Hope for Macular Degeneration
There is no cure for age-related macular degeneration (AMD) at this time, but treatment can slow progression of the disease and new treatments are in development. There are two types of macular degeneration: Dry AMD and Wet AMD. Dry AMD is the most common type and is sometimes called atrophic or non-neovascular macular degeneration. Wet AMD, also called exudative or neovascular macular degeneration, is less common.
People who lose their central vision to macular degeneration can often be helped by low-vision specialists. With the help of special low-vision devices, such as magnifying devices, large-print reading materials, or closed-circuit computers, people with macular degeneration can learn to use their remaining vision. Community organizations and support groups can help people with AMD and their families deal with vision loss and learn about other available resources.
High doses of certain vitamins may slow the vision loss caused by AMD. The Age-Related Eye Disease Study (AREDS) indicated that people at risk for developing advanced AMD may slow progression of vision loss by taking high doses of zinc, beta carotene, and vitamins C and E. The supplement combination tested was a daily dose of 500 mg of vitamin C, 400 IU of vitamin E, 15 mg of beta carotene, 80 mg of zinc (as zinc oxide), and two mg of copper (as cupric oxide). Talk to your healthcare provider before taking these supplements about possible health risks. If you are a smoker or a former smoker, high doses of beta carotene (vitamin A) may increase your risk for lung cancer. Doses of vitamin E higher than 400 IU have been associated with an increased risk for cardiovascular death.
If you have dry AMD, the National Eye Institute (NEI) recommends that you have a comprehensive eye exam at least once a year. Ask your eye care provider if high dose supplements would help delay the advancement of the condition.
Because dry AMD can turn into wet AMD at any time, the NEI recommends you get an Amsler grid from your eye care professional and use it every day to test your vision for signs of wet AMD. Check each eye separately. Cover one eye and look at the grid, then cover your other eye and look at the grid. Do this with your reading glasses or bifocals, if you normally use them for reading. If you detect any changes in the appearance of this grid (lines that are wavy, broken, or missing) or in your everyday vision, call your eye care provider.
If you have wet AMD, regularly check your vision with the Amsler grid. If you find any changes, schedule an eye exam promptly. If your healthcare provider advises treatment, do not wait. Realize that treatments are generally ongoing. After treatment, you should have eye exams often to find any recurrence of leaking blood vessels. If you smoke, attempt to quit because smoking is associated with a greater risk of recurrence.
Damage from wet AMD usually cannot be reversed, but further damage can be prevented with treatment. Several treatments have been used for some types of wet AMD. A high-energy laser beam can be used to destroy the new abnormal blood vessels. This therapy is called photocoagulation. A cold laser combined with a light-sensitizing drug called verteporfin can be used to close new abnormal blood vessels. This is called photodynamic therapy. Surgery is another treatment option for some types of wet AMD.
Newer treatments involve medicines (anti-VEGF) that are injected into the eye. These medicines inhibit the growth of abnormal blood vessels by inhibiting VEGF (vascular endothelial growth factor), a growth factor that promotes blood vessel growth and is higher in eyes with wet AMD. These medicines are injected every few weeks to months. Studies show that these new medicines are more effective in treating macular degeneration than the other treatments noted above.
In the future, other treatments may be available. For example, scientists are also studying the possibility of transplanting healthy cells into diseased retina. They are also studying the genetic or hereditary factors that cause AMD.
March 21, 2017
Age-related Macular Degeneration: Treatment and Prevention, UpToDate
Griggs, Paul B., MD,Taylor, Wanda, RN, Ph.D.