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Macular Degeneration Vision LossVision Deterioration in Dry AMD Vision loss in dry AMD is caused by atrophy or weakening of the retinal pigment epithelium (RPE) layer just outside the retina and the overlying photoreceptor cells. Vision loss with dry AMD is usually slow and gradual. A patient may begin to notice blank areas in their central vision. Over time, dry AMD can cause a large loss of detail vision; however, vision loss is generally not as severe compared to the wet form. Development of Wet AMD As previously discussed, dry AMD will often begin to convert to wet AMD, with the appearance of abnormal choroidal blood vessels - angiogenesis. The reason why angiogenesis occurs is unknown, however, it is believed that there is a link between angiogenesis and damage to Bruch’s membrane, which lies directly under the RPE, caused by the deposit of drusen. The drusen allows an angiogenic stimulant to promote the growth of underlying choroidal blood vessels into the subretinal space and retina. These tufts of blood vessels are fragile and have a propensity to leak and bleed, eventually forming scar tissue and resulting in irreversible vision loss.
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