Wet vs. Dry Macular Degeneration: The Difference and Why It Matters
About 9 in 10 people with macular degeneration have the dry form. Here's how it differs from wet AMD, how one can turn into the other, and what treatment looks like for each.
Quick answer: Both types of age-related macular degeneration (AMD) damage the macula, the part of the retina responsible for sharp central vision. Dry AMD is the common form, accounting for about 85% to 90% of cases. It progresses slowly as deposits called drusen build up and retinal tissue thins. Wet AMD happens when abnormal blood vessels grow under the retina and leak fluid or blood, which can cause rapid vision loss. Dry AMD can turn into wet AMD at any time. Wet AMD is treated with eye injections, and the advanced form of dry AMD, geographic atrophy, now has treatments that can slow it.
What is macular degeneration?
AMD is a leading cause of vision loss in adults over 50. It affects central vision, the vision you use to read, drive, recognize faces, and see fine detail. Side vision usually stays intact, so AMD rarely causes complete blindness, but it can make everyday tasks hard.
Risk factors include age, smoking, family history, and Caucasian ancestry.
How do the two types compare?
| Dry AMD | Wet AMD | |
|---|---|---|
| Share of cases | About 85% to 90% | About 10% to 15% |
| What happens | Drusen build up, retinal cells thin and die | Abnormal vessels grow and leak |
| Speed | Usually slow, over years | Can be fast, over weeks or days |
| Early symptoms | Often none; later, blurry central vision or trouble in dim light | Wavy or distorted lines, a dark or blank spot |
| Treatment | Monitoring, AREDS2 vitamins, injections for geographic atrophy | Anti-VEGF eye injections |
What are the stages of dry AMD?
- Early AMD: medium-sized drusen, usually no symptoms.
- Intermediate AMD: large drusen or pigment changes. Some people notice mild blurring or need more light to read.
- Late AMD: either geographic atrophy (advanced dry) or conversion to wet AMD.
Most people with early AMD never lose significant vision. The goal is to monitor for progression and catch any shift to wet AMD quickly.
Can dry AMD turn into wet AMD?
Yes. Wet AMD always starts as dry AMD. That's why people with intermediate dry AMD should check their vision at home with an Amsler grid and call promptly if lines look wavy or a new blank spot appears. Starting injections early gives the best chance of protecting vision.
How is wet AMD treated?
Anti-VEGF injections block the protein that drives abnormal vessel growth and leakage. They're done in the office in seconds. Many patients maintain their vision for years with regular treatment. Read Eye Injections for Macular Degeneration: What to Expect.
How is dry AMD treated?
- AREDS2 vitamins can lower the risk of progression to advanced AMD for people with intermediate disease or advanced AMD in one eye. See AREDS2 Vitamins.
- Geographic atrophy treatments like pegcetacoplan (Syfovre) and avacincaptad pegol (Izervay) slow the growth of damaged areas. See Geographic Atrophy Treatment.
- Lifestyle: not smoking, a diet rich in leafy greens and fish, and managing blood pressure.
- Regular monitoring with OCT imaging.
How is AMD diagnosed?
A dilated exam and OCT imaging show drusen, thinning, and fluid. If wet AMD is suspected, fluorescein angiography or OCT angiography shows the abnormal vessels.
Frequently Asked Questions
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Schedule a consultation with Dr. Pooja Garg at Retina Eye Specialists today.
Call (954) 633-8202References
- National Eye Institute. Age-Related Macular Degeneration.
- American Academy of Ophthalmology. Age-Related Macular Degeneration Preferred Practice Pattern.
- Age-Related Eye Disease Study 2 Research Group. JAMA. 2013.