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Macular Degeneration
WET AMD
Wet macular degeneration is an advanced and serious form of age-related macular degeneration (AMD). Unlike dry AMD, which typically progresses slowly, wet AMD involves the growth of abnormal, fragile blood vessels beneath the macula—the part of the retina responsible for sharp, central vision. This process, called choroidal neovascularization, can lead to leakage of fluid and blood under the retina, damaging vision and sometimes causing scar tissue. Because wet AMD can result in rapid and permanent vision loss, it requires prompt evaluation and treatment.
The symptoms of wet AMD often develop suddenly and may worsen quickly. Patients commonly notice changes in their central vision, which is critical for reading and recognizing faces. Straight lines may appear wavy or distorted, and a dark or blank spot (called a scotoma) may develop in the center of vision. Vision may also become blurred, and colors can appear less bright or vivid. Any of these symptoms should be taken seriously and evaluated as soon as possible.
Diagnosis of wet AMD requires a comprehensive eye examination by a retina specialist. This typically includes a dilated exam to closely evaluate the retina and macula. Imaging tests such as Optical Coherence Tomography (OCT) are used to detect fluid within or under the retina, which is a key sign of disease activity. In some cases, fluorescein angiography may be performed to identify leaking blood vessels. Patients are often encouraged to monitor their vision at home using an Amsler grid to detect early changes such as distortion or new blind spots.
The primary treatment for wet AMD is intravitreal injections of medications known as anti-vascular endothelial growth factor (anti-VEGF) agents. These medications work by blocking the signals that cause abnormal blood vessel growth and leakage. Treatment typically begins with a series of injections, often given monthly, followed by a personalized maintenance schedule based on how the eye responds. At Florida Retina Specialists, we work closely with each patient to develop an individualized treatment plan and coordinate care with insurance providers. These treatments are highly effective at stabilizing vision and, in many cases, improving it.
Protecting your vision with wet AMD requires ongoing care and attention. Early detection and consistent follow-up are critical to achieving the best outcomes. In addition to treatment, maintaining a healthy lifestyle can support eye health—this includes eating a diet rich in leafy green vegetables and fish, avoiding smoking, and controlling blood pressure and cholesterol. Most importantly, never ignore new symptoms. If you notice distortion, blurred vision, or a new dark spot, contact your retina specialist right away for an urgent evaluation.
DRY AMD
For the dry type of macular degeneration, high dose vitamin and antioxidant therapy has been shown to significantly decrease the long-term risk of vision loss with dry age-related macular degeneration (AMD). The Age-Related Eye Disease Study 2 (AREDS2) is a National Institute of Health trial that has showed the following supplementations can significantly decrease the risk of vision loss even beyond the original supplementation recommendations made by the original AREDS study results in 2001. The supplement ingredients recommended by AREDS 2 are:
Vitamin C 500 mg per day
Vitamin E 400 IU per day
Zinc 25 mg per day
Copper 2 mg per day
*Lutein 10 mg per day
*Zeaxanthine 2 mg per day
omega - 3LCPUFAs
In some advanced cases, such as geographic atrophy (GA), intravitreal eye injections may be used to help slow progression.
Photobiomodulation, popularly known as red light therapy, may be of benefit to some patients. Lifestyle changes are also important, including eating a Mediterranean-style diet rich in fish and leafy greens, avoiding smoking, and protecting the eyes from excessive sunlight. Here at Florida Retina Specialists, we will help you navigate the various treatment options best suited for your eye condition and overall health.
Normal Retina
Wet AMD
Dry AMD
In the wet type of AMD, which occurs in 10% of people, abnormal blood vessels grow under and lift up the retina which results in swelling and bleeding within the retina, causing loss of vision. These abnormal vessels are called choroidal neovascularization. The longer the neovascular membrane continues to leak, bleed and grow, the more central vision will be lost. Signs and symptoms of the wet type of AMD include sudden onset of decreased vision, central distortion, or a central blind spot in vision. An Amsler Grid self-testing by patients is highly effective for detecting early wet macular degeneration. (Someone with wet macular degeneration may view the lines to be distorted or possibly a central dark spot may be present.)
Risk Factors
Smoking is a very important and avoidable risk factor for developing macular degeneration. Also increasing evidence is showing lifestyle changes such as obesity reduction, and blood pressure control may help reduce the risk of vision loss from AMD. Cataract surgery has not been linked to the progression of AMD, and there is also no strong evidence linking UV light to the progression of AMD.
Treatment options
The current best available treatment for wet AMD is an injection of medication into the eye. The medications currently used to treat are called Anti-VEGF medications. Anti-VEGF treatment improves vision in about one third (1 out of 3) people who take it. And for a majority of patients, it at least stabilizes vision.
Anti-VEGF medicine blocks VEGF protein, which reduces abnormal blood vessels that bleed and damage the retina. This medicine slows or stops damage from the abnormal blood vessels and slows down vision loss. Sometimes it can even improve vision. Often these medications must be given every 4 to 6 weeks for an extended period of time. Many studies have shown that once the medications are stopped, the vision loss will continue. The study also showed that regularly scheduled monthly dosing produced more vision gain than as-needed regimen of treatment for both drugs. Currently, injections of these medications into the eye must be continued at regular intervals to prevent patients from losing vision.
