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Affects about 90 percent of those with the disease. Its cause is unknown and there is often a family history. It is responsible for a very slow atrophy and degeneration of the macular photoreceptors (light sensitive cells) and pigment cells (nutritional support cells). Gradual loss of central vision, usually one eye before the other, may begin as the degeneration progresses. There are no proven treatments, medications, or vitamins that halt or slow progression. There is no way to predict how severely the vision will eventually be affected. Drs. Greve and Hinz may diagnose dry AMD when they see drusen or atrophic changes in the macula. Accounts for only 10 % of patients, but unfortunately causes 90% of the severe visual loss. The "wet" is derived from the fact that new blood vessels (choroidal neovascularization or CNV) grow from beneath the retina and leak. These new fragile vessels sometimes leak blood, but more often leak protein, fat, and serum under the retina. (less frequently they actually bleed causing a large hemorrhage under the retina or even in the vitreous cavity). These leaky vessels and the ensuing healing and scarring by your body, are what causes the severe loss of central vision with wet AMD. Risk factors for AMD include age (2% in your 50's, almost 30% over age 75), cigarrette smoking and family history of AMD. Possible risk factors include elevated cholesterol and blood pressure. Women seem to be at more risk than men, but this may be because they live longer. Symptoms of AMD are visual. Decreased acuity or distortion of vision. There is no pain associated with wet or dry AMD. Diagnosis of wet or dry AMD is made by examining your retina with a slit lamp microscope, and also with the aid of fluorescein angiography. Drs. Greve and Hinz have extensive experience and training in the management of AMD. Possible treatments offered (depending on the extent and characteristics of the CNV) may include laser, surgery (submacular surgery and limited macular translocation in selected cases), and photodynamic therapy with Visudyne. (transpupillary thermotherapy is investigational). We are involved in the VIM and VIO studies with visudyne. Natural History of wet AMD: The following pictures show a typical course AMD. These photographs are from the same patient over a five year course.
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