Health Information
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Understanding This Symptom
Medical Definition
Subject Matter Expert Verified
Age-related macular degeneration (AMD) is a progressive eye disease that affects the macula, the central portion of the retina responsible for sharp, detailed vision.
It is the leading cause of irreversible vision loss in adults over 50.
AMD develops when the retinal pigment epithelium (RPE) cells deteriorate, leading to the accumulation of drusen deposits, photoreceptor death, and progressive central vision loss.
There are two forms: dry AMD (atrophic, 85-90% of cases) characterized by gradual RPE atrophy, and wet AMD (neovascular, 10-15% of cases) involving abnormal blood vessel growth beneath the retina that can cause rapid vision loss.
Quick Facts
What Optimal Health Looks Like
Understanding how your body functions when healthy helps identify dysfunction
In healthy vision, the macula functions as the retina's high-resolution center, containing the highest concentration of photoreceptor cells (cones) responsible for sharp central vision and color perception.
The retinal pigment epithelium (RPE) layer sits beneath the photoreceptors, performing critical functions: absorbing scattered light to improve image clarity, transporting nutrients from the choroidal blood supply to photoreceptors, removing metabolic waste products, regenerating visual pigment (11-cis-retinal), and maintaining the blood-retinal barrier.
The macula's fovea centralis provides 20/20 vision.
Bruch's membrane separates the RPE from the choroid, allowing nutrient exchange while blocking unwanted substances.
Healthy Function
Your body is designed to maintain balance and self-regulate
How This Develops
Lipofuscin accumulation - Aging RPE cells accumulate lipofuscin granules (undigested photoreceptor outer segments), impairing cellular function and creating oxidative stress
Drusen formation - Extracellular deposits accumulate between the RPE and Bruch's membrane, composed of lipids, proteins (complement components, amyloid-beta), and cellular debris; large, soft drusen indicate advanced disease risk
Oxidative stress - Reactive oxygen species (ROS) damage photoreceptors and RPE cells; mitochondrial dysfunction in RPE cells reduces ATP production and increases ROS generation
Chronic inflammation - Complement system dysregulation (especially CFH Y
Neovascularization (wet AMD) - VEGF (vascular endothelial growth factor) stimulates abnormal choroidal blood vessel growth beneath the retina; these fragile vessels leak fluid and blood, causing rapid photoreceptor death and scarring
Geographic atrophy (advanced dry AMD) - Progressive RPE and photoreceptor cell death creates expanding areas of retinal atrophy with irreversible vision loss
Impaired choroidal circulation - Reduced blood flow to the outer retina deprives photoreceptors of oxygen and nutrients
Matrix metalloproteinase activation - MMPs degrade extracellular matrix, compromising Bruch's membrane integrity
Understanding the mechanism helps us target the root cause rather than just treating symptoms.
What Happens If Left Untreated
Understanding the consequences helps you make informed decisions about your health
Short-Term Consequences
Days to weeks
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Time Matters
Don't wait for symptoms to worsen. Early intervention leads to better outcomes.