Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Dry macular degeneration, also called age related macular degeneration, is a progressive eye condition that affects adults, typicallyover the age of 60. It usually doesn’t cause symptoms in the early stages, but it may cause gradual vision loss as it progresses.
A number ofrisk factorsare associated with dry macular degeneration, including smoking and a family history of the condition. Because of the lack of symptoms, routine vision screening is important to identify early signs of dry macular degeneration—as well as other eye diseases.
If you have this condition, it’s important that you follow recommendations to avoid deterioration of your vision. There is no medication or procedure approved for treating age-related macular degeneration, but there are several medical and surgical options that are being investigated in research trials.
Advanced dry macular degeneration can develop into more serious eye problems, and there are prescription medications and interventional procedures that can help alleviate some of the effects of these more serious eye conditions.
Dry Macular Degeneration Symptoms
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You might not notice any symptoms of dry macular degeneration. As the condition advances, you can develop subtle vision loss. It is hard to specifically recognize thevisual changes of early macular degenerationbecause aging is associated with several other eye problems and types of vision loss—and the effects often feel very similar.
If they do occur, symptoms of dry macular degeneration include:
Dry macular degeneration usually involves both eyes to approximately an equal degree.
Symptoms of Macular Degeneration
One of the key things to remember is that dry macular degeneration does not cause eye pain or changes in the appearance of the eyes. So if you’ve already been diagnosed with this condition andthendevelop eye pain or other eye changes, it is important that you speak with your healthcare provider soon—because you could be developing another eye problemin additionto your dry macular degeneration.
Complications
Dry macular degeneration can advance to geographic atrophy orwet macular degeneration, which are more serious diseases of the retina. These advanced eye conditions aren’t necessarily associated with each other and they don’t cause each other. You can develop both geographic atrophy and wet macular degeneration.
How Dry AMD Becomes Wet AMD
You may be predisposed to dry macular degeneration if you are a smoker, have cardiovascular disease or obesity, or have a family history of dry or wet macular degeneration.
Dry macular degeneration is a progressive process. Themaculais a structure in the eye that detects light. It is the central area of theretina, located at the back of the eyeball. As dry macular degeneration develops, this structure becomes thin as the cells atrophy (shrink and die). Over time, the macula begins to lose its function, resulting in vision loss.
Eye Damage
Experts suggest that oxidative damage plays a role in the disease process of dry macular degeneration. Oxidation is a chemical process that occurs in normal metabolism, so all cells in the body are exposed to a reasonable amount of oxidation. Excess oxidation, however, causes damage.
It has been suggested that the mitochondria of the retinal cells, which are the energy-producing parts of the cell, may be especially susceptible to oxidative damage in dry macular degeneration. Inflammation may play a role as well. As dry macular degeneration worsens, there is an increase in complement activity, which is a marker of inflammation.
The risk factors associated with dry macular degeneration, including aging, may increase the predisposition to macular oxidative damage.
Genetics
There is a hereditary component to dry macular degeneration. The genetics of this condition are believed to be related to genes that promote inflammation. An increase in complement activity (a marker for inflammation) is more prominent in people who have genetic markers that are consistent with complement overactivity.
Drusen
Even if you don’t have a history of eye problems, it’s a good idea to have your eyes and vision checked on a regular basis after you reach age 40. Age related vision loss can cause headaches, difficulty reading, and may lead to accidents while driving.
Since early-stage dry macular degeneration doesn’t usually cause symptoms, you might bediagnosed with this conditionwithout having any complaints about your eyes or your vision.
Your diagnostic tests may include a vision examination and examination of your eyes, including your macula.
Vision and Eye Test
With dry macular degeneration, you may have diminished visual acuity and color vision in your central vision. Your peripheral vision shouldn’t be affected, especially at the early stages. Your eyes and eye movements should appear normal.
Fundoscopic Examination
Your healthcare provider may look at the structures inside of your eye with a fundoscopic examination, which is a non-invasive test. With a fundoscope, your healthcare provider can look inside your pupils from a few inches away to see the structures in the back of your retina, including your macula, the blood vessels, and theoptic nerve. Drusen might be detected with this test as well.
You might have adilated eye exam. Your healthcare provider might put drops in your eyes to dilate (widen) yourpupils (the dark area of your eye). This helps with the visualization of your macula with fundoscopic examination and other non-invasive imaging tests. Dilation of your eyes is safe, but your vision will be blurred for several hours afterward until the medication wears off.
How Long Do Pupils Remain Dilated After an Eye Exam?
Other non-invasive imaging tests you might have include:
Treatmentof this condition is focused on preventing its progression. There is no medical or surgical treatment that can reverse or stop the progression of dry macular degeneration. Smoking cessation and management of diabetes, heart disease, hypertension, and obesity are recommended to help prevent progression to wet macular degeneration.
General recommendations for the prevention of geographic atrophy include getting adequate vitamin intake, which experts suggest may prevent further oxidative damage.
What to Eat When You Have Macular Degeneration
Until recently, there were no approved treatments indicated for dry macular degeneration.There are several products in development that are being evaluated in clinical trials for their safety and effectiveness as possible treatments for dry macular degeneration.
AREDS/AREDS2 Vitamins
TheAREDS and AREDS2 vitamin formulationshave been shown to slow dry AMD progression.
Geographic Atrophy Treatments
Oracea
Oracea is a pill that is taken orally. It contains doxycycline, an antibiotic that has been in use for many years. It is being tested as a potential treatment for dry macular degeneration. It is believed to have potential anti-inflammatory action that may help in treating dry macular degeneration.
This medication is still in trials that will hopefully lead to FDA approval for use in dry macular degeneration.The side effects noted in the experimental trials using Oracea for dry macular degeneration are similar to those of doxycycline and include rash, sun sensitivity, and stomach upset.
Stem Cells
Stem cell transplant is being studied as a possible way to surgically replace macular cells. This may reverse or slow down dry macular degeneration.This procedure involves the injection of stem cells into the retina, and experts aren’t sure how often the injections would need to be repeated for it to be effective.
Metformin
Risuteganib
Risuteganib is a new medication that is being studied as a potential treatment for dry macular degeneration. It is injected into the eye, and it may have an effect in reducing oxidative damage. Risuteganib is an anti-integrin peptide that may stabilize the integrin protein. This protein is a structural stabilizing component of all the cells in the body, including cells of the macula.
D609
D609 is a new substance that is being investigated as a possible injectable therapy. Research has begun to establish it as a safe substance and has shown preliminary evidence that it may help protect the macula from advancing dry macular degeneration. It has been suggested that it may work as an antioxidant, preventing damage and degeneration of the macula.
Treatment of Advanced Complications
There are medications and interventional procedures used for treating wet macular degeneration. These treatments do not reverse the conditions but may prevent progression.
Eylea (aflibercept), for example, is an injectable treatment approved for treatment of wet macular degeneration.
What Is Wet Macular Degeneration?
A Word From Verywell
Dry macular degeneration is the most common type of macular degeneration. Even if you don’t have any vision problems, it is best if you schedule an eye examination at age 40, and ask your healthcare provider how often you should follow up with have regular eye examinations.
Several different potential treatments for dry macular degeneration are being investigated in clinical trials, but there is not currently any medication that can stop or reverse the disease. If you are diagnosed with dry macular degeneration, you can take some steps to prevent its progression.
It is also important to carefully manage other issues that contribute to vision loss, includingdiabetes. Your eye health has a major impact on your quality of life.
10 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 Academy of Ophthalmology.What is macular degeneration?Thiele S, Nadal J, Pfau M, et al.Prognostic value of intermediate age-related macular degeneration phenotypes for geographic atrophy progression.Br J Ophthalmol. 2020;bjophthalmol-2020-316004. doi:10.1136/bjophthalmol-2020-316004Brown EE, Lewin AS, Ash JD.Mitochondria: Potential targets for protection in age-related macular degeneration.Adv Exp Med Biol. 2018;1074:11‐17. doi:10.1007/978-3-319-75402-4_2Heesterbeek TJ, Lechanteur YTE, Lorés-Motta L, et al.Complement activation levels are related to disease stage in AMD.Invest Ophthalmol Vis Sci. 2020;61(3):18. doi:10.1167/iovs.61.3.18Kassa E, Ciulla TA, Hussain RM, Dugel PU.Complement inhibition as a therapeutic strategy in retinal disorders.Expert Opin Biol Ther. 2019;19(4):335‐342. doi:10.1080/14712598.2019.1575358Gorusupudi A, Nelson K, Bernstein PS.The Age-Related Eye Disease 2 Study: Micronutrients in the treatment of macular degeneration.Adv Nutr. 2017;8(1):40-53. doi:10.3945/an.116.013177Vakharia P, Eichenbaum D.Geographic atrophy: current and future therapeutic agents and practical considerations for retinal specialists.Curr Opin Ophthalmol. 2024 Feb 29. doi: 10.1097/ICU.0000000000001046American Academy of Ophthalmology.Promising new treatments for AMD.Shaw LT, Mackin A, Shah R, et al.Risuteganib-a novel integrin inhibitor for the treatment of non-exudative (dry) age-related macular degeneration and diabetic macular edema [published online ahead of print, 2020 May 13].Expert Opin Investig Drugs. 2020;1‐7. doi:10.1080/13543784.2020.1763953Wang B, Wang L, Gu S, et al.D609 protects retinal pigmented epithelium as a potential therapy for age-related macular degeneration.Signal Transduct Target Ther. 2020;5(1):20. doi:10.1038/s41392-020-0122-1
10 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 Academy of Ophthalmology.What is macular degeneration?Thiele S, Nadal J, Pfau M, et al.Prognostic value of intermediate age-related macular degeneration phenotypes for geographic atrophy progression.Br J Ophthalmol. 2020;bjophthalmol-2020-316004. doi:10.1136/bjophthalmol-2020-316004Brown EE, Lewin AS, Ash JD.Mitochondria: Potential targets for protection in age-related macular degeneration.Adv Exp Med Biol. 2018;1074:11‐17. doi:10.1007/978-3-319-75402-4_2Heesterbeek TJ, Lechanteur YTE, Lorés-Motta L, et al.Complement activation levels are related to disease stage in AMD.Invest Ophthalmol Vis Sci. 2020;61(3):18. doi:10.1167/iovs.61.3.18Kassa E, Ciulla TA, Hussain RM, Dugel PU.Complement inhibition as a therapeutic strategy in retinal disorders.Expert Opin Biol Ther. 2019;19(4):335‐342. doi:10.1080/14712598.2019.1575358Gorusupudi A, Nelson K, Bernstein PS.The Age-Related Eye Disease 2 Study: Micronutrients in the treatment of macular degeneration.Adv Nutr. 2017;8(1):40-53. doi:10.3945/an.116.013177Vakharia P, Eichenbaum D.Geographic atrophy: current and future therapeutic agents and practical considerations for retinal specialists.Curr Opin Ophthalmol. 2024 Feb 29. doi: 10.1097/ICU.0000000000001046American Academy of Ophthalmology.Promising new treatments for AMD.Shaw LT, Mackin A, Shah R, et al.Risuteganib-a novel integrin inhibitor for the treatment of non-exudative (dry) age-related macular degeneration and diabetic macular edema [published online ahead of print, 2020 May 13].Expert Opin Investig Drugs. 2020;1‐7. doi:10.1080/13543784.2020.1763953Wang B, Wang L, Gu S, et al.D609 protects retinal pigmented epithelium as a potential therapy for age-related macular degeneration.Signal Transduct Target Ther. 2020;5(1):20. doi:10.1038/s41392-020-0122-1
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 Academy of Ophthalmology.What is macular degeneration?Thiele S, Nadal J, Pfau M, et al.Prognostic value of intermediate age-related macular degeneration phenotypes for geographic atrophy progression.Br J Ophthalmol. 2020;bjophthalmol-2020-316004. doi:10.1136/bjophthalmol-2020-316004Brown EE, Lewin AS, Ash JD.Mitochondria: Potential targets for protection in age-related macular degeneration.Adv Exp Med Biol. 2018;1074:11‐17. doi:10.1007/978-3-319-75402-4_2Heesterbeek TJ, Lechanteur YTE, Lorés-Motta L, et al.Complement activation levels are related to disease stage in AMD.Invest Ophthalmol Vis Sci. 2020;61(3):18. doi:10.1167/iovs.61.3.18Kassa E, Ciulla TA, Hussain RM, Dugel PU.Complement inhibition as a therapeutic strategy in retinal disorders.Expert Opin Biol Ther. 2019;19(4):335‐342. doi:10.1080/14712598.2019.1575358Gorusupudi A, Nelson K, Bernstein PS.The Age-Related Eye Disease 2 Study: Micronutrients in the treatment of macular degeneration.Adv Nutr. 2017;8(1):40-53. doi:10.3945/an.116.013177Vakharia P, Eichenbaum D.Geographic atrophy: current and future therapeutic agents and practical considerations for retinal specialists.Curr Opin Ophthalmol. 2024 Feb 29. doi: 10.1097/ICU.0000000000001046American Academy of Ophthalmology.Promising new treatments for AMD.Shaw LT, Mackin A, Shah R, et al.Risuteganib-a novel integrin inhibitor for the treatment of non-exudative (dry) age-related macular degeneration and diabetic macular edema [published online ahead of print, 2020 May 13].Expert Opin Investig Drugs. 2020;1‐7. doi:10.1080/13543784.2020.1763953Wang B, Wang L, Gu S, et al.D609 protects retinal pigmented epithelium as a potential therapy for age-related macular degeneration.Signal Transduct Target Ther. 2020;5(1):20. doi:10.1038/s41392-020-0122-1
American Academy of Ophthalmology.What is macular degeneration?
Thiele S, Nadal J, Pfau M, et al.Prognostic value of intermediate age-related macular degeneration phenotypes for geographic atrophy progression.Br J Ophthalmol. 2020;bjophthalmol-2020-316004. doi:10.1136/bjophthalmol-2020-316004
Brown EE, Lewin AS, Ash JD.Mitochondria: Potential targets for protection in age-related macular degeneration.Adv Exp Med Biol. 2018;1074:11‐17. doi:10.1007/978-3-319-75402-4_2
Heesterbeek TJ, Lechanteur YTE, Lorés-Motta L, et al.Complement activation levels are related to disease stage in AMD.Invest Ophthalmol Vis Sci. 2020;61(3):18. doi:10.1167/iovs.61.3.18
Kassa E, Ciulla TA, Hussain RM, Dugel PU.Complement inhibition as a therapeutic strategy in retinal disorders.Expert Opin Biol Ther. 2019;19(4):335‐342. doi:10.1080/14712598.2019.1575358
Gorusupudi A, Nelson K, Bernstein PS.The Age-Related Eye Disease 2 Study: Micronutrients in the treatment of macular degeneration.Adv Nutr. 2017;8(1):40-53. doi:10.3945/an.116.013177
Vakharia P, Eichenbaum D.Geographic atrophy: current and future therapeutic agents and practical considerations for retinal specialists.Curr Opin Ophthalmol. 2024 Feb 29. doi: 10.1097/ICU.0000000000001046
American Academy of Ophthalmology.Promising new treatments for AMD.
Shaw LT, Mackin A, Shah R, et al.Risuteganib-a novel integrin inhibitor for the treatment of non-exudative (dry) age-related macular degeneration and diabetic macular edema [published online ahead of print, 2020 May 13].Expert Opin Investig Drugs. 2020;1‐7. doi:10.1080/13543784.2020.1763953
Wang B, Wang L, Gu S, et al.D609 protects retinal pigmented epithelium as a potential therapy for age-related macular degeneration.Signal Transduct Target Ther. 2020;5(1):20. doi:10.1038/s41392-020-0122-1
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