Retinal Conditions

Advanced Vision Loss with AMD: What to Expect

Atrophic Age-related Macular
Degeneration & Geographic Atrophy

 

Age-related macular degeneration (AMD) has different stages and types including mild AMD, intermediate AMD, wet AMD, and atrophic AMD. Wet AMD and atrophic AMD are both advanced forms of the disease which can cause vision loss, and it is possible to have both advanced forms in the same eye.

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What does atrophy mean in AMD?
The retina is like the film in a camera and lines the back wall of the inside of your eye. Right behind the retina is a barrier layer called the retinal pigment epithelium (RPE) which is also important for the health of the retina. In atrophic AMD, the RPE cells become sick and degenerate, leaving patches of tissue with poor vision.

 

When atrophic AMD starts, the vision is often decreased in a non-specific manner. The vision is less clear, color and contrast are affected, and glasses do not help. This is equivalent to the film in the camera wearing thin right in the center but still functioning. 

 

When atrophic AMD progresses further, it can result in geographic atrophy (GA), where discrete patches of the retina stop functioning entirely. This results in dark or missing spots in the vision. 

 

Atrophic AMD can sometimes cause black “ink spots” that are briefly visible when waking up or when the lighting changes suddenly. Patients will also sometimes experience their vision “jumping” because their eye is rapidly moving around, trying to find a spot with clear vision but struggling because healthy areas of the retina are irregular and patchy. There is no treatment available for these symptoms.

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If GA is located away from the center of the retina, it may have very little impact on visual function, even if the affected region is large. Sometimes non-central GA will affect the peripheral vision in a way that impacts driving safety. If GA is located in the center of the retina, even a small patch of GA may profoundly limit visual function. Atrophic AMD usually progresses over time. In many cases, the atrophy enlarges at about.