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

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Chattanooga Times Free Press

Ask a Doctor: What to do about dry macular degeneration
Chattanooga Times Free Press
Q: I have been diagnosed with dry macular degeneration. What can I do now? A: Dry age-related macular degeneration (AMD) is a slowly progressive disease affecting central vision. Typically, it is identified in adults greater than 50 years of age ...


Coherent Chronicle (press release) (blog)

Global Dry Age-Related Macular Degeneration Market and Competitive Landscape 2014-2023: Pipeline ...
PR Newswire (press release)
Global Dry Age-Related Macular Degeneration Market and Competitive Landscape - 2018, provides comprehensive insights into Dry Age-Related Macular Degeneration pipeline, epidemiology, market valuations, product sales, market forecast, product ...
Age–Related Macular Degeneration Market Size ,Share to See Modest Growth Through 2026Coherent Chronicle (press release) (blog)
Age-related Macular Degeneration Market to Garner Brimming Revenues by 2025marketresearchday.com

all 14 news articles »

Mass Device

Optos Announces Collaboration for Monitoring and Treating Dry Age-Related Macular Degeneration in Europe
Business Wire (press release)
The MacuLogix AdaptDx, a dark adaptometer that can be used to detect AMD at a subclinical stage at least three years before structural changes such as drusen are visible. And the LumiThera's Valeda Light Delivery System, the first approved for ...
LumiThera and Optos Announce Collaboration to Commercialize the Valeda™ Light Delivery System for Treating Dry ...PR Newswire (press release)
LumiThera inks distro deal with Nikon's OptosMass Device

all 4 news articles »

Business Wire

OpRegen shows positive phase 1/2a study results for dry AMD
Healio
Early data from a phase 1/2a study also showed encouraging results in earlier-stage dry AMD, including evidence of continued presence of the transplanted cells and improvements in visual acuity, the release said. Data from the study were presented at ...
BioTime Presents New OpRegen® Data at American Academy of Ophthalmology Annual MeetingBusiness Wire (press release)

all 2 news articles »

Dry AMD: Oxurion licences heparanase blockers from Beta Therapeutics
European Biotechnology
Under the terms of the agreement Oxurion will have an exclusive option to license the heparanase inhibitor programmes developed for the treatment of dry AMD. Beta Therapeutics has several preclinical candidates in its pipeline, which go back to the ...


Dry (Atrophic) Macular Degeneration Market Growth by Top Company, Region, Application, Driver, Trends & Forecasts ...
Unique Analyst (press release) (blog)
Dry (Atrophic) Macular Degeneration Market Research Report provide analysis of main manufactures and geographic regions. Dry (Atrophic) Macular Degeneration Market report includes Dry (Atrophic) Macular Degeneration definitions, classifications, ...


Study Finds

Eat Leafy Greens To Stop Development Of Macular Degeneration
Study Finds
A new study conducted by Australian researchers finds that eating more leafy greens — such as lettuce, spinach, or kale — may help prevent macular degeneration, a condition that causes loss in the center of the field of vision. There are two main ...
Age–Related Macular Degeneration Market to Rake in Hugh Revenue by the End of 2026Coherent News (press release) (blog)
Wet Age Related Macular Degeneration Market Variables, Trends and Segment Forecasts by 2025MilTech

all 67 news articles »

Change Within Eye A Hint of Macular Degeneration?
WebMD
For the study, the researchers analyzed clinical images from AMD patients and found that calcified nodules in the retina increased the risk of progression to advanced AMD by more than six times. The new findings could improve treatment of AMD, the ...


Optos announces collaborations in Alzheimer's disease, AMD
Healio
... announced exclusive distribution agreements in Europe and Australia with MacuLogix, for its AdaptDx, a dark adaptometer that can be used to detect AMD at a subclinical stage, and with LumiThera, for its Valeda Light Delivery System for treating dry ...


News-Medical.net

Easier treatment for age-related macular degeneration shows promise in clinical study
News-Medical.net
A new study shows that an implantable delivery system for a widely used medication to treat a blinding eye disease has enabled some patients to go 15 months in between treatments. This represents a vast improvement over the typical regimen of nearly ...
Easier treatment for blinding eye disease shows promise in clinical trialMedical Xpress

all 5 news articles »

Ophthotech Announces Results from Phase 2a Safety Trial of Zimura® in Combination with Lucentis® in Wet Age ...
BioSpace (press release) (blog)
“The current Phase 2a trial further reinforced the previously observed safety profile of intravitreal Zimura administered in combination with Lucentis 0.5mg in patients with wet AMD who have not had any previous anti-VEGF treatment,” stated Kourous A.

and more »

Two-year data for Novartis brolucizumab reaffirm superiority versus aflibercept in reducing retinal fluid in ...
BioSpace (press release) (blog)
"Over two years, brolucizumab consistently dried retinal fluid better than aflibercept; additionally, the robust visual gains shown in year one with brolucizumab were maintained in year two," said Shreeram Aradhye, Global Head Medical Affairs and Chief ...

and more »

Wills Eye Hospital releases new implant to help macular degeneration
KYW Newsradio 1060 (blog)
Wet macular degeneration is a leading cause of vision loss, but it can be treated, according to Dr. Carl Regillo, director of Retina Service at Wills Eye Hospital. He said the medicines work well, but treatment isn't pleasant. "These are medicines that ...


News-Medical.net

Novel approach could provide painless, efficient alternative for ...
News-Medical.net
Nanyang Technological University, Singapore scientists have developed a 'contact lens' patch with microneedles that could provide a painless and efficient ...

and more »

Oxurion and Beta Therapeutics to Develop New Heparanase Inhibitors for Treatment of dry AMD
Markets Insider
LEUVEN, Belgium, November 5, 2018 /PRNewswire/ --. Oxurion NV (Euronext Brussels: OXUR), a biopharmaceutical company developing innovative treatments to preserve vision in patients with diseases affecting the back of the eye, announced today that it ...

and more »

Medscape

'Eye Health' Supplements: Do the Benefits Justify the Cost?
Medscape
What can I eat to prevent macular degeneration? Such questions are common in the ... Lutein, zeaxanthin, and omega-3 fatty acids were included in the AREDS2 formulation but did not decrease the risk for AMD progression (Figure). The Blue Mountains Eye ...


MD Magazine

Ted Smith, MD, PhD: Learning More From Hyperspectral Autofluorescence Imaging
MD Magazine
... age-related macular degeneration, to judge the health of the retina and the health of the underlying structure such as the pigment epithelium. So, it's used to diagnose, for example, conditions like geographic atrophy which is the advanced form of ...


Medscape

Fewer Injections With New Wet Macular Degeneration Therapies
Medscape
CHICAGO — The number of injections required for the successful treatment of neovascular age-related macular degeneration could be reduced considerably with experimental therapies, new research shows. Treatments in the late stages of development ...


Technique enables direct imaging of neural tissue; could lead to earlier detection of diseases affecting eye tissue
Science Daily
Resolving these tissues and cells in the outermost region of the retina in such unprecedented detail promises to transform the detection and treatment of diseases such as age-related macular degeneration (AMD), a leading cause of blindness among the ...

and more »

Genetic Engineering & Biotechnology News

Ophthotech Expands Innovative Retinal Disease Pipeline with Acquisition of Versant Ventures' Inception 4
Associated Press (press release) (blog)
HtrA1 is potentially implicated in a range of retinal diseases including geographic atrophy, an advanced form of dry age-related macular degeneration (AMD). As a major new investor with substantial geographic reach, Versant Ventures has agreed to help ...
Ophthotech Expands Eye Disease Pipelines of Small Molecule, Gene Therapy CandidatesGenetic Engineering & Biotechnology News
Ophthotech Reports Third Quarter 2018 Financial and Operating ResultsBusiness Wire (press release)
Ophthotech adds to pipeline again as climb back continuesFierceBiotech
Seeking Alpha
all 13 news articles »

Pixium Vision reports positive data with PRIMA implant, at the American Academy of Ophthalmology 2018
GlobeNewswire (press release)
Daniel Palanker, Department of Ophthalmology at Stanford University, inventor of PRIMA chip, highlighted: "We are happy to witness the remarkable success of the PRIMA chip in providing prosthetic vision to dry-AMD patients. The feasibility study in ...

and more »

Market News Today

Global Juvenile Macular Degeneration Treatment Market 2018 Report with Comprehensive Research and ...
Market News Today
The Juvenile Macular Degeneration Treatment Market Report covers a broad market structure across the world with a thorough analysis of major dynamics. This report provides strategic recommendations consulted by the industrial experts including market ...
Age-related Macular Degeneration Market 2018-2025 Development Trends, Key Manufacturers and Competitive ...TokenSpectra (press release)

all 36 news articles »

Pixium Vision: presentations of current clinical data with PRIMA implant during the AAO annual congress
GlobeNewswire (press release)
The selection for presentation by the sub-specialty course directors at AAO 2018 is also a recognition of the high level of interest in efforts to address a significant unmet need for advanced atrophic dry Age-related Macular Degeneration (dry-AMD) and ...

and more »

Ora®, Inc. has been retained by ProQR Therapeutics to provide mobility test services using the Ora-VNC™ for the QR ...
PRNewswire (press release)
To address the need for functional vision endpoints in Inherited Retinal Diseases (IRDs) and dry age-related macular degeneration (dry AMD) clinical studies, Ora developed a series of mobility courses (Ora-VNC™ (Visual Navigation Challenge)).

and more »

Calcified Nodules Linked to AMD Progression
Medscape
The presence of a specific type of calcified nodule in the retinal drusen of patients with age-related macular degeneration (AMD) is associated with a more than sixfold increased risk for late-stage progression of the disease, a study has shown. In a ...


Open Access Government

Brits risk damaging their sight with prolonged binge drinking
Open Access Government
Amy comments further that, “Alcohol is linked to over sixty medical conditions and can be the trigger for early onset of age-related macular degeneration, causing a drinker to lose focus in their central field of vision. It's really important for ...


Mperia Therapeutics Appoints Paul Chipperton as President and CEO
Associated Press (press release) (blog)
MONTREAL--(BUSINESS WIRE)--Nov 9, 2018--November 9, 2018, Mperia's Board of Directors announces today the appointment of Mr Paul Chipperton, as the new President and CEO, effective immediately. He will lead CD36 development programs in ...

and more »

News-Medical.net

Calcified nodules in the retina increase risk for progression to late stages of AMD
News-Medical.net
The team discovered that large calcified nodules in the retina were associated with progression of late stages of AMD, especially with the more insidious atrophic form of the disease, of which there are currently no treatment options. The experts ...

and more »

VIDEO: ForeseeHome helps monitor AMD progression
Healio
CHICAGO — Lisa K. Feulner, MD, PhD, discusses the importance of early detection of a transition from dry to wet age-related macular degeneration and how the ForeseeHome program (Notal Vision) has helped her patients monitor progression at home at ...


Medical Xpress

Calcifications in the eye increase risk for progression to advanced AMD by more than six times
Medical Xpress
The team discovered that large calcified nodules in the retina were associated with progression of late stages of AMD, especially with the more insidious atrophic form of the disease, of which there are currently no treatment options. The experts ...

and more »
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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