Age-Related Macular Degeneration: Management and Treatment

How is age-related macular degeneration treated?

Although there's no treatment to reverse the dry form of AMD, eyesight may be helped with low-vision aids, such as devices that have special lenses or electronic systems that produce enlarged images of nearby objects. They help people with partial vision make the most of their remaining vision.

The Age-Related Eye Disease study (AREDS) found that taking vitamin and mineral supplements can reduce some patients’ chances of developing AMD or reduce the chance of progression. For instance, Vitamins C, E, lutein, zinc and copper have been shown to decrease the risk of vision loss in patients with intermediate to advanced dry AMD. Ask your eye doctor if this type of therapy could work for you. The newest versions of the vitamins tend to have “AREDS 2” in the name or on the label.

Several options are available to treat the wet form of AMD, but not all are appropriate or successful for all patients. These treatments include:

• Anti-angiogenesis medications: Several drugs work to prevent the growth of abnormal blood vessels. These drugs are injected into the eye at 4 to 8 week intervals to cause the blood vessels to shrink. This treatment may improve vision in some patients and stabilize it in most patients. The most common of these medicines are bevacizumab (Avastin®), ranibizumab (Lucentis®), and aflibercept (Eylea®). These drugs are also called anti-vascular endothelial growth factor (VEGF).
• Photodynamic therapy (PDT): The doctor injects a light-sensitive drug into the bloodstream to be absorbed by the abnormal blood vessels in the eye. The doctor then shines a cold laser into the eye to activate the drug, damaging the abnormal blood vessels. PDT is used very infrequently, being supplanted in most instances by the medications above.
• Laser therapy: High-energy lights are used to destroy actively growing abnormal blood vessels. Laser is considered in the minority of cases where the leaky vessels are outside the central macular area.

Can treatment help if I am legally blind?

Depending upon the cause of legal blindness, it is possible that treatment may help. If recent bleeding or leakage under the retina has resulted in legal blindness, surgery is a possibility. Retinal cell transplants and stem cell therapy are under study; a new implanted electronic retinal “chip” was recently approved for human use but is used for retinal degenerations and not yet for AMD.

Can I have treatment if lasers were used as an earlier treatment?

Because bleeding or leakage may occur beneath the retina even after the laser treatment, it's possible that treatment with injected drugs can help.

I have other medical conditions. Can I still have treatment?

Other medical conditions or age shouldn't be a factor if you're considered an appropriate candidate for treatment, although sometimes anti-VEGF injections may be delayed after a recent heart attack or stroke.