In macular degeneration, which form cannot be prevented?

• A. Exudative (wet)
• B. Non-exudative (dry)
• C. Both forms
• D. Neither form

Answer: (B)

Key idea: dry (non-exudative) AMD tends to progress despite available measures, whereas the sight-threatening deterioration from the wet form can often be prevented or significantly slowed with targeted therapy.

Dry AMD is characterized by gradual degeneration of the retinal pigment epithelium and photoreceptors with geographic atrophy. At present, no proven treatment stops this process from advancing to advanced dry AMD or geographic atrophy in the general patient population, although nutritional strategies like AREDS vitamins can modestly slow progression in some people who already have intermediate disease. In contrast, the wet (exudative) form involves abnormal new blood vessels that leak, causing rapid vision loss. This neovascular component can be targeted with therapies such as intravitreal anti-VEGF injections, which can prevent severe vision loss and stabilize or improve vision if started promptly. Therefore, the non-exudative form is the one that cannot be prevented from progression with current standard options, while the exudative form can be mitigated to prevent major vision loss with appropriate treatment.