Dry Age Related Macular Degeneration

Overview of mild, moderate and severe dry AMD including drusen and geographic atrophy.

What are Drusen?

The hallmark of dry AMD is macular drusen (see photo). Drusen are made up of lipids, a type of fatty protein. They may be the result of a failure of the eye to dispose of waste products that are produced when the photoreceptors of the eye drop off older parts of the cell. There are several types of drusen with different levels of risk. Drusen can be small, hard and scattered far apart from each other. They are round and distinct. This type may not create vision problems for a long time and may not even be an indication of macular degeneration. Some drusen can become larger, softer and closer together. Their edges are less distinct. When they get to that stage, there is a greater risk for developing wet macular degeneration and more severe vision loss. They can also disrupt the layers of the retina and may lead to retinal pigment epithelium detachment (PED). Your doctor can see these drusen during a dilated eye exam, even if you are not aware of a vision change. That is one reason why regular eye exams are so important. If you have the larger, soft drusen, your doctor will probably want you to come into the office for check-ups more often. If they do lead to wet macular degeneration, early treatment is essential.

What is Geographic Atrophy?

Geographic atrophy occurs when the photoreceptors (seeing part of the retina) no longer works and the patient develops a blind spot or spot of poor vision in the macula (see photo). Geographic atrophy (GA) is considered the late stage of the dry form of Age-related Macular Degeneration (AMD). It only occurs in about 10 percent of dry AMD patients. GA is usually a sharply delineated round or oval area of hypopigmentation, or apparent absence of the retinal pigment epithelium (RPE), in which choroidal vessels are more visible than in surrounding areas The most common sequence of events leading to GA is the progression of a large drusen to hyperpigmentation, followed by regression of the drusen, hypopigmentation and ultimately RPE cell death, with development of an atrophic area of retina and underlying choriocapillaris, sometimes preceded by the appearance of refractile deposits. This usually takes more than 5 years. Less frequently, GA can follow a drusenoid RPE detachment, regression of a CNV membrane or a RPE rupture. As other forms of late AMD, GA tends to be bilateral (over 50% of cases) and there is high symmetry between eyes for total atrophic area, presence of peripapillary atrophy and enlargement rate. GA often first develops surrounding the fovea, sparing the central area.

What is Progressive Geographic Atrophy?

Geographic atrophy can progress and lead to vision loss. When people with dry AMD lose vision, it is almost always from geographic atrophy. The animated image with this text shows growing geographic atrophy over 3 years in an 86 year old patient. This person is fortunate to have good vision because the dark areas of geographic atrophy are not yet affecting the central vision. Given the progression, the central vision will likely be affected within about 10 years. The images are fundus autofluorescent images that are useful for following geographic atrophy because the atrophy shows up as well delineated dark spots.

What is Pattern Dystrophy?

Pattern dystrophy is a type of dry age-related macular degeneration that involves mostly the very center of the macula. There are several types of pattern dystrophy. The image with this text is of a patient with adult vitelliform macular dystrophy. The image shows the buildup of abnormal deposits under the retina in the center of the macula. Unlike typical dry macular degeneration where the buildup of material is below the retinal pigment epithelium, in pattern dystrophy, the buildup of material is above the pigment epithelium and directly beneath the retina (see asterisks on image). Pattern dysrophy is autosomal dominant, usually presents at a younger age than typical dry AMD, and usually does not progress to wet AMD.

Pattern Dystrophy

What about Diet?

Patients who consume fruits and vegetables have the lowest rates of macular degeneration development. Lutein, a carotenoid pigment found exclusively in fruit and vegetables, serves as the primary protector of the eye. Lutein accumulates in the macula and likely blocks the damage caused by sunlight, one proposed cause of AMD. Fruits and vegetables are also high in antioxidant vitamins such as Beta- carotene, Vitamin E, and Vitamin C. Green leafy vegetables and other colorful foods like kiwi, squash, red grapes, and corn are good sources of Lutein. Other dietary habits have been shown to increase the risk of AMD. Individuals with a higher percentage of vegetable, monounsaturated, and polyunsaturated fats in their diet have higher rates of Wet AMD development. Diets rich in Omega 3 fatty acids reduce the risk of vision loss. These are found naturally in cold-water fish such as salmon and tuna, and in flaxseeds and flaxseed oil. Two servings of fish per week are adequate.

What about Vitamins?

The Age-Related Eye Disease Study 2 showed that among people at high risk for developing late-stage, or wet, macular degeneration (such as those who have large amounts of drusen or who have significant vision loss in at least one eye), taking a dietary supplement of vitamin C, vitamin E, lutein and zeaxanthin, along with zinc, lowered the risk of macular degeneration progressing to advanced stages by at least 25 percent. The supplements did not appear to provide a benefit for people with minimal macular degeneration or people without evidence of the disease during the course of the study. These vitamins contain a mixture of Vitamins C and E, Lutein, Zeaxanthin, Zing and Copper. Another large study in women showed a benefit from taking folic acid and vitamins B6 and B12. It is very important to remember that vitamin supplements are not a cure for macular degeneration, nor will they give you back vision that you may have already lost from the disease. However, these supplements do play a key role in helping some people at high risk for developing advanced (wet) AMD to maintain their vision, or slow down the progression of the disease.

What about Amsler Grid?

One of the first signs of macular degeneration can be wavy, broken or distorted lines OR a blurred or missing area of vision. The Amsler Grid can help you spot these early. Early detection of wet AMD is critical because laser treatment, when indicated, is most successful when performed before damage occurs. Since dry AMD can lead to development of wet AMD, most patients should use the Amsler Grid. Check with your eye doctor to find out how often you should use this test. Wear your reading glasses, if you normally use them and sit about 14 inches away from the screen. Check one eye at a time. Cover the eye you are not testing. Focus on the dark dot in the center of the grid. While looking at this dot, you still should be aware of the lines of the grid. Notice if any of the lines are distorted or broken or if there are blurred areas.

Download Amsler Grid

Dry Macular Degeneration NEWS

Below are current articles from a Google News Feed on Dry Macular Degeneration


Nasdaq

How is the Age-Related Macular Degeneration Space Faring Now?
Nasdaq
Per American Academy of Ophthalmology, dry AMD occurs when parts of the macula get thinner with age and tiny clumps of protein grow. Although dry AMD is the most common form of AMD, there are no approved therapies in the United States and Europe to ...

and more »

Chicago Sun-Times

Ask the Doctors: Some risk factors for macular degeneration
Chicago Sun-Times
Dry AMD is much more common than wet AMD, constituting 85 to 90 percent of all cases. There has been no single cause established for dry AMD, which occurs when a mixture of protein and fat (called drusen) builds up behind the retinal layers. Dry AMD ...

and more »

Pocono Record

Macular degeneration best when caught, treated early
Pocono Record
“Most patients get signs of dry macular degeneration before wet develops, but dry macular degeneration does not always develop into wet,” Pravak says. “Wet macular degeneration can develop where dry has not been detected, but that's not too common.”.


Bel Marra Health

New test for age-related macular degeneration could help identify the disease sooner
Bel Marra Health
The current treatment for wet AMD involves the utilization of a medication called anti-vascular endothelial growth factor. This drug helps reduce the number of abnormal blood vessels within the retina. The problem arises with its method of use, as wet ...


BIOPHYTIS filed IND application for approval by FDA of SARA-INT ...
Markets Insider
Protocol has been adjusted according to EMA Scientific AdviceFiling in Europe will be done in the coming days PARIS, Sept. 25, 2017 (GLOBE NEWSWIRE) ...

and more »

BIOPHYTIS filed IND application for approval by FDA of SARA-INT Phase 2b study of Sarconeos in Sarcopenia
GlobeNewswire (press release)
Specifically, the company is advancing two lead products into mid-stage clinical testing this year: Sarconeos (BIO101) to treat sarcopenic obesity and Macuneos (BIO201) to treat dry age-related macular degeneration (AMD). The business model of ...


Ophthalmology Pipeline Database - 2017 Update - Research and ...
Business Wire (press release)
The "Ophthalmology Pipeline Database - 2017 Update" report has been added to Research and Markets' offering. Ophthalmology Pipeline Highligh.

and more »

Age–Related Macular Degeneration Market — Global Industry Insights, Trends, Outlook, and Opportunity Analysis ...
Medgadget (blog)
However, restraints that are likely to hamper the growth of age-related macular degeneration market include high cost of the treatment, growing off –label use and stringent regulatory policies. For instance, single injection of anti-vascular ...

and more »

Macular Degeneration (AMD) & Diabetic Retinopathy (DR) Market Forecast 2017-2027
PR Newswire (press release)
NEW YORK, Sept. 4, 2017 /PRNewswire/ -- Outlook & Analysis for Ophthalmic Drugs for Other Retinal Diseases Including Age-Related Macular Degeneration (ARMD), Dry AMD, Wet AMD, Diabetic Macular Edema (DME), Retinal Vein Occlusion (RVO) ...

and more »

Independent.ie

'I would have been blind by now, God forbid' - woman (83) on how routine eye test saved her sight
Independent.ie
AMD is the leading cause of sight loss in people aged 50 and over in Ireland – almost 100,000 people throughout the country have AMD, with 7,000 new cases diagnosed each year in the over 50 population. There are two types of AMD – wet and dry – and I ...

and more »

The Guardian

Working to prevent avoidable sight loss
The Guardian
The most common cause of blindness in the UK is age-related macular degeneration (AMD), which isolates and handicaps many thousands of sufferers. Yet I, and many others, have had very successful treatment for dry AMD, contrary to recent media reports ...


Dry Macular Degeneration Pharmaceutical and Healthcare Pipeline Review H2
Medgadget (blog)
Dry (Atrophic) Macular Degeneration Global Clinical Trials Review, H2, 2017″ provides an overview of Dry (Atrophic) Macular Degeneration clinical trials scenario. This report provides top line data relating to the clinical trials on Dry (Atrophic ...

and more »

Medical Xpress

Researchers identify potential biomarkers of age-related macular degeneration
Medical Xpress
Furthermore, the team noted varying characteristics between the blood profiles of each stage of disease. This information has the potential to improve earlier diagnoses for AMD patients, and ultimately, may lead to more treatment options, as well as ...

and more »

Catalyst Biosciences, Inc. (NASDAQ:CBIO) Sees Light Trading Volume with 102K Shares Changing Hands
Modern Readers
... including the treatment of hemophilia and surgical bleeding, and inflammation, including prevention of delayed graft function (DGF) in renal transplants and the treatment of dry age-related macular degeneration (dry AMD), a condition that can cause ...

and more »

Boston Herald

Kalter: Breakthrough could inhibit eyesight loss
Boston Herald
There are few treatment options for the two main types of macular degeneration. Eye injections are used for the “wet” variety, caused by swelling and bleeding of blood vessels. Those who suffer from the “dry” type, caused by the deterioration of the ...


BLOG: Should we treat asymptomatic dry eye like diabetes?
Healio (blog)
As clinicians, we owe it to our patients to stay up to date in our treatment approaches. If we treated macular degeneration like we did just a few years ago — by treating every leaking lesion in the macula with argon laser — we would be guilty of ...


Medscape

AMD: Brolucizumab Noninferior to Aflibercept in Early Study
Medscape
The authors caution that treatment regimens for patients with AMD will still require an individualized approach, but they may be able to extend the treatment cycles for brolucizumab. "A 12-week treatment cycle for brolucizumab may be viable in a ...


Drug Discovery & Development

Apellis Pharmaceuticals Announces APL-2 Met Primary Endpoint in Phase II Geographic Atrophy Story
Drug Discovery & Development
David Boyer, MD, of Retina-Vitreous Associates Medical Group, said, “These results are very exciting for all people afflicted with dry AMD with geographic atrophy. It is currently an untreatable condition, and the reduction of the progression of ...


Complement Programs for Treatment of Eye Diseases
Business Wire (press release)
“We believe that supplementing anti-VEGF therapy with a complement inhibitor such as Zimura may have the potential to further enhance the efficacy of anti-VEGF monotherapy in wet AMD,” stated Kourous A. Rezaei, M.D., Senior Vice President of Medical ...
Ophthotech provides update on Zimura complement programs for treatment of eye diseasesSeeking Alpha

all 2 news articles »

Cleveland Jewish News

Important to protect eyes from office environments
Cleveland Jewish News
That blue light can cause macular degeneration and the coating can help fight that (vision loss). “Any time that you have eye strain that happens in (office) jobs and work, you can have headaches, blurry vision and dry eyes. Also, if you find yourself ...


PharmaMar: Sylentis Presents New Data on a New Eye Drop siRNA for the Treatment of Retinal Diseases Avoiding ...
PR Newswire (press release)
Sylentis presents, for the first time, positive data on the efficacy of SYL136001v10, a siRNA (small interference RNA) for the treatment of neovascular diseases of the retina such as Age-Related Macular Degeneration (AMD) and Diabetic Retinopathy (DR).


Daily Sabah

Take care of your vision for higher quality of life
Daily Sabah
Common diseases such as high cholesterol, hyperthyroidism, diabetes, retinal migraines and xerophthalmia (chronic dry eye) can also have an effect on eye health, making it important to take care of the "windows to the soul. ... Even if you think your ...


Healio

Switching Anti-VEGF Drugs in the Treatment of Diabetic Macular Edema
Healio
Thus, the intraocular half-life of bevacizumab and aflibercept are longer than ranibizumab. VEGF suppression time after intravitreal injection of aflibercept (IVA) in patients with AMD is more than two-times longer than that seen after intravitreal ...


Microbot Medical Inc. (NASDAQ:MBOT) Trading Volume Significantly Higher
Highlight Press
Its HuCNS-SC is also in Phase I/II clinical trials for the treatment of thoracic spinal cord injury; Phase II clinical trials for the treatment of cervical spinal cord injury; and Phase I/II clinical trials for dry age-related macular degeneration ...

and more »

Microbot Medical Inc. (NASDAQ:MBOT) Experiences Heavier than Usual Trading Volume
First News 24
Its HuCNS-SC is also in Phase I/II clinical trials for the treatment of thoracic spinal cord injury; Phase II clinical trials for the treatment of cervical spinal cord injury; and Phase I/II clinical trials for dry age-related macular degeneration ...


MD Magazine (registration) (blog)

APL-2 Meets Primary Endpoint In AMD Patients With Geography Atrophy
MD Magazine (registration) (blog)
“These results are very exciting for all people afflicted with dry AMD with geographic atrophy,” David Boyer (pictured), MD, of Retina-Vitreous Associates Medical Group, said in a statement. “It is currently an untreatable condition, and the reduction ...


Markets Insider

ZEISS Unveils Ultra-Widefield Fundus Imaging Technology in US
Markets Insider
Specifically, accurate coloration and resolution is important for evaluating focal change in rim tissue, nerve pallor, dry age-related macular degeneration RPE pigment changes, and drusen. According to retinal specialist, Roger Goldberg MD, MBA with ...


ModernMedicine

Educate patients with a seminar at your practice
ModernMedicine
Dry eye is not the only eye disease that would draw a crowd—diabetic eye disease, glaucoma, cataract, and macular degeneration are other focus area to consider. For patients, attending a seminar has numerous benefits: improving communication, gaining ...


Herald Sun

Vision Eye Institute Box Hill at centre of trial to combat blindness caused by macular degeneration
Herald Sun
Lampalizumab was given as an eye injection and specifically targets an enzyme called complement factor D, which was implicated in the development of dry age-related macular degeneration. Vision Eye Institute Box Hill and the Centre for Eye Research ...


Reading Eagle

Showing the way to better night vision
Reading Eagle
Cataracts and dry eyes are the most common causes for difficulty with night driving, followed less commonly by macular degeneration, according to Dr. Domenic C. Izzo Jr. of Berks Eye. Cataracts result from a progressive increase in cloudiness of the ...

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What about Resources?

Dr. Pautler's Blog
American Academy of Ophthalmology
MedlinePlus
National Institutes of Health
  • ARMD
    NIH's SeniorHealth website covers the topic of Age-Related Macular Degeneration
National Eye Institute
American Foundation for the Blind - Senior Site
  • Macular Degeneration
    Basic information about AMD and low vision; includes a self-test using an Amsler Grid
Journal of the American Medical Association (JAMA)
WebMD
LightHouse International
  • Macular Degeneration
    Provides a general overview of the basics of AMD, and a simulation showing a scene as it might be viewed by a person with AMD
Prevent Blindness America