now available and offer similar results at lower cost

Longer-acting medications, implants, and gene therapies are also being studied to reduce treatment frequency.

Reducing Your Risk and Protecting Your Vision

While genetics play a major role, several lifestyle choices can help slow progression:

✔ Eat a diet rich in leafy greens, fruits, colorful vegetables, and omega-3s (fish)
✔ Take AREDS2 supplements if recommended by your eye doctor
✔ Stop smoking — smoking doubles the risk of AMD progression
✔ Exercise regularly and maintain healthy blood pressure and cholesterol levels
✔ Wear UV-protective sunglasses outdoors
✔ Use an Amsler grid at home to monitor vision changes
✔ Keep regular appointments with your ophthalmologist or retina specialist

In Summary

• Dry AMD progresses slowly; AREDS2 vitamins and lifestyle changes can help.

• Geographic atrophy now has treatment options like SYFOVRE® to slow vision loss.

• Wet AMD requires urgent treatment with anti-VEGF injections. Newer options like Eylea HD and biosimilars offer improved convenience and affordability.

• Early detection and consistent follow-up are the best ways to protect your sight.