Dry and Wet Age-Related Macular Degeneration

The more common form, accounting for approximately 85-90% of all AMD cases. It develops when the light-sensitive cells in the macula gradually break down over time, and small yellow deposits called drusen accumulate beneath the retina.

Dry AMD tends to progress slowly over many years, and vision loss is usually gradual. In its early stages, dry AMD may cause no noticeable symptoms at all. As it progresses, you may notice that your central vision becomes slightly blurred, that you need brighter light for reading, or that colours appear less vivid.

Less common but more serious, and it can cause rapid and significant vision loss if not treated promptly. Wet AMD develops when abnormal blood vessels grow beneath the retina. These new vessels are fragile and prone to leaking fluid and blood, which damages the macula.

Wet AMD can cause sudden distortion or loss of central vision. It almost always develops in people who already have dry AMD, though not everyone with dry AMD will go on to develop the wet form.

There is currently no medical treatment that can reverse dry AMD. Management focuses on monitoring the condition, supporting your remaining vision, and reducing the risk of progression. Your consultant may recommend dietary supplements containing specific vitamins and minerals (based on the AREDS2 formula), which have been shown to slow the progression of intermediate dry AMD.

Lifestyle modifications - including stopping smoking, eating a diet rich in leafy green vegetables and oily fish, maintaining a healthy weight, and protecting your eyes from ultraviolet light - can also help. Regular monitoring with OCT scans allows your consultant to detect any changes early, particularly any signs that dry AMD may be converting to the wet form.

Wet AMD is treated with intravitreal injections of anti-VEGF (anti-vascular endothelial growth factor) medication. VEGF is a protein that stimulates the growth of new blood vessels. In wet AMD, there is an overproduction of VEGF, which drives the growth of the abnormal, leaky blood vessels beneath the retina. Anti-VEGF injections block this protein, helping to stop the growth of new vessels, reduce leakage, and stabilise or improve vision.

The medications used include ranibizumab (Lucentis), aflibercept (Eylea), and faricimab (Vabysmo). Your consultant will recommend the most appropriate medication based on your individual circumstances and current clinical guidelines.