Once AMD progresses from an early or intermediate case it is considered advanced AMD. Advanced AMD is split into two categories: atrophic AMD (also known as geographic atrophy) and exudative AMD (also known as neovascular or commonly ‘wet’ AMD). Exudative AMD or geographic atrophy can result in significant loss of visual function over time. Exudative AMD often causes scarring of the macula and retina, producing rapid and permanent loss of central vision in as little as three months if not treated promptly.

People living with advanced AMD can have many visual problems that profoundly affect their quality of life. Daily activities like dialing the telephone, reading, driving, preparing food, and doing laundry can be very difficult or impossible due to vision loss. It can also be difficult to read and recognize faces. Talk to your doctor about how AMD is impacting your life and whether they can refer you to support services in your community that can help.

Exudative AMD is the most serious and severe form of AMD. All people who develop exudative AMD once had intermediate AMD, but only 10 to 15% of people with intermediate AMD will progress to the exudative form. Exudative AMD is characterized by the growth and leaking of abnormal blood vessels under the macula. Exudative AMD can rapidly damage the macula and quickly cause a loss of central vision. Routine eye examinations are very important for patients at a higher risk of developing exudative AMD.

In exudative AMD, blood vessels grow abnormally beneath the macula, through a process called angiogenesis. These abnormal vessels leak fluid and blood, which may cause a blister-like pocket to form beneath the macula. These blisters distort vision in the affected eye, making straight lines appear wavy. The patient may see a dark spot or spots in the center of their vision due to blood or fluid collecting under the macula. You can monitor changes in vision at home using the Amsler Grid (downloadable here) and other at-home monitoring tools.

If exudative AMD is left untreated, bleeding in the eye can cause scar tissue to form, leading to irreversible vision loss. The good news is that there are several effective treatment options, known as anti-VEGF therapies, for exudative AMD. Anti-VEGF treatments can stabilize or, in some cases, reverse vision loss if used before scar tissue forms.

Anti-VEGF treatments are administered as injections in the eye by a trained retina specialist. These injections can be slightly uncomfortable, but you can talk with your doctor about minimizing discomfort during the procedure. Most people notice that injections help them maintain the vision they have, and in some cases, the vision can even improve. If the first anti-VEGF treatment you try isn’t working, you still have options. Talk to your doctor about trying another anti-VEGF therapy that could be better for you.

A diagnosis of wet AMD meant certain vision loss before anti-VEGF treatments became available in 2006. Now people are able to prevent vision loss, especially when treated early.

Once you are receiving anti-VEGF treatment, it’s important to stay on the treatment schedule recommended by your doctor.

Eye care professionals once thought intermediate AMD (dry) went away once it progressed to exudative AMD (wet), but the advent of anti-VEGF treatments have shown that dry AMD remains even after someone is diagnosed with exudative AMD. This may explain why AMD cannot be completely reversed even with effective anti-VEGF treatments.