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Feature:
Age-related Macular Degeneration

What Is Age-Related Macular Degeneration?

Age-related macular degeneration (AMD) is a common eye condition and a leading cause of vision loss among people age 50 and older. It causes damage to the macula, a small spot near the center of the retina and the part of the eye needed for sharp, central vision, which lets us see objects that are straight ahead.

In some people, AMD happens so slowly that vision loss does not occur for a long time. In others, the disease progresses faster and may lead to a loss of vision in one or both eyes. As AMD progresses, the appearance of a blurred area near the center of vision is common. Over time, the blurred area may grow larger, causing blank spots in your central vision.

AMD by itself does not lead to complete blindness, with no ability to see. But the loss of central vision in AMD can interfere with simple everyday activities, such as seeing faces, driving, reading, writing, or doing close work, such as cooking or fixing things around the house.

Who Is At Risk?

Age is a major risk factor for AMD. The disease is most likely to occur after age 60, but it can occur earlier. Other risk factors include:

  • Smoking. Research shows that smoking doubles the risk of AMD.
  • Race. AMD is more common among Caucasians than among African-Americans or Hispanics/Latinos.
  • Family history and genetics. People with a family history of AMD are at higher risk. At last count, researchers had identified nearly 20 genes that can affect the risk of developing AMD. Many more genetic risk factors are suspected.

You might be able to reduce your risk of AMD or slow its progression by making these healthy choices:

  • Exercise regularly.
  • Maintain normal blood pressure and cholesterol levels.
  • Eat a healthy diet rich in green, leafy vegetables and fish high in omega-3 fatty acids.

Find Out More

How Is AMD Detected?

The early and intermediate stages of AMD usually start without symptoms. Only a comprehensive dilated eye exam can detect AMD.

AMD has few symptoms in the early stages, so it is important to have your eyes examined regularly. If you are at risk for AMD because of age, family history, lifestyle, or some combination of these factors, you should not wait to experience changes in vision before getting checked for AMD.

How Is AMD Treated?

Currently, no treatment exists for early AMD, which in many people shows no symptoms or loss of vision. Your eye care professional may recommend you get a comprehensive dilated eye exam at least once a year. The exam will help determine if your condition is advancing.

Researchers at NEI tested whether taking nutritional supplements could protect against AMD in the Age-Related Eye Disease Studies (AREDS and AREDS2). They found that daily intake of certain high-dose vitamins and minerals can slow progression of the disease in people who have intermediate AMD and those who have late AMD in one eye.

If you have intermediate or late AMD, you might benefit from taking such supplements. Consult your doctor or eye care professional about which supplement, if any, is right for you.

The introduction of anti-VEGF drugs for treatment of neovascular, or wet, AMD a decade ago has proved to be effective in preserving vision for many with the condition. (See this article)

Researcher Kapil Bharti, PhD, at work in a National Eye Institute laboratory.
Photo Courtesy of: Rhoda Baer, courtesy of NIH Intramural Research Program

AMD Research Roundup

...with Kapil Bharti, PhD, a Stadtman Investigator at the National Eye Institute (NEI) Unit on Ocular & Stem Cell Translational Research. Bharti leads efforts to grow and transplant a patient's own tissue to halt or reverse retinal diseases like age-related macular degeneration (AMD).

Aiming to restore damaged eyesight, Bharti says his work is "a dream that came true in my life." He won a Therapeutic Challenge Award through the NIH Common Fund in 2014 to develop a treatment for AMD. He leads research using induced pluripotent stem (iPS) cell technology, where cells are genetically reprogrammed to an embryonic stem cell-like state.

Like embryonic stem cells, iPS cells can be used to make virtually any cell in the body. But because they are sourced from patients, there's less potential for rejection. The ethical issues around the use of embryonic stem cells are also avoided.

"We know that if you replace the damaged tissue in the eye with healthy tissue from another part of the eye, we're able to restore vision in some patients," Bharti says. "So, if we're able to make these cells—not from the eye itself—but from another part of the body, it may have beneficial results for AMD patients."

That's where the iPS technology comes in. It allows Bharti and his team to take cells from another part of the patient's body and differentiate those cells into tissue that can be transplanted into the eye. "In this case, we're using iPS cells to make retinal pigment epithelium (RPE)—the layer of tissue in the retina that breaks down, causing AMD," Bharti says.

With the first clinical trial set to begin in 2018, Bharti believes that once the lab-grown RPE is mature, the tissue can be transplanted into the patient with the goal of slowing, reversing, or halting AMD. The new cells will serve as replacement tissue in the eye.

Read More "Age-related Macular Degeneration" Articles

New Eye Treatment Saves Former Math Teacher's Sight / What Is Age-Related Macular Degeneration? / New Treatment Greatly Improves Prognosis for Patients with AMD

Summer 2016 Issue: Volume 11 Number 2 Page 25-26