Age-Related Macular Degeneration

Age-related macular degeneration (AMD) (synonyms: Age-Related Eye Disease; Age-related marcular degeneration; Wet macular degeneration; Macular degeneration; Macular drusen; Dry macular degeneration; ICD-10-GM H35.3-: Degeneration of the macula and posterior pole) is a degenerative disease of the macula lutea (yellow spot of the retina). The macula is the site of sharpest vision on the center of the retina. The function of the macula is necessary for activities such as reading, driving and watching television.

Macular degeneration has become the most common cause of vision loss beyond the age of 50 in Germany and other industrialized countries.

It is now known that early stages of age-related macular degeneration can also be seen in people as young as 34 to 44 years of age.

AMD can be divided into an early form, an intermediate form, and two late forms:

  • “Dry” form of AMD – In this case, so-called drusen (yellowish, partly confluent subretinal (“located below the retina”) lipid deposits) form at the back of the eye in the early stage. In the late stage, there are two-dimensional degeneration, through which the photoreceptors (light-sensitive sensory cells) perish; frequency 85-95% of cases.
  • “Wet” or “exudative” AMD (synonym: neovascular AMD, nAMD) – The focus is on the growth of vascular membranes from the choroid into the overlying macular retina (= choroidal neovascularization). As a result, macular hemorrhages and the formation of edema (water accumulation) in the area of the macula occur. This also leads to the demise of photoreceptors.

Note: Not infrequently, mixed forms of the two late stages also occur in the same eye.

Frequency peak: The disease occurs predominantly in older age, preferably from the age of 65.

The prevalence (disease frequency) for late stages of AMD is 1% in the age group 65-74 years and 5% in the age group 75-84 years. Annually 300.000 new cases of macular degeneration are diagnosed in Germany; currently about 7.000.000 people are affected by AMD.Dark-skinned people get the disease significantly less often than light-skinned people.

Course and prognosis: The course of age-related macular degeneration is progressive. In contrast to the dry form, which accounts for 80% of the cases, the wet form can progress very fast! Therefore the wet form is more common in patients with advanced macular degeneration. In the final stage, activities like reading and driving are no longer possible. However, the ability to orient oneself in a room remains.