Wet macular degeneration (AMD)

Wet age-related macular degeneration symptoms

The most severe form of macular degeneration is called wet macular degeneration (also neovascular); it is less frequent than the dry form (about 10-15% of cases). It is also often an evolution of the dry form; it progresses faster and is more severe.

This form of macular degeneration is called wet or exudative because it’s characterized by the formation of abnormal subretinal neovessels with a very fragile wall. These vessels grow towards the retina and are extremely permeable. They can lead to the formation of subretinal fluid, potentially causing macular edema and leading to the detachment of the retinal pigment epithelium.

Neovascular senile macular degeneration, characterized by choroidal neovascularization (CNV), is present in less than 20% of all age-related macular degeneration (AMD) cases, but it is responsible for approximately 90% of all cases of severe vision impairment and loss related to AMD.

Chronic inflammation develops when the retinal tissue is unable to regulate its natural inflammatory responses. Release of enzymatic granules from immune cells (macrophages) can cause rupture of the Bruch’s membrane, a very thin tissue that is located between the choroid and the retina. The rupture of the Bruch’s membrane allows subretinal neovessels to invade into the retinal tissue.

To treat wet macular degeneration, it is essential to counteract the underlying chronic inflammatory processes.

We recommend

  • not to smoke;
  • doing moderate physical exercise;
  • protecting from ultraviolet rays which can damage the macula;
  • a correct diet with an intake of natural antioxidant and anti-inflammatory substances;

Be sure to ask your ophthalmologist for advice.

Retinal specialists can make the diagnosis for wet AMD and guide treatments by performing different types of retinal examinations. During the visit, the ophthalmologist examines the central part of the retina (examination of the fundus) with an instrument called the indirect ophthalmoscope. Optical coherence tomography (OCT) is very easy to perform and is very useful for monitoring AMD progression. Either an optical coherence tomography (OCT, a non-invasive examination that allows imaging the different layers of the retina), or an OCT angiography (Angio OCT), may be used.

The current focus of wet AMD treatment is mainly pharmacological treatment aimed at inhibiting the angiogenesis process that underlies wet macular degeneration. In wet AMD, VEGF inhibitors are injected directly into the area to be treated to block VEGF signaling, which is the key mediator in the process of neovessel formation.