Age-Related Macular Degeneration

Normal healthy retinal fundus image

Age-related macular degeneration (ARMD) is the most common cause of severe vision loss in elderly persons in developed countries and accounts for one-third of cases of untreatable vision loss. ARMD is a painless, irreversible, degenerative eye condition associated with the damage and ultimate death of photoreceptors. There are two types of ARMD, dry and wet; dry ARMD is far more common, but wet ARMD is usually a more advanced disease state and is associated with rapid distortion and sudden loss of central vision. Various agents are used for treatment, and lifestyle changes and dietary constituents are important for preventing ARMD and halting its progression. As new therapies become available, early identification of patients with risk factors for ARMD will be increasingly important.

Introduction

Age-related macular degeneration (ARMD) is the leading cause of irreversible visual impairment in the elderly.^[1] ARMD is a degenerative disease of the central part of the retina— known as the macula—that results in a loss of central vision, which is essential for most daily activities.^[2] It is characterized by a loss of visual acuity caused by degeneration of the choriocapillaris, retinal pigment epithelium (RPE), and photoreceptors, usually beginning with drusen and pigmentary changes in Bruch's membrane.^[1,3]

^{Wet Age Related Macular Degeneration/Hemorrhage}

The condition, which affects 30 million to 50 million people worldwide, is the leading cause of irreversible blindness in developed countries in people aged 50 years and older.^[1,2] More than 1.75 million persons in the United States were reported to have ARMD in the year 2000, and it is thought that the incidence will increase to almost 3 million by 2020.^[2]

^{Progression of Age Related Macular Degeration}

The prevalence of ARMD increases exponentially every decade after age 50.^[4] In many Western countries, the prevalence of ARMD in individuals older than 55 years is 1.6% and increases to about 13% in persons older than 84 years.^[2] The loss of central visual acuity leads to a reduction in activities of daily living, as well as to mobility problems and an increased risk of falls, fractures, and depression in the elderly.^[5]

 

Age-Related Macular Degeneration