Age-Related Macular Degeneration in Men vs. Women: Are There Differences in Risk and Progression?

Age-related Macular Degeneration is an eye disease that affects the macula, the part of the retina responsible for central vision. Over time, the macula deteriorates, leading to blurry vision, dark spots, and difficulty recognizing faces or reading fine print. Unlike other eye conditions that can be corrected with glasses or surgery, AMD gradually impairs vision without a cure.

• Dry AMD: This is the more common form, where the macula thins due to aging and the accumulation of drusen (small yellow deposits under the retina). It develops slowly, with subtle changes in vision
• Wet AMD: A more aggressive form, occurring when abnormal blood vessels leak fluid or blood into the macula, causing very rapid vision loss.

Common symptoms include:

• Blurry or distorted vision (straight lines appearing wavy)
• Dark spots in central vision
• Difficulty recognizing faces
• Needing more light to read or do close-up work

Do Men Have Any Unique Risk Factors?

• Higher Rates of Smoking: Smoking is one of the most significant risk factors for AMD, and men have historically had higher smoking rates than women. Smoking damages blood vessels in the eyes, accelerating macular degeneration.
• Increased Cardiovascular Disease: Heart disease, high blood pressure, and poor circulation can reduce blood flow to the eyes, potentially worsening AMD. Men, who tend to develop cardiovascular issues earlier in life, might be at risk for faster progression.
• Less Frequent Eye Exams: Studies show that men are less likely to visit an eye doctor regularly, which means they might not catch AMD in its early stages when treatment is most effective.

While women are more likely to develop AMD due to biological factors, men’s lifestyle choices could influence how early and severely the disease progresses. Understanding these differences can help you take steps to lower your risk—whether that means scheduling regular eye exams, maintaining a healthy diet, or quitting smoking.

AMD could progress at different rates in men and women. Women not only have a higher risk of developing AMD but also may experience a more severe disease process due to hormonal and genetic factors.

Women: Slower Onset but More Severe Late-Stage AMD

• More Likely to Develop Geographic Atrophy (GA): Geographic atrophy, an advanced form of dry AMD, is more common in women. This condition leads to the gradual breakdown of the retinal pigment epithelium, causing irreversible vision loss over time.
• Greater AMD Prevalence: Studies, including those published in the British Journal of Ophthalmology, show that prevalence estimates for AMD tend to be higher among women, especially in late-stage cases.
• Increased Risk of Exudative AMD: Women are also more likely to develop exudative AMD, the wet form of the disease, which progresses very rapidly and leads to severe macular degeneration if untreated.

Men: Faster Decline but Lower Lifetime Risk

• Higher Risk of Early AMD Men may develop early-stage AMD at a younger age, possibly due to other factors like smoking and cardiovascular disease. However, their overall prevalence rates of late-stage AMD are lower than in women.
• Faster Progression in Certain Cases: While men are less likely to live long enough to develop late-stage AMD, those who do often experience a more aggressive decline in vision compared to women.

Additional Risk Factors for AMD

Other key risk factors influence the prevalence estimates and severity of age-related macular degeneration:

• If you have a family history of AMD, you have a higher risk of developing the condition yourself.
• Smokers are two to four times more likely to develop AMD than non-smokers.
• Poor circulation can increase the risk of AMD progression by limiting oxygen supply to the retina.
• Prolonged exposure to sunlight might contribute to retinal damage over time.
• A lack of antioxidants, omega-3 fatty acids, and essential vitamins can worsen macular degeneration.