Age-related macular degeneration (AMD) is one of the leading causes of vision loss among adults over 65. This condition affects the back of the eye where light is processed by macula. The macula is the part of the retina providing sharp, detailed vision needed for reading, driving, and recognizing faces. Two categories of macular degeneration are “dry” and “wet”. This article will focus on dry macular degeneration and therapy options to help slow vision loss from it.
Macular degeneration begins silently. Early symptoms may include mild blurring, difficulty seeing in low light, or the appearance of wavy or distorted lines. Later on, a dark or empty spot near the center of the vision can develop. In advanced stages, central vision may be lost entirely. Regular eye exams are crucial because early AMD can be detected during a dilated retinal examination or with specialized imaging.
A few major risk factors include age, family history, current smoking, and genetics. Individuals with a family history of AMD should be especially vigilant about screening.
Routine eye exams with an optometrist or general ophthalmologist are the first line of defense in identifying AMD. However, once AMD is suspected or diagnosed, referral to a retina specialist is essential. Retina specialists undergo additional years of fellowship training specifically in identifying and treating diseases of the retina and macula. This specialized expertise allows for detailed diagnostic imaging, tailored treatment plans, and access to the latest clinical advances in emerging therapies for AMD.
For patients with intermediate dry AMD, one of the most promising new therapies involves photobiomodulation (PBM) using the Valeda Light Delivery System, an FDA-authorized device. PBM works by exposing the retina to specific wavelengths of light that stimulate the mitochondria—the “powerhouses” of our cells. By energizing these tiny structures, PBM helps improve cellular metabolism and reduce oxidative stress thought to have a role in slowing AMD. Clinical trials, including the LIGHTSITE III and LIGHTSITE IIIB, have shown that PBM can lead to improved visual function and contrast sensitivity in patients with intermediate AMD. These studies support PBM as a safe, non-invasive treatment option for eligible patients. In addition, there are FDA-approved injections for geographic atrophy, a more advanced stage of dry AMD. These treatments aim to slow progression and preserve remaining vision, marking a major milestone for patients who previously had limited options.
For AMD that has advanced beyond the ability to benefit from the therapies mentioned there are still options. Many vision aids and tools are available today that can help optimize remaining vision. Getting a referral to a Low Vision specialist is another step available to help individuals affected by advanced AMD. Early identification and intervention is key. Just like controlling blood pressure or diabetes early to prevent complications later on, addressing macular degeneration before it becomes advanced can make a significant difference in the long run. Current therapy slows down AMD to keep vision better for longer, but does not completely stop or reverse dry AMD. Regular follow-ups and referral to a retina specialist can ensure timely diagnosis, access to cutting-edge treatments, and personalized care to preserve sight for as long as possible.
Dr. Jed Assam is a board-certified, fellowship-trained retina specialist dedicated to the diagnosis and treatment of AMD along with other macular and retinal disorders. He is the founder of VRA Vision in Sioux Falls, a Center for Excellence in Macular Degeneration, and is passionate about patient education and early intervention to prevent vision loss. Follow The Prairie Doc® at www.prairiedoc.org Facebook, Instagram, YouTube and TikTok includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).
