Age-related macular degeneration (ARMD)

The retina and therefore also the macula rest on another section of the posterior part of the eye known as the choroids. This provides oxygen and nutrients to the retina and is responsible for cleaning waste products generated by the retina. All these exchanges must be done crossing a very fine membrane which is between the retina and the choroids, the Bruch membrane. Therefore, anomalies in the latter structure are precisely those that cause ARMD initially. In this way it may be that these changes prevent the correct nutrition of the retina which causes secondary degeneration of the retina that stands on that area and that is recognised as the dry or atrophic form of the disease. The other possibility, is that, stimulated by the lack of nutrients and oxygen, a growth of abnormal veins occurs that finally destroy the structures and surround them at the same time as they grow, which is known as the wet or exudative form.

Risk factors

Age is the most important risk factor. There have been cases detected in people who are 55 years old or over, although the usual age is from 70 years old onwards.
Genetic factors: if you have a relative with this disease you are more likely to suffer it
Smoking and excessive sun exposure
Lack of natural nutrients that are present in the retina

There are two types of macular degeneration

Dry macular degeneration is the most common one. It progresses at a slower pace, the patient notices blurry vision and distortion of straight lines, which appear to be wavy. There is no specific treatment for Dry AMD, but monitoring must be performed. Taking the Amsler Grid test is recommended to check how these lines are seen by the patient.

Wet or exudative macular degeneration is less frequent, but it presents a faster progression. There is an abnormal growth of the blood vessels behind the macula, developing new extremely fragile blood vessels that bleed and exude liquid.

No changes

Healthy macula, without drusen

Normal changes because age

Only small drusens

Starting ARMD

Mid-size drusens and/or pigmentation alterations

Advanced ARMD

Associated injuries to ARMD and/or geographic atrophy