The Macula: The Center of Sharp Vision
To understand age-related macular degeneration, it is helpful to first look at the anatomy of the eye. The retina lines the inside of the eye and functions similarly to a camera's image sensor: it converts incoming light into electrical signals, which are then transmitted to the brain via the optic nerve.
In the center of the retina is a small but extremely important area: the macula, also called the 'yellow spot.' With a diameter of only about five millimeters, it is responsible for sharp, central vision. Here, the light-sensitive cells (photoreceptors) are particularly densely concentrated, especially the cones, which are responsible for color vision and recognizing fine details.
When we read, recognize faces, watch TV, or drive, we primarily use the macula. Although it makes up only a small part of the entire retina, it is responsible for about 90 percent of our vision. Damage to this area, therefore, has far-reaching effects on quality of life, even if peripheral vision is preserved.
Regular eye exams help in the early detection of AMD
What Happens in AMD?
In age-related macular degeneration, there is a progressive breakdown of cells in the macula. This process typically begins in the retinal pigment epithelium (RPE), a layer of cells located directly under the photoreceptors. The RPE performs important tasks: it supplies the photoreceptors with nutrients, disposes of metabolic waste, and regenerates the light-sensitive pigments.
Over the course of life, metabolic products accumulate that can no longer be completely removed. These deposits, called drusen, are visible as small yellowish spots under the retina during an eye examination. Drusen are an early sign of AMD and may be present before those affected notice changes in vision.
As the disease progresses, the drusen become larger and more numerous. The RPE can no longer perform its functions adequately, which eventually leads to the death of the overlying photoreceptors. In the advanced stage of dry AMD, areas of complete tissue death, known as geographic atrophy, develop.
The Dry Form: Common, but Often Underestimated
Two main forms of AMD are distinguished: the dry (atrophic) and the wet (exudative) form. Learn more about the differences on our page <Link href={localePath('/amd-verstehen/trockene-vs-feuchte')} className='text-primary hover:underline font-medium'>Dry vs. Wet AMD</Link>. This website focuses on dry AMD, which is by far the more common form, accounting for about 80 to 90 percent of cases. For a long time, research focused on wet AMD, but dry AMD also deserves attention, as it affects millions of people and can significantly impair quality of life.
Dry AMD usually develops slowly over years to decades. In the early stages, many affected people notice no or only minor changes. As the disease progresses, blurred vision, difficulty reading, and reduced contrast perception can occur.
Important Note
AMD does not lead to complete blindness. Peripheral vision is preserved, so those affected can still orient themselves and move independently. However, the disease can significantly impair quality of life, which is why early detection and timely treatment are so important.
Impact on Daily Life
AMD affects the central field of vision, while peripheral (side) vision usually remains intact. This means that those affected can still orient themselves in space and move independently. However, activities that require sharp central vision become increasingly difficult: reading, recognizing faces, driving, fine handicrafts, or reading clocks and displays.
Despite these limitations, many people with AMD lead active and fulfilling lives. Aids such as magnifying glasses, special reading devices, and good lighting can make everyday life easier. Rehabilitation measures help to make optimal use of the remaining vision and learn new strategies for daily activities. In addition, there are now innovative therapeutic approaches that can slow the progression of the disease.
Frequently Asked Questions
Answers to the most important questions about AMD and Photobiomodulation
Dry AMD is the more common form (approx. 80–90% of cases) and typically develops slowly through deposits (drusen) beneath the retina. Wet AMD is rarer but often progresses faster, as abnormal blood vessels form beneath the retina. Both forms can impair central vision and require different therapeutic approaches.