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ARMD is a condition that all should familiarize themselves with but you should also be aware that are two different types of this disease. Wet and dry macular degeneration are two completely different diseases with two distinctive treatment approaches.

Macular degeneration is a blanket term to refer to a number of different pathologies that ultimately result in some type of vision loss if left untreated. As we dive deeper into what this diagnosis actually means, you need to understand that are multiple varieties of how this disease can present. You may hear your doctor refer to something called "wet" and "dry" macular degeneration. They sound completely different because they have completely different pathologies on how they cause vision loss.

Dry age-related macular degeneration is the condition where there are not enough blood vessels around the center of your eye. This starves the eye from essential nutrients and you lose vision as a result. Wet macular degeneration, on the other hand, is when there are too many blood vessels that encroach the central part of the eye and cause vision loss because there are blood vessels blocking your vision.

Here, we will cover how to tell the difference between wet and dry age-related macular degeneration and how macular degeneration treatment can vary based on the type of macular degeneration that a patient may have. [1]

What You Should Know About Dry Macular Degeneration 

If you had to choose between having dry or wet macular degeneration, the preferable one would be dry macular degeneration because the onset of vision loss is much slower compared to that seen within wet macular degeneration. This is a disease that worsens depending on other risk factors seen in patients. Some of the most common associated diseases with dry macular degeneration include obesity, smoking and hypertension. [2] When you have these long-term conditions, the blood supply to your eye is usually cut off so your eye function will begin to decline. Some of the first noticeable signs that you may be suffering from dry macular degeneration include blurry vision, needing to use brighter and brighter sources of light to see, and inability to recognize faces. [3]

Treatment options are unfortunately more limited for this condition because it is not so easy to re-establish blood into the extremely sensitive cavity. Doctors urge patients to routinely have vision check-ups after the age of 50 and make sure your eye doctor routinely checks the health of your macula to make sure that risk factors can be limited to reduce the progress of the disease. It is also wise to try to solidify your health by starting anti-hypertensive medications as well as developing a diet that is more favorable for eye health

In the event you are unsuccessful at reducing the progress of your dry macular degeneration, the disease can progress in one of two ways. Your body can either try to re-establish circulation into this area by creating blood vessels around your retina (and making you now have wet macular degeneration) or your disease course will continue to progress slowly to visual loss within the next decade.  

New-aged treatment options are showing promise and can help reduce the oxidative damage that is caused by decreased blood into the eye. They work by mostly targeting the chronic inflammation that is associated with dry macular degeneration and when these levels are reduced, the eye health can be better preserved. [4]

What You Should Know About Wet Macular Degeneration 

Now that we know a little about dry age-related macular degeneration, wet macular degeneration is the true form of AMD that patients need to familiarize themselves with. This is the less common form of macular degeneration and accounts for only 10 percent of cases of all types of macular degeneration. Patients will experience the same types of symptoms that are seen in dry macular degeneration, the only difference is the speed that these symptoms will appear.

Whereas dry macular degeneration was seen to be something that occurs over years, wet macular degeneration is a much more rapid process and patients can easily go from diagnosis to total vision loss in a matter of a few months. 

Risk factors are similar as well in this form of macular degeneration but patients who have a history of diabetes are also generally more likely to develop this form of the disease. Diabetes follows a similar mechanism where high levels of sugar stimulate the production of new blood vessels and because the eyes are highly vascularized, patients are at an increased risk of developing this wet type of macular degeneration

When a doctor suspects that you may be suffering from wet macular degeneration, time is of the essence so treatments need to be started as soon as possible. The class of medication that is routinely used when patients are suffering from wet macular degeneration falls into the category of anti-VEGF medications. VEGF is an acronym that stands for vascular endothelial growth factor [5]. These medications work by blocking the formation of new blood vessels and preventing them from encroaching on the surface of the eye [6]. Studies show that this is an effective treatment option for people to try to save their vision. After 1 year of therapy using anti-VEGF, patients on average were able to not lose 15 letters of visual acuity 90 percent of the time [7]. These investigations also show that the macula thickens after using these drugs restoring the eye to a healthier baseline level. 

Unfortunately, these measures are not guaranteed to last and eventually, more definite treatments are needed in order to try to salvage vision in patients. Laser photocoagulation is the process of passing a laser beam into the eye chamber and burning off vessels that are building in the eye cavity [8]. Physicians need to be highly skilled but there are many more potential side effects due to an invasive procedure such as this. As a macula degeneration treatment, it is an effective option to consider but you may loss partial vision if the laser accidentally damages parts of your eye or risk retinal detachment due to instability. [9] As you can see, there are quite a few differences between wet and dry age-related macular degeneration that you need to consider when the doctor tells you it is something that you may have. 

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