Summary: definition, etiology, and risk factors

Wet (neovascular) age-related macular degeneration (AMD) is the late-stage form of AMD in which abnormal blood vessels (macular neovascularization, historically called choroidal neovascularization) grow beneath or into the macula. The American Academy of Ophthalmology (AAO) estimates that about 80% of people with AMD have the non-neovascular form, while the neovascular form accounts for most of the severe vision loss. Unmodifiable risk factors are increasing age, Northern European ancestry, and genetic factors; cigarette smoking is the principal modifiable risk factor. In the Global Burden of Disease Study 2021, tobacco accounted for 9.96% of age-standardized disability-adjusted life-years attributed to AMD.

Wet AMD as the neovascular late stage of AMD

“Age-related macular degeneration (AMD) is an eye disease that can blur your central vision. It happens when aging causes damage to the macula” (opens the source at this quote in a new tab)
“Wet AMD (also called advanced neovascular AMD), is a less common type of late AMD that usually causes faster vision loss. Any stage of dry AMD can turn into wet AMD” (opens the source at this quote in a new tab)
“but wet AMD is always late stage. It happens when abnormal blood vessels grow in the back of the eye and damage the macula.” (opens the source at this quote in a new tab)

Guideline disease definition and advanced AMD classification

“Age-related macular degeneration (AMD) is a spectrum of disorders of the macula characterized by one or more of the following:” (opens the source at this quote in a new tab)
“Advanced AMD (AREDS category 4) is characterized by one or more of the following (in the absence of other causes) in one eye:” (opens the source at this quote in a new tab)
“Macular neovascularization (MNV) historically referred to as CNV and includes the following:” (opens the source at this quote in a new tab)
“Although an estimated 80% of patients with age-related macular degeneration (AMD) have non-neovascular or atrophic AMD, the neovascular form is responsible for most of the severe vision loss associated with AMD.” (opens the source at this quote in a new tab)

Risk factors: age, ancestry, genetics, and smoking

“The main unmodifiable risk factors for the development of advanced AMD are increasing age, Northern European ancestry, and genetic factors. Although a number of modifiable risk factors have been investigated, cigarette smoking is the main one that has been consistently identified in” (opens the source at this quote in a new tab)
“Smoking significantly increases the risk of AMD and there appears to be a dose-response” (opens the source at this quote in a new tab)
“the risk of developing AMD in individuals who have not smoked for more than 20 years is comparable to the risk in nonsmokers.” (opens the source at this quote in a new tab)

Risk factors: patient-facing summary

“Your risk for AMD increases as you get older. People age 55 and older are more likely to have AMD. The risk for AMD is also higher for people who:” (opens the source at this quote in a new tab)
“Have a family history of AMD” (opens the source at this quote in a new tab)
“Are Caucasian” (opens the source at this quote in a new tab)
“Smoke” (opens the source at this quote in a new tab)

Tobacco-attributable burden of AMD vision impairment

“The global contribution of tobacco to age-standardised DALYs decreased by 20%, declining from 12·45% (95% UI 7·73–17·37) in 1990 to 9·96% (6·12–14·06) in 2021.” (opens the source at this quote in a new tab)

Duravyu (vorolanib intravitreal insert)

Definition and etiology