Table of ContentsView AllTable of ContentsStagesStages in Each EyeHow to Get StagedTreatment
Table of ContentsView All
View All
Table of Contents
Stages
Stages in Each Eye
How to Get Staged
Treatment
Macular degenerationis an eye disease that affects yourcentral vision. It is a common problem that ranks as the leading cause of vision loss among adults who are more than 60 years old. Because it is linked with aging, it is also calledage-related macular degeneration (AMD).
Macular degeneration occurs due to the damage that aging causes to yourmacula. This part of your eye helps you see the details of what is in front of you. It is a small place at the center of yourretina(the light-sensitive tissue at the back of your eye).
The causes of macular degeneration are not fully known. Symptoms can affect your central vision, though they do not cause total blindness. There is no cure. Treatments may help preserve some central vision based on the type and stage of your disease.
This article describes the stages of macular degeneration and their common symptoms. It also explains the treatments used at each stage and what they do.
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Stages of Macular Degeneration
Macular degeneration is categorized into:
The late stage of the disease can occur as one of two macular degeneration types, as follows:
The dry form of macular degeneration is the most common type. It affects up to 90% of people with AMD.
Below are the stages in detail.
Early-Stage Dry AMD
Early-stage dry AMD usually occurs without noticeable symptoms. It results when parts of your macula thin with age and allow for the formation ofdrusen. Drusen are small clumps of lipid and protein that build up on the tissue of your retina.
Drusen can be identified during a routine dilated eye exam. Having a few small drusen can occur in people 50 and older without macular degeneration or vision loss. However, the presence of many small drusen or medium-sized drusen can often indicate early-stage AMD.
Intermediate-Stage Dry AMD
When dry AMD progresses to the intermediate stage, large drusen and/or abnormalities in your retinal pigment are detected. While this stage may still be asymptomatic for some people, intermediate-stage AMD may involve one or more of the following more subtle symptoms:
Advanced or Late-Stage Dry AMD (Geographic Atrophy)
It occurs when dry AMD progresses to the point that clearly defined areas of your retina lose pigment and photoreceptors, causing areas of tissue atrophy (cell degeneration). This can result in irreversible vision loss. Up to 19% of people with AMD may progress to geographic atrophy within two years of diagnosis of intermediate dry AMD. This can occur with or without wet AMD.
Late-stage dry AMD results in the worsening of symptoms that occur during intermediate-stage dry AMD. This can lead to the following symptoms:
Advanced Stage Wet-AMD
All AMD begins in the dry form. The condition changes to wet AMD in 10% to 15% of people. This can occur at any stage of dry AMD. There are no symptoms linked with early or intermediate stages of wet AMD. Wet AMD is only identified as an advanced-stage disease when it is diagnosed.
Though less common than advanced dry AMD, advanced wet AMD is a more serious condition. It occurs when new, abnormal blood vessels form under your retina. Your macula can become damaged when these new blood vessels leak blood and other fluids.
Symptoms of wet AMD are similar to those that occur at the intermediate and advanced stages of dry AMD. However, vision loss occurs much faster and more dramatically with wet AMD than dry AMD.
Advanced wet AMD differs from dry AMD in the following two key ways:
Stargardt’s DiseaseMacular degeneration can happen at any age. Stargardt disease is a common form of juvenile macular degeneration. It typically affects both eyes, causing a slow loss of central vision between age 5 and early adulthood. Stargardt disease is linked to genetic causes.While there is no cure, treatments and assistive devices can help make the best use of a person’s remaining peripheral vision, which is the vision you see out of the corners of your eye).
Stargardt’s Disease
Macular degeneration can happen at any age. Stargardt disease is a common form of juvenile macular degeneration. It typically affects both eyes, causing a slow loss of central vision between age 5 and early adulthood. Stargardt disease is linked to genetic causes.While there is no cure, treatments and assistive devices can help make the best use of a person’s remaining peripheral vision, which is the vision you see out of the corners of your eye).
Macular degeneration can happen at any age. Stargardt disease is a common form of juvenile macular degeneration. It typically affects both eyes, causing a slow loss of central vision between age 5 and early adulthood. Stargardt disease is linked to genetic causes.
While there is no cure, treatments and assistive devices can help make the best use of a person’s remaining peripheral vision, which is the vision you see out of the corners of your eye).
AMD Stages in Different Eyes
AMD can occur in one or both eyes. Research indicates that 64.5% of people with AMD have the same stage of AMD in both eyes simultaneously.
When AMD exists at different stages in each eye, your healthier eye may compensate for the vision loss caused in the eye with the more advanced disease stage. This can delay your recognition of symptoms because you may not notice changes in your vision.
When AMD is diagnosed in only one eye, your healthier eye is likely to develop AMD. Research indicates that having any stage of AMD in one eye is expected to affect the second eye within five years in 19% to 28% of people. When late AMD is diagnosed in one eye, the condition is likely to affect the second eye within five years in 50% of affected people.
The dry and wet forms of AMD can occur at the same time. The dry form may continue to progress in an eye that has developed the wet form. You can have dry AMD, wet AMD, or both simultaneously in one or both eyes.
Macular Degeneration: Timeline of Vision Loss Progression
How to Get Macular Degeneration Staged
If you are at risk of AMD, monitoring your eye health with regular comprehensive eye exams from an ophthalmologist or optometrist is important. An eye exam includes a series of tests that measure your eye health and vision.
Age is the major risk factor for macular degeneration. Being age 55 or older increases your risk of AMD. The American Academy of Ophthalmology (AAO) advises more frequent eye exams as you age, based on the following schedule:
You may need eye exams more often based on factors such as your demographic characteristics, medical history, personal history of smoking, or a family history of eye disease.
The diagnosis and staging of macular degeneration typically involves one or more of the following tests:
Macular Degeneration Staging vs. ProgressionDisease staging is a system of classifying disease severity based on diagnostic findings. The stage of disease is used to determine your treatment and prognosis.Disease progression describes the natural way that a disease changes, worsens, and possibly improves over time.
Macular Degeneration Staging vs. Progression
Disease staging is a system of classifying disease severity based on diagnostic findings. The stage of disease is used to determine your treatment and prognosis.Disease progression describes the natural way that a disease changes, worsens, and possibly improves over time.
Disease staging is a system of classifying disease severity based on diagnostic findings. The stage of disease is used to determine your treatment and prognosis.
Disease progression describes the natural way that a disease changes, worsens, and possibly improves over time.
Treatment for Different Stages of Macular Degeneration
Treatments do not cure macular degeneration at any stage. However, appropriate treatments administered as early as possible canhelp slow the disease progression of AMD.
Treatment of early-stage dry AMD focuses on identifying modifiable lifestyle risk factors and the actions you can take to slow the disease’s progression. These actions can include the following:
A diagnosis of intermediate-stage dry AMD increases your risk of developing late-stage AMD and the vision loss that it can cause. Research from the Age-Related Eye Disease Study (AREDS) and AREDS2 studies signifies that certain antioxidants, vitamins, and minerals can help protect against the progression from intermediate to late-stage AMD.
The current recommended regimen of supplements, called AREDS2 supplements, can be purchased over the counter in a single formulation. They are taken daily and consist of the following ingredients:
Check with your ophthalmologist before taking the AREDS2 supplements because they may not be effective for treating all forms of the disease.
Recommendations for managing intermediate AMD and reducing your risk of disease progression also include the following:
These in-office treatments are administered asintravitrealinjectionsin the vitreous cavity (the space at the back of your eye behind the lens). The medications are injected into your eye on a scheduled basis to slow the atrophy, hoping to delay vision loss.
Advanced or Late-Stage Wet AMD
Treatment for late-stage wet AMD is used to reduce the number of abnormal blood vessels in your retina and slow any leaking from the vessels:
Anti-VEGF (anti-vascularendothelialgrowth factor) treatment: Anti-VEGF treatment is considered the primary treatment for wet AMD. The medication is administered every one to three months via an intravitreal injection. Current anti-VEGF therapies include the following medications:
Summary
Stages of macular degeneration include early, intermediate, and late stages. Late-stage disease can involve wet or dry AMD. While there is no cure for the disease, treatments can help slow progression. They can also help prevent further vision loss in certain cases.
Always report any vision changes to your eye care provider even if you are not due for an exam. Some changes that occur with this disease can progress very quickly but may respond to treatment if given quickly.
24 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Macular Degeneration Foundation.What is macular degeneration?Harvard Health Publishing Harvard Medical School.Age-related macular degeneration: early detection and timely treatment may preserve vision.National Eye Institute.Age-related macular degeneration (AMD).American Macular Degeneration Foundation.Dry macular degeneration.American Academy of Ophthalmology.What are drusen?American Macular Degeneration Foundation.Types and stages of macular degeneration.BrightFocus Foundation.View how macular degeneration may affect vision.American Macular Degeneration Foundation.Macular degeneration symptoms.University of Wisconsin Department of Ophthalmology and Visual Sciences.Macular degeneration.American Macular Degeneration Foundation.Wet macular degeneration.Stanford Medicine.Macular degeneration symptoms.National Eye Institute.Stargardt disease.Wilde C, Poostchi A, Mehta RL, et al.Prevalence of age-related macular degeneration in an elderly UK Caucasian population—The Bridlington Eye Assessment Project: a cross-sectional study.Eye (Lond). 2017;31(7):1042-1050. doi:10.1038/eye.2017.30Joachim N, Colijn JM, Kifley A, et al.Five-year progression of unilateral age-related macular degeneration to bilateral involvement: the Three Continent AMD Consortium report.Br J Ophthalmol. 2017;101(9):1185-1192. doi:10.1136/bjophthalmol-2016-309729American Academy of Ophthalmology.Frequency of ocular examinations - 2015.American Academy of Opthalmology.What is macular degeneration?American Macular Degeneration Foundation.Diagnosing age-related macular degeneration.Thomas Jefferson University.Disease staging.Mould DR, Holford NHG, Peck, CC.Chapter 21 - disease progress models.Atkinson’s Principles of Clinical Pharmacology (Fourth Edition).2022;389-403. doi:10.1016/B978-0-12-819869-8.00017-3García-Layana A, Cabrera-López F, García-Arumí J, Arias-Barquet L, Ruiz-Moreno JM.Early and intermediate age-related macular degeneration: update and clinical review.CIA. 2017;12:1579-1587. doi:10.2147/CIA.S142685Danese C, Lanzetta, P.Treating AMD at the intermediate level.Retinal Physician. 2022;19(April):30, 32, 34.National Eye Institute.AREDS2 supplements for age-related macular degeneration (AMD).American Academy of Ophthalmology.Anti-VEGF treatments.National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).
24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Macular Degeneration Foundation.What is macular degeneration?Harvard Health Publishing Harvard Medical School.Age-related macular degeneration: early detection and timely treatment may preserve vision.National Eye Institute.Age-related macular degeneration (AMD).American Macular Degeneration Foundation.Dry macular degeneration.American Academy of Ophthalmology.What are drusen?American Macular Degeneration Foundation.Types and stages of macular degeneration.BrightFocus Foundation.View how macular degeneration may affect vision.American Macular Degeneration Foundation.Macular degeneration symptoms.University of Wisconsin Department of Ophthalmology and Visual Sciences.Macular degeneration.American Macular Degeneration Foundation.Wet macular degeneration.Stanford Medicine.Macular degeneration symptoms.National Eye Institute.Stargardt disease.Wilde C, Poostchi A, Mehta RL, et al.Prevalence of age-related macular degeneration in an elderly UK Caucasian population—The Bridlington Eye Assessment Project: a cross-sectional study.Eye (Lond). 2017;31(7):1042-1050. doi:10.1038/eye.2017.30Joachim N, Colijn JM, Kifley A, et al.Five-year progression of unilateral age-related macular degeneration to bilateral involvement: the Three Continent AMD Consortium report.Br J Ophthalmol. 2017;101(9):1185-1192. doi:10.1136/bjophthalmol-2016-309729American Academy of Ophthalmology.Frequency of ocular examinations - 2015.American Academy of Opthalmology.What is macular degeneration?American Macular Degeneration Foundation.Diagnosing age-related macular degeneration.Thomas Jefferson University.Disease staging.Mould DR, Holford NHG, Peck, CC.Chapter 21 - disease progress models.Atkinson’s Principles of Clinical Pharmacology (Fourth Edition).2022;389-403. doi:10.1016/B978-0-12-819869-8.00017-3García-Layana A, Cabrera-López F, García-Arumí J, Arias-Barquet L, Ruiz-Moreno JM.Early and intermediate age-related macular degeneration: update and clinical review.CIA. 2017;12:1579-1587. doi:10.2147/CIA.S142685Danese C, Lanzetta, P.Treating AMD at the intermediate level.Retinal Physician. 2022;19(April):30, 32, 34.National Eye Institute.AREDS2 supplements for age-related macular degeneration (AMD).American Academy of Ophthalmology.Anti-VEGF treatments.National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Macular Degeneration Foundation.What is macular degeneration?Harvard Health Publishing Harvard Medical School.Age-related macular degeneration: early detection and timely treatment may preserve vision.National Eye Institute.Age-related macular degeneration (AMD).American Macular Degeneration Foundation.Dry macular degeneration.American Academy of Ophthalmology.What are drusen?American Macular Degeneration Foundation.Types and stages of macular degeneration.BrightFocus Foundation.View how macular degeneration may affect vision.American Macular Degeneration Foundation.Macular degeneration symptoms.University of Wisconsin Department of Ophthalmology and Visual Sciences.Macular degeneration.American Macular Degeneration Foundation.Wet macular degeneration.Stanford Medicine.Macular degeneration symptoms.National Eye Institute.Stargardt disease.Wilde C, Poostchi A, Mehta RL, et al.Prevalence of age-related macular degeneration in an elderly UK Caucasian population—The Bridlington Eye Assessment Project: a cross-sectional study.Eye (Lond). 2017;31(7):1042-1050. doi:10.1038/eye.2017.30Joachim N, Colijn JM, Kifley A, et al.Five-year progression of unilateral age-related macular degeneration to bilateral involvement: the Three Continent AMD Consortium report.Br J Ophthalmol. 2017;101(9):1185-1192. doi:10.1136/bjophthalmol-2016-309729American Academy of Ophthalmology.Frequency of ocular examinations - 2015.American Academy of Opthalmology.What is macular degeneration?American Macular Degeneration Foundation.Diagnosing age-related macular degeneration.Thomas Jefferson University.Disease staging.Mould DR, Holford NHG, Peck, CC.Chapter 21 - disease progress models.Atkinson’s Principles of Clinical Pharmacology (Fourth Edition).2022;389-403. doi:10.1016/B978-0-12-819869-8.00017-3García-Layana A, Cabrera-López F, García-Arumí J, Arias-Barquet L, Ruiz-Moreno JM.Early and intermediate age-related macular degeneration: update and clinical review.CIA. 2017;12:1579-1587. doi:10.2147/CIA.S142685Danese C, Lanzetta, P.Treating AMD at the intermediate level.Retinal Physician. 2022;19(April):30, 32, 34.National Eye Institute.AREDS2 supplements for age-related macular degeneration (AMD).American Academy of Ophthalmology.Anti-VEGF treatments.National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).
American Macular Degeneration Foundation.What is macular degeneration?
Harvard Health Publishing Harvard Medical School.Age-related macular degeneration: early detection and timely treatment may preserve vision.
National Eye Institute.Age-related macular degeneration (AMD).
American Macular Degeneration Foundation.Dry macular degeneration.
American Academy of Ophthalmology.What are drusen?
American Macular Degeneration Foundation.Types and stages of macular degeneration.
BrightFocus Foundation.View how macular degeneration may affect vision.
American Macular Degeneration Foundation.Macular degeneration symptoms.
University of Wisconsin Department of Ophthalmology and Visual Sciences.Macular degeneration.
American Macular Degeneration Foundation.Wet macular degeneration.
Stanford Medicine.Macular degeneration symptoms.
National Eye Institute.Stargardt disease.
Wilde C, Poostchi A, Mehta RL, et al.Prevalence of age-related macular degeneration in an elderly UK Caucasian population—The Bridlington Eye Assessment Project: a cross-sectional study.Eye (Lond). 2017;31(7):1042-1050. doi:10.1038/eye.2017.30
Joachim N, Colijn JM, Kifley A, et al.Five-year progression of unilateral age-related macular degeneration to bilateral involvement: the Three Continent AMD Consortium report.Br J Ophthalmol. 2017;101(9):1185-1192. doi:10.1136/bjophthalmol-2016-309729
American Academy of Ophthalmology.Frequency of ocular examinations - 2015.
American Academy of Opthalmology.What is macular degeneration?
American Macular Degeneration Foundation.Diagnosing age-related macular degeneration.
Thomas Jefferson University.Disease staging.
Mould DR, Holford NHG, Peck, CC.Chapter 21 - disease progress models.Atkinson’s Principles of Clinical Pharmacology (Fourth Edition).2022;389-403. doi:10.1016/B978-0-12-819869-8.00017-3
García-Layana A, Cabrera-López F, García-Arumí J, Arias-Barquet L, Ruiz-Moreno JM.Early and intermediate age-related macular degeneration: update and clinical review.CIA. 2017;12:1579-1587. doi:10.2147/CIA.S142685
Danese C, Lanzetta, P.Treating AMD at the intermediate level.Retinal Physician. 2022;19(April):30, 32, 34.
National Eye Institute.AREDS2 supplements for age-related macular degeneration (AMD).
American Academy of Ophthalmology.Anti-VEGF treatments.
National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).
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