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Wet Macular Degeneration: Causes, Symptoms, and Treatment
Who Is at Risk for Wet AMD
Wet AMD is not caused by one single factor. A combination of age, genetics, and lifestyle all influence who develops the condition. Knowing your personal risk factors helps guide how closely you and your eye care team should monitor your retinal health over time.
Age is the strongest risk factor for wet AMD. The condition primarily affects people over 50, and risk increases meaningfully with each additional decade of life. Wet AMD is one of the leading causes of central vision loss in older adults in the United States.
Genetics play a significant role in AMD. People with a first-degree relative who has AMD carry a notably higher risk of developing the condition themselves. Genetic factors are estimated to account for roughly half of all AMD cases. Having dry AMD in one or both eyes is also a major risk factor for conversion to the wet form.
Several modifiable risk factors are linked to wet AMD. Smoking is one of the most significant and increases risk two to three times compared to nonsmokers. Additional factors that raise risk include:
- Cardiovascular disease and high blood pressure
- High cholesterol levels
- Obesity, which may accelerate AMD progression
- Prolonged ultraviolet light exposure without protective eyewear
Addressing these modifiable factors supports both general health and long-term eye health.
People of Caucasian descent have a higher prevalence of wet AMD compared to other racial groups. Women are affected more frequently than men. People with lighter-colored eyes may also carry increased risk due to lower levels of natural pigment in the retina, which normally provides some protection against light-related damage.
Recognizing the Signs and Symptoms
Wet AMD often comes on suddenly, and its early symptoms can be subtle enough to miss, especially if only one eye is affected. Knowing what to watch for, and when to seek urgent care, can significantly affect how much vision is preserved.
The first noticeable symptom of wet AMD is often a change in how straight lines appear. They may look wavy, curved, or distorted. This is called metamorphopsia and is a hallmark early sign of wet AMD. Other early changes include a blurry or dark spot in the center of your vision, difficulty reading even with glasses, trouble recognizing faces, and colors that appear less vivid than they once did.
Certain vision changes should not wait for a routine appointment. Contact a Retina Specialist as soon as possible if you notice any of the following:
- Sudden blurring or loss of central vision
- Straight lines appearing wavy or distorted
- A new dark or blank area in the center of your vision
- Any rapid or unexplained change in vision quality
Because wet AMD can progress quickly, even a delay of a few days can allow additional vision loss to occur. Prompt evaluation gives the best chance of protecting the vision you have.
Wet AMD often affects one eye before the other. When one eye is healthy, it compensates for the affected eye, which can mask early changes. This is why daily self-monitoring with an Amsler grid, a simple chart with a grid of straight lines and a central dot, is so important. Checking each eye separately by covering one eye at a time can reveal distortion or blank spots that would otherwise go unnoticed. Any new changes should be reported to a Retina Specialist right away.
How Wet AMD Is Diagnosed
Diagnosing wet AMD requires a thorough retinal examination combined with advanced imaging. Our team uses multiple diagnostic tools to confirm the diagnosis, identify the location and extent of abnormal blood vessel activity, and create a foundation for tracking your response to treatment over time.
Diagnosis begins with a comprehensive dilated eye exam. Drops are placed in the eye to widen the pupil, allowing a detailed view of the retina and macula. A Retina Specialist looks for abnormal blood vessels, signs of fluid or blood beneath the retina, and any early scarring. This exam is the starting point for all further evaluation.
Optical coherence tomography (OCT) is one of the most important tools for diagnosing and managing wet AMD. It uses light waves to create detailed cross-sectional images of the retina, revealing fluid within or beneath the retinal layers, swelling of the macula, and changes in retinal thickness. The test is quick and comfortable, and it is used routinely to monitor how well treatment is working.
Fluorescein angiography maps abnormal blood vessels by injecting a special dye into a vein in the arm. As the dye travels through the blood vessels of the eye, a camera captures images showing where vessels are leaking or growing abnormally. This helps determine the location and extent of neovascularization and guides treatment decisions.
OCT angiography (OCTA) is a newer technique that visualizes blood flow in the retina without a dye injection. It provides detailed maps of retinal and choroidal vessels and is particularly useful for ongoing monitoring. Together, these imaging methods give our team a thorough picture of disease activity.
Treatment Options for Wet AMD
Treatment for wet AMD has advanced significantly, and most patients today can maintain useful central vision with consistent care. The primary goal of treatment is to stop the leakage from abnormal blood vessels, reduce swelling in the macula, and prevent further damage before scarring occurs.
Anti-VEGF injections are the primary treatment for wet AMD. These medications block vascular endothelial growth factor, the protein responsible for driving abnormal blood vessel growth and leakage. By lowering VEGF activity, the treatments help shrink abnormal vessels, reduce fluid in the retina, and slow the progression of damage to the macula.
Anti-VEGF medications are delivered as intravitreal injections, meaning they are injected directly into the vitreous (the gel-like fluid inside the eye). Treatment usually begins with a series of monthly injections during a loading phase. After that, the interval between injections may be extended based on how the eye responds.
Several anti-VEGF medications are currently used to treat wet AMD. Each has different dosing schedules and properties, and the right choice depends on your individual situation. Medications our team may use include:
- Avastin (bevacizumab), widely used in retinal care
- Lucentis (ranibizumab), one of the first anti-VEGF treatments approved for wet AMD
- Eylea (aflibercept), commonly used with a flexible dosing schedule
- Vabysmo (faricimab), a newer bispecific antibody that targets two pathways involved in wet AMD and may allow extended dosing intervals for many patients
Your Retina Specialist will recommend the most appropriate medication based on your response to treatment, the severity of the disease, and your overall care goals.
While anti-VEGF injections are the cornerstone of wet AMD care, other treatment approaches exist for specific situations. Photodynamic therapy (PDT) uses a light-activated medication injected into the bloodstream, which is then activated by a low-power laser aimed at the abnormal vessels. Retinal laser photocoagulation uses thermal laser energy to seal leaking blood vessels. These approaches are used less commonly today but may be considered alongside anti-VEGF therapy in certain cases.
Living with Wet AMD
Wet AMD is a long-term condition that requires consistent care and attention. With the right treatment plan and daily habits, many patients are able to maintain functional central vision and continue the activities that matter most to them.
Intravitreal injections are performed in a Retina Specialist's office. The eye is numbed with anesthetic drops, and the surface is cleaned with an antiseptic solution to minimize infection risk. The injection itself takes only a few seconds. Most patients feel mild pressure during the procedure. Temporary blurred vision, mild redness, or a gritty sensation are common and typically resolve within a day or two.
Wet AMD requires ongoing treatment and regular monitoring visits. After the initial loading phase, your Retina Specialist will use OCT imaging and clinical exams to evaluate your response and adjust injection intervals accordingly. Some patients are able to extend the time between injections significantly. Others need more frequent visits to keep the disease stable. Missing or delaying appointments can allow fluid to return and cause additional vision loss, so keeping your schedule is essential.
Certain daily habits can support your retinal health alongside formal treatment. Checking an Amsler grid each morning, one eye at a time, is one of the simplest and most effective ways to catch early signs of disease activity. Quitting smoking, eating a diet rich in leafy greens and omega-3 fatty acids, maintaining a healthy weight, and wearing UV-blocking sunglasses may all help slow AMD progression.
For patients at risk of progression, AREDS2 nutritional supplements (a specific combination of vitamins and minerals studied in the Age-Related Eye Disease Study) may be recommended. A Retina Specialist can advise whether supplements are appropriate based on your stage and type of AMD. Our team offers Focus Vision Supplements, including Focus Select (AREDS2 formula) and Focus MaculaPro (AREDS formula), developed with macular health in mind.
Even with treatment, some patients experience lasting changes to central vision, particularly if significant damage occurred before treatment began. Low vision specialists can recommend magnifying tools, large-print materials, high-contrast device settings, audiobooks, and improved task lighting to help maintain independence. These adaptations can make a meaningful difference in day-to-day quality of life.
Frequently Asked Questions
These questions address common points of uncertainty that patients often raise when navigating a wet AMD diagnosis and long-term treatment plan.
There is currently no cure for wet AMD. However, it can be effectively managed with anti-VEGF treatment. The goal is to control disease activity, reduce fluid in the macula, and preserve as much central vision as possible over the long term. Many patients maintain stable, functional vision for years with consistent care.
Wet AMD damages central vision, not peripheral (side) vision. Even in advanced cases, most patients retain their peripheral vision, which supports mobility and daily orientation. With modern anti-VEGF therapy, the risk of severe central vision loss has decreased significantly compared to earlier decades. Early treatment gives the best chance of protecting useful central vision.
Most patients with wet AMD need treatment for years, and many require it indefinitely. The frequency of injections may decrease over time as your Retina Specialist finds the longest safe interval for your eye. Stopping treatment without medical guidance can cause the disease to reactivate and lead to additional vision loss. Treatment schedules are individualized and adjusted based on how your eye responds at each visit.
There is no guaranteed way to prevent the conversion from dry to wet AMD. However, not smoking, following a diet and supplement regimen recommended by your Retina Specialist, managing cardiovascular health, and using UV protection may all reduce risk. Daily Amsler grid monitoring is one of the most important steps because it allows early detection of conversion, when treatment is most effective at protecting vision.
Yes, treatment options have evolved to help reduce the burden of frequent injections. Vabysmo (faricimab) targets two biological pathways involved in wet AMD and allows many patients to extend treatment intervals to every 12 to 16 weeks. Eylea in higher-dose formulations also supports extended dosing schedules for qualifying patients. Researchers continue to study additional approaches, including gene therapy, that may further reduce how often treatment is needed. A Retina Specialist can help determine which approach is most appropriate for your specific situation.
Contact your Retina Specialist's office right away. Do not wait for your next scheduled visit. Sudden changes in central vision, new distortion on the Amsler grid, or a new dark spot can indicate that the disease has become more active and may need prompt retreatment. Acting quickly in these situations helps limit damage and protect remaining vision.
Expert Wet AMD Care Close to Home
At Atlantic Retina Center, our team of vitreoretinal fellowship-trained Retina Specialists is dedicated exclusively to the health of the retina, vitreous, and macula, bringing focused expertise to every visit across our offices on the Eastern Shore of Maryland and in central and southern Delaware. We use advanced retinal imaging at every visit, including serial year-over-year photo comparisons, to track subtle changes and guide your care with precision. If you have been diagnosed with wet AMD, are experiencing changes in your central vision, or have risk factors that concern you, we encourage you to schedule an evaluation with our team. Protecting your vision is our highest priority.