Macular degeneration

Macular degeneration
Other names	Age-related macular degeneration
Picture of the back of the eye showing intermediate age-related macular degeneration
Specialty	Ophthalmology, optometry
Symptoms	Blurred or no vision in the center of the visual field[1]
Complications	Visual hallucinations[1]
Usual onset	Older people[1]
Types	Early, intermediate, late[1]
Causes	Damage to the macula of the retina[1]
Risk factors	Genetics, smoking[1]
Diagnostic method	Eye examination[1]
Prevention	Exercising, eating well, not smoking[1]
Treatment	Anti-VEGF medication injected into the eye, laser coagulation, photodynamic therapy[1]
Frequency	8.7% global prevalence in 2020[2]

Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred or no vision in the center of the visual field.^[1] Early on there are often no symptoms.^[1] Over time, however, some people experience a gradual worsening of vision that may affect one or both eyes.^[1] While it does not result in complete blindness, loss of central vision can make it hard to recognize faces, drive, read, or perform other activities of daily life.^[1] Visual hallucinations may also occur.^[1]

Macular degeneration typically occurs in older people,^[1] and is caused by damage to the macula of the retina.^[1] Genetic factors and smoking may play a role.^[1] The condition is diagnosed through a complete eye exam.^[1] Severity is divided into early, intermediate, and late types.^[1] The late type is additionally divided into "dry" and "wet" forms, with the dry form making up 90% of cases.^[1][3]

The difference between the two forms is categorized by the change in the macula. Those with dry form AMD have drusen, cellular debris in their macula that gradually damages light-sensitive cells and leads to vision loss. In wet form AMD, blood vessels grow under the macula, causing blood and fluid to leak into the retina.^[4]

Exercising, eating well, and not smoking may reduce the risk of macular degeneration.^[1] There is no cure or treatment that restores the vision already lost.^[1] In the wet form, anti-VEGF medication injected into the eye or, less commonly, laser coagulation or photodynamic therapy may slow worsening.^[1] Dietary antioxidant vitamins, minerals, and carotenoids do not appear to affect the onset;^[5] however, dietary supplements may slow the progression in those who already have the disease.^[5]

Age-related macular degeneration is a main cause of central blindness among the working-aged population worldwide.^[6] As of 2022, it affects more than 200 million people globally with the prevalence expected to increase to 300 million people by 2040 as the proportion of elderly persons in the population increases.^[2][7] It affects females more frequently than males, and it is more common in those of European or North American ancestry.^[2][8] In 2013, it was the fourth most common cause of blindness, after cataracts, preterm birth, and glaucoma.^[9] It most commonly occurs in people over the age of fifty and in the United States is the most common cause of vision loss in this age group.^[1][3] About 0.4% of people between 50 and 60 have the disease, while it occurs in 0.7% of people 60 to 70, 2.3% of those 70 to 80, and nearly 12% of people over 80 years old.^[3]