“Wet” and “dry” macular degeneration differ but both cause vision loss
By Deborah Jeanne Sergeant
Age-related macular degeneration (AMD) may be wet or dry. The two types of macular degeneration typically occur in people older than 50 and it’s most common in those who over 70.
The macula is in the center of the retina at the back of the eye. The macula allows people to see the details of things directly in front of them and is vital for tasks like reading, recognizing people visually and driving.
Wet AMD (W-AMD) refers to fluid accumulation and swelling at the back of the eye and sometimes bleeding. W-AMD progresses more quickly and the swelling and bleeding can cause severe vision loss. Dry age-related macular degeneration (D-AMD) typically presents with less vision loss. D-AMD patients tend to experience trouble with reading, as near vision is affected more.
Patients with W-AMD may report seeing wavy lines or crooked lines. That can interfere with working on a laptop or reading a book.
“There’s a difference in progression rate,” said Yaseen Morshid, doctor of optometry at Harbor Eye Associates in Oswego. “Dry progresses slower and affects the vision at less magnitude than wet. Wet macular degeneration is faster and more harmful, mainly because of the formation of abnormal, weak blood vessels. They have a weak integrity and start to leak blood into the retinal tissue and that’s toxic to the retinal tissue. Dry AMD can be a more advanced condition where a part of the retina can dry up and die off.”
The outlook for patients varies. Both W-AMD and D-AMD may be treated. With W-AMD, treatments can improve vision; however, for D-AMD, providers can only stabilize patients to try to slow further damage. Without treating D-AMD, it quickly progresses in a year or two.
“Some have a start of dry macular degeneration and the progression rate will be so slow that they won’t experience significant vision loss; others progress at a much faster rate,” Morshid said. “It’s important to see your doctor. In the most severe form, patients lose the center of their vision. Some will die before they experience any serious central vision loss. Others progress at a faster rate.”
As with most conditions, it’s important to seek care right away for a better chance at a positive outcome.
Quynh Le, doctor of optometry at Harbor Eye, said that for D-AMD, “studies show formulas with antioxidants are good for the pigment cells in the back of the eye: AREDS for intermediate to advanced dry macular degeneration. In earlier stages, the formulation doesn’t have much effect in benefits. We only recommend it for intermediate to advanced.”
The AREDS 1 formula contains beta carotene, so Le said it’s not recommended for people who smoke or who have a history of smoking. For them, AREDS 2 may be recommended.
“In wet macular degeneration, we typically refer those patients out to retinal to injections,” Le said. Those injections typically help with the abnormal blood vessel growth to prevent bleeding.”
In general, for eye health, Le tells patients to eat more leafy green vegetables like kale and spinach, as these support good eye health. They should also eschew smoking and should wear sunglasses outdoors.