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ARMD

Definition

Age-related macular degeneration is a progressive disease affecting the macula, the central part of the retina which allows us to see details. Occurring after the age of 50, macular degeneration is the leading cause of poor vision in the elderly. It leads to a progressive loss of central vision, which is needed for activities like reading, recognising faces, and driving. Peripheral vision is usually retained.

Experts distinguish two forms of macular degeneration: wet and dry. In dry macular degeneration, also called atrophic macular degeneration, the macula atrophies progressively with age and is replaced with scar tissue. It is the most common and least severe form of the disease, and it progresses over many years.

In wet macular degeneration, also called exudative macular degeneration, small blood vessels develop newly under the macula. Due to the fact that they bleed easily, these new blood vessels lead to haemorrhages in the back of the eye. This bleeding may eventually result in macular scarring. This form of macular degeneration is less common but more severe than the dry form, and causes more rapid and profound vision loss.1

Note:
The macula, also called the yellow spot, is located in the centre of the retina, in the optical axis of the eye. Owing to its central position, the macula transmits 90% of the visual information handled by the eye, and is responsible for visual acuity. The macula is composed of numerous photoreceptors which enable it to perceive colours and details.2

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Epidemiology

ARMD is a common disease. In the United Kingdom, 3.7% of subjects over 75 years of age and 14.4% of subjects over 90 years of age present a visual deficiency due to ARMD.3 In Canada, more than 2 million people over 50 years of age suffer from ARMD.4 In the United States, the disease affects more than 1.7 million people.5 In France, over 2 million people are currently diagnosed with ARMD, among which 150,000 to 200,000 suffer from a severe form of the disease.6

In industrialised countries, ARMD is currently the leading cause of severe loss of visual acuity. Owing to the increase in life expectancy, the number of affected people is expected to continue to increase in the future. 7


3 Evans JR, Fletcher AE, Wormald RP. Age-related macular degeneration causing visual impairment in people 75 years or older in Britain: an add-on study to the Medical Research Council Trial of Assessment and Management of Older People in the Community. Ophthalmology 2004;111:513-7.
4 Cruess A, Zlateva G, Xu X, et al. Burden of illness of neovascular age-related macular degeneration in Canada. Canadian Journal of Ophthalmology 2007;42:836-43.
5 Evans JR, Fletcher AE, Wormald RP. Age-related macular degeneration causing visual impairment in people 75 years or older in Britain: an add-on study to the Medical Research Council Trial of Assessment and Management of Older People in the Community. Ophthalmology 2004;111:513-7.
6 Brain changes with macular degeneration. MIT Tech Talk 2005;49:4.
7 Cohen SY, Desmettre T. La DMLA est-elle une maladie fréquente ? Dans: DMLA – Dégénérescence liée à l’âge, Bash 2008, p 44.

 

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