Age-Related Macular Degeneration (AMD)

What it is

Progressive loss of central vision from degeneration of the macula (the central retina). Two main forms:

• Dry (atrophic) AMD — ~85–90% of cases. Drusen accumulate; later geographic atrophy of photoreceptors and RPE.
• Wet (neovascular) AMD — ~10–15% of cases. Abnormal subretinal blood-vessel growth (CNV) with rapid vision loss.

Risk factors

• Age (the dominant factor).
• Smoking.
• Family history (CFH, ARMS2 variants).
• White / European ancestry.
• Cardiovascular risk factors.
• Diet low in carotenoids and omega-3s.

Treatment

• Wet AMD: intravitreal anti-VEGF injections (ranibizumab, aflibercept, bevacizumab, faricimab) have transformed outcomes — from almost universal central vision loss to preserved vision in most patients with regular treatment.
• Dry AMD with geographic atrophy: complement inhibitors (pegcetacoplan, avacincaptad pegol) slow lesion growth, with limited functional vision benefit so far.

Modifiable risk

• Smoking cessation is by far the most impactful.
• AREDS2 formula (vitamins C, E, zinc, copper, lutein, zeaxanthin) reduces progression in intermediate AMD.
• Mediterranean-style diet with fish, leafy greens.
• Photobiomodulation (LIGHTSITE trials) for dry AMD is emerging.

Related entries

Photobiomodulation, Mediterranean diet, Mitochondrial dysfunction.