Age-Related Macular Degeneration
Age-related macular degeneration, or AMD, is the leading cause of blindness in people 55 and older in developed countries. The condition can lead to significant loss of central vision.
What is Age-Related Macular Degeneration?
Age-related macular degeneration, commonly referred to as AMD, is a retinal degenerative disease that causes a progressive loss of central vision. AMD is the most common cause of blindness in individuals over the age of 55 in developed countries. More than 10 million people in the United States have AMD.
The retina is packed with photoreceptors, the cells that enable us to see. Photoreceptors convert light into electrical impulses, which are transferred to the brain via the optic nerve and converted into the images we see. The macula is a small region in the center of the retina that’s rich in cones, the photoreceptors that enable a person to perceive fine details (e.g., read, recognize faces), colors, and objects in daylight or lighted conditions. Central vision loss from AMD occurs when cone photoreceptors in the macula degenerate.
The greatest risk factors for AMD are aging and smoking. An unhealthy diet and unprotected sunlight exposure can also increase AMD risk. Genetics is also a risk factor.
Age-Related Macular Degeneration Explainer Video
Symptoms
People with AMD may first notice a blurring of central vision, especially during tasks such as reading or sewing. Also, straight lines may appear distorted or warped. As the disease progresses, blind spots may form within the central field of vision. In most cases, if one eye has AMD, the other eye has the condition or is at risk of developing it. The extent of central vision loss varies and can depend on the type of AMD — dry or wet.
Most people with AMD start off with the dry form. In many cases, people will not experience vision loss from the condition. In some cases, dry AMD can progress and cause varying degrees of central vision loss. Advanced dry AMD is sometimes referred to as geographic atrophy.
The hallmark of dry AMD is the accumulation of tiny protein and fat deposits known as drusen underneath the retina. Many people have drusen, which do not affect vision. However, certain types of drusen may interfere with the health of the macula, causing progressive degeneration of the photoreceptor cells and vision loss.
About 10-15 percent of people with dry AMD will develop the wet form in one or both eyes. With wet AMD, abnormal blood vessels grow beneath the macula. These vessels leak blood and fluid into the macula and damage photoreceptor cells. Wet AMD often progresses rapidly and causes substantial loss of central vision, if left untreated.
Inheritance
Researchers have discovered that genetics can play a role in AMD risk. In 2005, three groups of researchers, including a team funded by the Foundation, discovered that a gene called Complement Factor H (CFH) is linked to at least 50 percent of all cases of AMD. Since that breakthrough, researchers have found several other genes linked to AMD. CFH and many of the other AMD genes are involved in the innate immune system, which fights off infection. Scientists believe that over activity of the innate immune system increases AMD risk.
While genetics can play a role in AMD risk, people with low risk genetics can still get the condition. Likewise, people with high risk genetics may not get AMD.
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Treatment
The Age-Related Eye Disease Study (AREDS) — a landmark investigation conducted by the National Eye Institute (NEI) — determined that a specific antioxidant supplementation can slow the progression of AMD. The AREDS2 formulation is an over-the-counter antioxidant supplement recommended for people who are at risk of developing more advanced forms of dry or wet AMD.
The AREDS2 formulation contains the following nutrients:
500 milligrams (mg) of vitamin C
400 international units of vitamin E
80 mg zinc as zinc oxide
2 mg copper as cupric oxide
10 mg lutein and 2 mg zeaxanthin
Several therapies are now available for the wet form of AMD. Most involve regular ocular injections to halt the growth of leaky, vision-robbing blood vessels.
EYLEA™ (alflibercept) — Regeneron’s wet AMD treatment, Eylea, blocks the development of unhealthy blood vessels underneath the retina. Regeneron reports that in clinical trials, Eylea treated wet AMD as effectively as Lucentis, but with fewer intraocular injections. Typically, patients are treated monthly with Eylea for three months and every other month thereafter. Eylea was FDA approved in 2011.
Lucentis™ (ranibizumab) — Developed by Genentech, Lucentis is effective in reducing the risk of losing vision from the abnormal blood vessel growth under the retina associated with wet AMD. The treatment was approved by the FDA and made available in 2006. A two-year study showed that 95 percent of people with wet AMD who received monthly injections of Lucentis experienced no significant loss in visual acuity from baseline. Genentech also reported moderate visual improvement in 24.8 percent of participants treated with a 0.3 mg dose of Lucentis and 33.8 percent of participants treated with a 0.5 mg dose.
A colorectal-cancer drug called Avastin® — a drug similar to Lucentis — has been used “off-label” by some ophthalmologists to treat wet AMD. The NEI completed a large-scale, two-year clinical study comparing Avastin and Lucentis. Results of the study showed that the drugs were similar in safety and efficacy.
Next Section
Read the Most Recent Research on Age-Related Macular Degeneration
Latest News
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Luxa Reports Vision Improvements in Clinical Trial of its RPE Stem Cell Therapy for Dry AMD
Research NewsPatients with worse vision at trial enrollment had greatest vision improvements.
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Neurotech’s Encapsulated Cell Technology Receives FDA Approval for Treatment of MacTel
Research NewsThe technology was previously funded by the Foundation for the treatment of retinitis pigmentosa and dry age-related macular degeneration.
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Adverum Advancing Wet AMD Gene Therapy into Phase 3 Clinical Trials
Research NewsIn earlier clinical trials, the emerging gene therapy greatly reduced the treatment burden associated with injections of approved anti-VEGF therapies.
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4DMT Planning Phase 3 Clinical Trial for Wet AMD Gene Therapy
Research NewsKnown as 4D-150, the wet AMD gene therapy performed well in a Phase 2b clinical trial.
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Therapeutic Targets for Dry AMD: A Foundation Fighting Blindness Webinar for Eye Care Professionals
Foundation NewsThe free, online event will feature a lecture from David Boyer, MD, a Senior Partner at Retina-Vitreous Associates Medical Group and dry AMD expert.
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The Retinal Degeneration Fund invests in a $78M Series B for Perceive Biotherapeutics
In the PressThe investment supports the clinical development of two novel programs, both with the aim of being protective against vision loss.
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Economic Burden of Ageing Eye conditions estimated on the scale of up to billions in USA, Germany and Bulgaria
In the PressOn World Sight Day 2022, Retina International is presenting data from a report on its study into the Socio-economic Impact of late-stage age-related macular degeneration (AMD) in Bulgaria, Germany, and USA.
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COVID-19 Resources
Foundation NewsThe Foundation Fighting Blindness is closely monitoring the COVID-19 situation and its impact on the IRD community.
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ProQR Therapeutics Teams Up with the Foundation Fighting Blindness and Blueprint Genetics to Support the My Retina Tracker® Program for People Living with Inherited Retinal Diseases
Foundation NewsMy Retina Tracker Program is the highest volume IRD genetic testing program in the U.S.
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Blueprint Genetics, InformedDNA and the Foundation Fighting Blindness launch an open access program for patients with inherited retinal disease in the United States
Foundation NewsThe program will offer patients with inherited retinal disease no-cost genetic testing and genetic counseling in the United States. Look for updated information on how to participate to be posted in mid-October, with program registration starting shortly thereafter.
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Foundation Fighting Blindness Investing Nearly $6.5 Million in New Grants
Foundation NewsThe newly funded research efforts include several therapies that have strong potential to treat a wide range of inherited retinal diseases.
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Sustained Suppression of VEGF: Looking Forward and Looking Back
Research NewsThe results of the LADDER trial demonstrate a major step forward but introduce many questions.
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Gene Therapy Trials for Wet Age-Related Macular Degeneration
Research NewsAfter a series of failed trials, current research suggests that the next generation of gene therapies for wet age-related macular degeneration holds promise. Learn how investigators are inducing the body’s cells to administer their own therapeutic response to disease activity.
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Foundation Fighting Blindness Endorses 'Eye Bonds' Legislation
Foundation NewsBipartisan Bill Will Stimulate Up to $1 Billion in New Funding for Blindness Research
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The Foundation Fighting Blindness and Dr. H. James & Carole Free Collaborate to Combat AMD
Foundation NewsAge-related macular degeneration (AMD) is the leading cause of blindness for people over 50 years of age in developed countries.
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Foundation Fighting Blindness Urges Congress to Pass ‘Eye-Bonds’ Legislation
Foundation NewsBill Introduced in U.S. House Would Speed Up Cures for Blindness
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Foundation Fighting Blindness and CheckedUp® Partner to Educate Retinal-Disease Patients About Research, Resources, and Emerging Therapies During Doctor Visits
Foundation NewsThe Foundation Fighting Blindness (the Foundation) and CheckedUp have formed a collaborative partnership to deliver patient-friendly diagnostic and disease-management information to people with retinal diseases such as age-related macular degeneration, retinitis pigmentosa, and Stargardt disease during their visits to eye doctors.
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Researchers Take another Critical Step toward Using Skin Cells to Treat Retinal Disease
Foundation NewsA research team funded by the Foundation Fighting Blindness used an innovative repair technique to correct the disease-causing genetic defect in stem cells derived from a person’s skin — stem cells that hold the potential to treat their retinal degenerative condition.
Podcasts
Eye on the Cure Podcast | Episode 78: Dr. Sheldon Rowan
Dr. Rowan talks about the impact of the glycemic index, microbiome, and diet on the development of age-related macular degeneration and optimization of overall retinal health.
