ExudativeRetinaDrusenMaculaAtrophyType of macular degenerationTypes of macular degenerationOccursVitelliform macular dARMDPigmentBlood vesselsOphthalmologyNonexudativeBlindnessSymptomsStagesDiabetic retinopathyDiseasesChoroidalMaculopathyAffectsVisual impairmentBilateralDelveInsight'sCystoidFormTreatmentPatientsNutritional supplementsLuteinPeopleGenetic2019EpidemiologyVision lossChoriocapillarisPosteriorHeredityCentralDiagramTherapiesRisk factorsClinicalPrevalenceCommonTreatments
Exudative9
- In the wet, or exudative, form of age-related macular degeneration (AMD or ARMD), pathologic choroidal neovascular membranes (CNVM) develop under the retina. (medscape.com)
- AMD is a loss of central vision that can occur in two forms: "dry" (atrophic) and "wet" (exudative). (aoa.org)
- The early stages of AMD may progress to either atrophic ('dry') or exudative ('wet') AMD. (cehjournal.org)
- Approximately 10-20% of patients with atrophic AMD can progress to the exudative form. (cehjournal.org)
- AMD can also be characterized as either dry (atrophic or non-neovascular) or wet (exudative or neovascular). (delveinsight.com)
- Wet (neovascular or exudative) macular degeneration accounts for approximately 10 percent of the cases of age-related macular degeneration. (brightfocus.org)
- The two most important causes of the disease are age related and caused by dryness of the eye or wetness of the eye, atrophic or exudative. (aanos.org)
- The wet, or exudative, form of macular degeneration occurs in about 10 percent of all macular degeneration cases, but it can cause more damage to your central or detail vision than the dry form. (windsoreyeclinic.com)
- Majorly, there are two types of AMD: dry (atrophic) and wet (neovascular or exudative). (secunderabadchronicle.in)
Retina20
- This could allow this novel bioactive substrate to be a potential treatment for atrophic AMD that would function two-fold: deliver the required monolayer of healthy RPE cells to the macula on a synthetic BM and remove diseased structures within the retina, restoring the waste/exchange pathway and preventing vision loss. (frontiersin.org)
- Age-related macular degeneration (AMD) is a progressive disease of the retina that is the leading form of blindness in developed countries. (frontiersin.org)
- Macular degeneration affects the retina, a layer at the back of the eyeball. (medicalnewstoday.com)
- Initially, patients often have good visual acuity if the GA lesions are not involved in the central macular, or foveal, region of the retina. (wikipedia.org)
- Note prominence of the macular xanthophyll, thickening of the retina (see Figure 6 ), and preservation (darker areas) of the para-arteriolar RPE. (aao.org)
- The dry form is associated with atrophic cell death of the central retina or macula. (news-medical.net)
- Macular Degeneration is an eye disease affecting the macula (the center of the light-sensitive retina at the back of the eye), causing loss of central vision. (aoa.org)
- Age-related macular degeneration (AMD) is a disease of the retina that usually develops in people aged 60 years and older. (cehjournal.org)
- In the "dry" type of macular degeneration, the deterioration of the retina is associated with the formation of small yellow deposits, known as drusen , under the macula. (macular.org)
- AMD is characterized by progressive degeneration of the macula, the central part of the retina, leading to central vision loss. (delveinsight.com)
- Although macular degeneration reduces vision in the central part of the retina, it usually does not affect the eye's side, or peripheral, vision. (ivretina.com)
- Deposits under the retina called drusen are a common feature of macular degeneration. (ivretina.com)
- Age-related macular degeneration (AMD) is an irreversible destruction of the central area of the retina, called the macula. (brightfocus.org)
- Macular degeneration decreases the vision of the central part of the retina. (aanos.org)
- Macular degeneration usually begins with the appearance of drusen under the retina. (windsoreyeclinic.com)
- Age-related macular degeneration (AMD) causes progressive damage to the macula, the central and most vital area of the retina, resulting in gradual loss of central vision. (msdmanuals.com)
- Unlike typical dry macular degeneration where the buildup of material is below the retinal pigment epithelium, in pattern dystrophy, the buildup of material is above the pigment epithelium and directly beneath the retina (see asterisks on image). (rvaf.com)
- Macular degeneration affects the area of the retina called the macula, the part of the eye responsible for central vision. (drconleyeyecare.com)
- Although the cause of macular degeneration is not clear, possible causes and risk factors may include: reduction of macular pigment in the fovea area of the retina, lack of certain dietary intake of vitamins and minerals, breakdown in circulation to the retina, untreated health conditions such as high blood pressure, excessive exposure to ultraviolet light from the sun, heredity, and cigarette smoking. (drconleyeyecare.com)
- Oxidative stress is believed to play a major role in the pathogenesis of age-related macular degeneration (ARMD) because of combined exposures of the retina to light and oxygen. (medscape.com)
Drusen8
- Early dry form typically has drusen (usually around 63u) and RPE degeneration and only needs periodic follow-ups, intermediate dry form has large drusen (>125u) and RPE degeneration and proliferation which requires examinations every 3 to 6 months depending on the severity of the presentation. (optos.com)
- The early stage of dry age-related macular degeneration is associated with minimal visual impairment and is characterized by large drusen and pigmentary abnormalities in the macula (5). (macular.org)
- Only eyes with large drusen are at risk for late age-related macular degeneration (8). (macular.org)
- 6. NM Bressler et al, Clinicopathological correlation of drusen and retinal pigment epithelial abnormalities in age-related macular degeneration. (macular.org)
- Drusen are often found in the eyes of older people, but an increase in the size and number of these deposits is frequently the first sign of macular degeneration. (brightfocus.org)
- The hallmark of dry AMD is macular drusen (see photo). (rvaf.com)
- The first sign of macular degeneration is the appearance of age-related deposits called drusen. (retinagroupofnewengland.com)
- Funduscopic examination in age-related macular degeneration (ARMD) is significant for drusen in the early stages of disease. (medscape.com)
Macula13
- Both atrophic and hypertrophic changes occur in the RPE underlying the central macula and can lead to the loss of retinal photoreceptors. (medscape.com)
- With "dry" macular degeneration, the tissue of the macula gradually becomes thin and stops working properly. (aoa.org)
- Less common, "wet" macular degeneration occurs when fluids leak from newly formed blood vessels under the macula. (aoa.org)
- In atrophic AMD there is atrophy of the central macula, with gradual destruction of the RPE and the photo-receptors. (cehjournal.org)
- Central visual loss as a result of advanced myopic macular degeneration can affect people of working age, so examine the macula at every visit. (cehjournal.org)
- Macular degeneration is a deterioration or breakdown of the macula. (ivretina.com)
- Wet macular degeneration occurs when abnormal blood vessels grow behind the macula (called choroidal neovascularization ) as retinal pigment epithelial cells (RPE) and photoreceptor cells die. (brightfocus.org)
- In some cases, the disease may progress to the point where the entire macula becomes atrophic, resulting in complete and permanent vision loss in the affected eye. (rvaf.com)
- Pattern dystrophy is a type of dry age-related macular degeneration that involves mostly the very center of the macula. (rvaf.com)
- Macular holes happen when an opening forms in the macula - usually after being stretched or pulled. (sankarfoundation.org)
- In wet macular degeneration, new blood vessels growing near the macula may leak or bleed. (drconleyeyecare.com)
- In age-related macular degeneration (AMD), the macula deteriorates. (retina-doctors.com)
- Best disease, also termed vitelliform macular dystrophy, is typically an autosomal dominant disorder, which classically presents in childhood with the striking appearance of a yellow or orange yolklike lesion in the macula. (medscape.com)
Atrophy5
- Background/Aims To investigate the presence of short-wave fluorophores within regions of age-related macular degeneration (AMD)-associated macular atrophy (MA) area. (unimi.it)
- Geographic atrophy (GA), also known as atrophic age-related macular degeneration (AMD) or advanced dry AMD, is an advanced form of age-related macular degeneration that can result in the progressive and irreversible loss of retinal tissue (photoreceptors, retinal pigment epithelium, choriocapillaris) which can lead to a loss of visual function over time. (wikipedia.org)
- In February 2023, the FDA approved Pegcetacoplan for the treatment of people with geographic atrophy secondary to age-related macular degeneration. (wikipedia.org)
- Geographic atrophy is a type of advanced dry age-related macular degeneration that can lead to irreversible vision loss. (rvaf.com)
- The size of the atrophic area usually increases over time, and new areas of atrophy usually develop, leading to further vision loss. (rvaf.com)
Type of macular degeneration4
- This form of macular degeneration is much more common than the "wet" type of macular degeneration, and it tends to progress more slowly than the "wet" type. (macular.org)
- However, a certain percentage of the "dry" type of macular degeneration turns to "wet" with the passage of time. (macular.org)
- There is no known cure for the "dry" type of macular degeneration. (macular.org)
- For patients with permanent vision loss from either type of macular degeneration can benefit from low vision rehabilitation. (drconleyeyecare.com)
Types of macular degeneration3
- Physicians have traditionally recognized 2 types of macular degeneration: dry and wet. (medscape.com)
- There are two basic types of macular degeneration: "dry" and "wet. (macular.org)
- The two types of macular degeneration are dry and wet . (brightfocus.org)
Occurs3
- Given just 1 percent of Americans are born blind, the majority of blindness occurs later in life due to deterioration caused by diseases such as age-related macular degeneration (AMD), glaucoma and diabetes. (naturalproductsinsider.com)
- Macular Degeneration typically occurs in people as they age, hence the term 'age-related macular degeneration' (ARMD or AMD). (drconleyeyecare.com)
- The atrophic stage usually occurs after age 40 years. (medscape.com)
Vitelliform macular d3
- The image with this text is of a patient with adult vitelliform macular dystrophy. (rvaf.com)
- Adult vitelliform macular dystrophy resembles Best disease, but it can be differentiated by its later age of onset, smaller lesion, and normal electro-oculogram testing. (medscape.com)
- Miller SA, Bresnick GH, Chandra SR. Choroidal neovascular membrane in Best's vitelliform macular dystrophy. (medscape.com)
ARMD1
- Patients with age-related macular degeneration (ARMD) usually report a family history of decreased vision late in life. (medscape.com)
Pigment3
- During atrophic AMD the waste/exchange pathway between the blood supply (choroid) and the retinal pigment epithelium (RPE) is compromised. (frontiersin.org)
- Age-related macular degeneration (AMD) is a multifactorial ocular disease that affects the maculae due to late-onset progressive neurodegeneration and dysfunction of photoreceptors and retinal pigment epithelium (RPE). (secunderabadchronicle.in)
- This article will address 2 facets of dry AMD management-early diagnosis and early intervention-with a focus on color vision, macular pigment optical density (MPOD) measurement, and carotenoid vitamin therapy. (optometrytimes.com)
Blood vessels2
- Older individual (30s) with RDH12 mutations and a macular atrophic lesion, as well as attenuated blood vessels and peripheral pigmentary changes. (aao.org)
- For wet macular degeneration , anti-VEGF drugs, which are injected into the eyes, can stop the growth of abnormal blood vessels and preserve vision. (everydayhealth.com)
Ophthalmology2
- Age-related macular degeneration affects an estimated 20 million people in the United States age 40 and older, according to an investigation published November 3, 2022, in JAMA Ophthalmology . (everydayhealth.com)
- ForeseeHome is the first FDA cleared system for home-based monitoring of patients at risk of vision loss from wet age-related macular degeneration and the first biotelemetry device in ophthalmology. (retinagroupofnewengland.com)
Nonexudative1
- neovascular and atrophic (nonexudative). (frontiersin.org)
Blindness10
- if the RPE fails it leads on to photoreceptor death, ultimately leading to central blindness (atrophic AMD) as the end stage of the disease. (frontiersin.org)
- An 88-year-old man at The Methodist Hospital in Houston is one of two patients in the world today to receive an investigational eye drop that may restore sight for those suffering from neovascular (wet) age-related macular degeneration, a major cause of central visual loss and one of the leading causes of blindness in people over 60 in the United States. (news-medical.net)
- Age-related macular degeneration (AMD) is a leading cause of blindness with no treatment available for early stages. (mdfoundation.com.au)
- UC3M/DICYT Researchers from the Universidad Carlos III de Madrid (UC3M) have created a mathematical model and simulated numerically the progression of age-related macular degeneration, one of the main causes of blindness. (dicyt.com)
- Bradley Gelfand, PhD, is using prozac to slow macular degeneration and blindness. (uvahealth.com)
- UVA Health researchers discovered a possible first-ever treatment for atrophic age-related macular degeneration (dry AMD), the cause of irreversible blindness in nearly 200 million people worldwide. (uvahealth.com)
- Age-related Macular Degeneration (AMD) is the leading cause of blindness in elderly patients in developed communities. (delveinsight.com)
- Macular degeneration alone does not result in total blindness. (ivretina.com)
- Macular degeneration is a leading cause of vision loss and irreversible blindness in Americans age 60 years and older and advanced AMD is a leading cause of irreversible blindness and visual impairment in the world. (brightfocus.org)
- Peripheral vision is typically not affected and macular degeneration does not generally cause total blindness, but the effects are devastating nonetheless. (drconleyeyecare.com)
Symptoms2
- What are the symptoms of macular degeneration? (ivretina.com)
- Macular degeneration can cause different symptoms in different people. (ivretina.com)
Stages2
- In its early stages, the following signs of macular degeneration can go unnoticed. (aoa.org)
- As many as 20 million Americans have some form of macular degeneration, including both early and later stages of the wet and dry forms. (brightfocus.org)
Diabetic retinopathy1
- TG100801 is also designed to reduce inflammation (including edema), a common symptom of AMD, and other back of the eye diseases, including diabetic macular edema and diabetic retinopathy. (news-medical.net)
Diseases2
- Researchers have linked eye-friendly nutrients such as lutein and zeaxanthin , omega 3 supplements or consumption of fatty fishes, vitamin C, vitamin E and zinc to reducing the risk of certain eye diseases, including macular degeneration. (aoa.org)
- Belite Bio, Inc, a clinical-stage biopharmaceutical drug development company, engages in the research and development of novel therapeutics targeting atrophic age-related macular degeneration and autosomal recessive stargardt diseases. (ashkon.com)
Choroidal2
- 9 Myopic maculopathy may take the form of atrophic changes or be complicated by choroidal neovascular membrane (CNV) formation. (cehjournal.org)
- RPE often appears atrophic with an easier visualization of the underlying choroidal plexus. (medscape.com)
Maculopathy2
- 5. AC Bird et al, An international classification and grading system for age-related maculopathy and age-related macular degeneration. (macular.org)
- 10 Advanced myopic maculopathy causes loss of central vision and there is currently no treatment for the atrophic form. (cehjournal.org)
Affects3
- Age-related macular degeneration (AMD) affects a person's central vision. (medicalnewstoday.com)
- The most common age-related macular degeneration is dry or atrophic which affects almost 85% of cases. (barraquer.com)
- Macular degeneration affects your ability to see near and far, and can make some activities-like threading a needle or reading-difficult or impossible. (ivretina.com)
Visual impairment1
- Macular degeneration is currently the leading cause of visual impairment in the U.S. Breakthrough treatment with anti-VEGF eye injections such as Avastin® (bevacizumab, Genentech), Lucentis® (ranibizumab, Genentech) and Eylea® (aflibercept, Regeneron) has almost arrested the progression of the wet form of the disease. (clevelandclinic.org)
Bilateral1
- Cahill MT, Banks AD, Stinnett SS, Toth CA. Vision-related quality of life in patients with bilateral severe age-related macular degeneration. (jamanetwork.com)
DelveInsight's3
- DelveInsight's 'Age-related Macular Degeneration (AMD)-Market Insights, Epidemiology, and Market Forecast-2032' report deliver an in-depth understanding of the Age-related Macular Degeneration, historical and forecasted epidemiology as well as the Age-related Macular Degeneration market trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan. (delveinsight.com)
- DelveInsight's, "Wet Age-Related Macular Degeneration (Wet-AMD) Pipeline Insight, 2023," report provides comprehensive insights about 75+ companies and 80+ pipeline drugs in Wet Age-Related Macular Degeneration (Wet-AMD) pipeline landscape. (secunderabadchronicle.in)
- DelveInsight's Wet Age-Related Macular Degeneration pipeline report depicts a robust space with 75+ active players working to develop 80+ pipeline therapies for Wet Age-Related Macular Degeneration treatment. (secunderabadchronicle.in)
Cystoid1
- The EOG in Best's disease and dominant cystoid macular dystrophy (DCMD). (medscape.com)
Form7
- Atrophic age-related macular degeneration (AMD) is the most common form of AMD accounting for 90% of patients. (frontiersin.org)
- Most people with macular degeneration have the dry form. (aoa.org)
- The "wet" form of macular degeneration accounts for about 10% of all AMD cases. (ivretina.com)
- Most people who have AMD have the dry, or atrophic, form. (windsoreyeclinic.com)
- Most macular holes form because of changes in the eye that happen as we age. (sankarfoundation.org)
- Approximately 85-95% of people with macular degeneration have the dry form. (retinagroupofnewengland.com)
- Most (80% to 90%) of people with AMD have the dry (also called atrophic) form. (retina-doctors.com)
Treatment10
- There is currently no treatment or cure for atrophic AMD. (frontiersin.org)
- If signs of neovascular AMD found, the physician can initiate treatment of wet age-related macular degeneration. (wikipedia.org)
- To investigate the relationship of anti-VEGF treatment discontinuation with baseline factors and outcomes in eyes treated initially with aflibercept or bevacizumab for macular edema from central or hemiretinal vein occlusion. (mdfoundation.com.au)
- The discontinued treatment early group had a higher proportion with complete resolution of macular edema at Month 60, and lower mean CST over follow-up, but not better VA, than the treated continuously and treated intermittently groups. (mdfoundation.com.au)
- Results support the need for continued monitoring and individualized treatment for patients treated with anti-VEGF for macular edema from central or hemiretinal vein occlusion. (mdfoundation.com.au)
- The age-related macular degeneration market report provides current treatment practices, emerging drugs, market share of the individual therapies, current and forecasted 7MM age-related macular degeneration market size from 2019 to 2032. (delveinsight.com)
- The Report also covers current age-related macular degeneration treatment practice, market drivers, market barriers, SWOT analysis, reimbursement, market access, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market. (delveinsight.com)
- A macular degeneration treatment breakthrough is making headway using a wireless retinal implant. (webrn-maculardegeneration.com)
- If they do lead to wet macular degeneration, early treatment is essential. (rvaf.com)
- Macular Degeneration: Cause and Treatment. (retinagroupofnewengland.com)
Patients6
- Patients who develop atrophic AMD may notice a scotoma (blind spot), which slowly enlarges over months or years before becoming stable. (cehjournal.org)
- FDA approval to evaluate 'PRIMA' implant in up to five patients with atrophic dry age-related macular degeneration. (optics.org)
- The Prima System subretinal miniature photovoltaic wireless implant, developed by Pixium Vision, is in clinical testing for patients who have lost their sight due to outer retinal degeneration, initially for atrophic dry age-related macular degeneration (dry AMD). (mddionline.com)
- Pixium, a Paris based company has developed a system that may enhance vision by stimulating degenerated photoreceptor cells in patients with advanced dry macular degeneration. (webrn-maculardegeneration.com)
- Patients who consume fruits and vegetables have the lowest rates of macular degeneration development. (rvaf.com)
- This study will evaluate the safety, tolerability, and preliminary efficacy of NG101 AAV gene therapy administered by subretinal injections into a single selected eye as a single selected dose for patients with wet age-related macular degeneration (wAMD). (secunderabadchronicle.in)
Nutritional supplements1
- Nutritional supplements in the prevention of age-related macular degeneration. (medscape.com)
Lutein1
- Lutein and Zeaxanthin, the main macular pigments, limit macular degeneration and are linked to reduced incidence of cataract. (naturalproductsinsider.com)
People11
- Juvenile macular degeneration can affect younger people. (medicalnewstoday.com)
- In addition, as it is closely linked to ageing, it is estimated that the number of people with macular degeneration could double in the next 20 years due to the increase in the life expectancy of the population. (barraquer.com)
- Many older people develop macular degeneration as part of the body's natural aging process. (ivretina.com)
- Many people do not realize that they have a macular problem until blurred vision becomes obvious. (ivretina.com)
- Although the exact causes of macular degeneration are not fully understood, antioxidant vitamins and zinc may reduce the impact of AMD in some people. (ivretina.com)
- Age-related macular degeneration (AMD) is the leading cause of vision loss in people over the age of 60. (brightfocus.org)
- Age-related macular degeneration (AMD) is the most common cause of irreversible loss of central vision in older people. (msdmanuals.com)
- However, almost 80 percent of people diagnosed with age-related macular degeneration (AMD) have the non-neovascular (dry) or atrophic subtypes. (clevelandclinic.org)
- People with macular degeneration still have peripheral vision, but lose the ability to see the details. (retinagroupofnewengland.com)
- People with dry macular degeneration in one eye may be able to function very well using the central vision from the other eye. (retinagroupofnewengland.com)
- Because age-related macular degeneration can be such a visually and psychologically devastating disease, people who have family members with AMD are eager to determine if they can prevent it. (visivite.com)
Genetic1
- Predicting Progression to Advanced Age-Related Macular Degeneration from Clinical, Genetic, and Lifestyle Factors Using Machine Learning. (bvsalud.org)
20191
- Age-Related Macular Degeneration PPP - Update 2019. (exploremyplan.com)
Epidemiology1
- 1. JM Seddon, Epidemiology of age-related macular degeneration. (macular.org)
Vision loss4
- Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in adults over age 50. (aoa.org)
- Macular degeneration is the leading cause of severe vision loss in Caucasians over 65. (ivretina.com)
- Dry macular degeneration may advance and cause vision loss with or without turning into the wet type of the disease. (brightfocus.org)
- When they get to that stage, there is a greater risk for developing wet macular degeneration and more severe vision loss. (rvaf.com)
Choriocapillaris1
- These and other products of oxidative stress can trigger inflammation via multiple pathways, particularly the complement cascade, ultimately leading to loss of photoreceptors, RPE, and choriocapillaris, culminating in atrophic lesions that grow over time. (wikipedia.org)
Posterior1
- During the follow-up period, a posterior staphyloma developed and the macular area became atrophic. (nih.gov)
Heredity1
- Risk factors for getting macular degeneration include age (over 50), heredity, smoking, excessive alcohol intake, light skin and blue eyes. (retinagroupofnewengland.com)
Central4
- Age-related macular degeneration (AMD) is an eye disease that causes a person's central vision to become blurry. (medicalnewstoday.com)
- Central vision that is lost to macular degeneration cannot be restored. (aoa.org)
- Photovoltaic Restoration of Central Vision in Atrophic Dry AMD. (upmcphysicianresources.com)
- In macular degeneration, cells in the macular region begin to die, causing blind spots and distorted central vision. (brightfocus.org)
Diagram1
- Diagram on right: dry or atrophic AMD. (barraquer.com)
Therapies1
- The Wet Age-Related Macular Degeneration pipeline report proffers an integral view of the Wet Age-Related Macular Degeneration emerging novel therapies segmented by stage, product type, molecule type, mechanism of action, and route of administration. (secunderabadchronicle.in)
Risk factors1
- Current prediction models for advanced age-related macular degeneration (AMD) are based on a restrictive set of risk factors . (bvsalud.org)
Clinical3
- Ultimately, the best way to test whether fluoxetine benefits macular degeneration is to run a prospective clinical trial," notes Gelfand. (uvahealth.com)
- It covers the Wet Age-Related Macular Degeneration pipeline drug profiles, including clinical and nonclinical stage products. (secunderabadchronicle.in)
- The Wet Age-Related Macular Degeneration pipeline report provides detailed profiles of pipeline assets, a comparative analysis of clinical and non-clinical stage Wet Age-Related Macular Degeneration drugs, inactive and dormant assets, a comprehensive assessment of driving and restraining factors, and an assessment of opportunities and risks in the Wet Age-Related Macular Degeneration clinical trial landscape. (secunderabadchronicle.in)
Prevalence1
- Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. (jamanetwork.com)
Common2
- What is the most common type of age-related macular degeneration? (barraquer.com)
- There are different kinds of macular problems, but the most common is age-related macular degeneration (AMD). (ivretina.com)
Treatments2
- Currently, there are no FDA-approved treatments for dry macular degeneration. (uvahealth.com)
- Wet macular degeneration can be treated with injections of medication into the eye, photodynamic therapy (PDT), or laser surgery, injections of anti-VEGF agents such as Lucentis or Avastin are currently first-line treatments for "wet" macular degeneration. (ivretina.com)