There’s been some confusion in what eye doctors have told patients about the disease process in AMD and there are 2 questions that have come up in the Facebook group: 1) does wet AMD start as dry? 2) once the bleeding is stopped in the wet form, does the deterioration of the macula continue, ie, does the dry process continue?
About question 1, through my research I’ve found that a lot of articles don’t specify this, they just say there is the wet kind and the dry kind. However, most descriptions from reliable sources say YES, wet AMD starts as dry but sometimes the dramatic symptoms from the bleeding gets a person to the eye doctor & they never got the diagnosis of dry where the early stage has few symptoms.
About number 2, here’s the clearest answer to that question I can find:
Click here for the full article. There is at least one error in the transcript. In the second paragraph of Dr. Gorin’s response that starts with “We understand a great deal more in recent years because of the genetics studies that have been done.”, there is the word ‘bruising’ which should be ‘drusen’.
In this article, here is a quote is from the transcript of a telephone discussion with Michael B. Gorin, MD, PhD, an ophthalmologist from UCLA who is devoted to research and clinical care of hereditary retinal disorders, especially age-related macular degeneration, retinal dystrophies and other medical retinal conditions.
Dr. Gorin:
“But for a group of patients, it can diverge into two different paths of progression. One is where the cells that care for the retina begin to die and you start getting areas of atrophy—that is, cell loss—and on those areas of cell loss, you lose areas of vision. And that’s called atrophic, or advanced dry macular degeneration. That’s usually slower, but it can be very problematic for people, because it can create little holes in their vision and ultimately, if those holes get larger and coalesce, one can lose central vision from that. The second pathway—and by the way, they are not mutually exclusive, some people can have both of these things going on—is because of the damage to the cells underneath the retina, it triggers the formation of a blood vessel, either a blood vessel underneath the retina or sometimes even in the retina. That blood vessel is an abnormal growth; it’s not a tumor or a cancer, but it’s a blood vessel that’s stimulated to grow, and it unfortunately leaks and can bleed, and because of that leakage and bleeding, you get the term ‘wet’, because the fluid is leaking into the retina. Over time, that accumulation of blood and fluid disrupts not only the architecture of the cells, but can lead to fairly rapid vision loss. So, wet macular degeneration treatments at this stage are really focused on trying to prevent the ongoing growth and leakage of these abnormal blood vessels. The treatments do not stop the underlining degenerative process or the causes of macular degeneration in the first place. A person who is having successful treatment of the wet form of macular degeneration is really not having their macular degeneration stopped. The treatment is blocking and limiting the amount of damage that occurs.”