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Treatment: Goals of Treatment

Macular degeneration is one of the most common eye conditions causing vision loss in older individuals. In macular degeneration, the macula is damaged, causing impairment of central vision. Some people with the condition progress slowly, with gradual vision loss, while others may have quickly progressing symptoms or sudden vision loss.

Stargardt disease

Stargardt disease is a subtype of macular degeneration that is inherited and usually causes vision loss by late childhood or adolescence, although it can occur in early adulthood.1 There is no treatment for Stargardt disease, just suggested lifestyle changes.

MMD and AMD

Although it is a distinct condition separate from macular degeneration, myopic macular degeneration shares similarities with wet age-related macular degeneration (AMD). Due to these similarities, myopic macular degeneration is often treated like wet AMD. There are two kinds of AMD: dry AMD and wet AMD, and treatment can vary depending on the stage and type of AMD. While dry AMD can have early, intermediate, and advanced stages, wet AMD is by definition always considered advanced or late AMD.2 The focus, then, of this page will be mainly AMD and the goals of its treatment.

Slowing disease progression

While there is no cure for AMD, there are various treatments available for certain stages of the condition, and both you and your doctor can decide what treatments are most appropriate for your stage and symptoms. The goal of treatment is not to cure or reverse the damage that has been done by AMD, but rather to slow or stop the progression of the disease and improve quality of life for the patient.

Treatments and therapies to slow progression

Each person with AMD is unique, and so each person will respond differently to certain treatments and therapies. Therapies are primarily aimed at slowing down the progression of AMD, because it is a progressive condition without a cure.

Dry AMD

Nutritional supplements such as the AREDS2 formulation may help slow the progression of dry AMD for some individuals, preserving both vision and quality of life for a longer period of time.

Wet AMD

Other treatments such as eye injections, laser procedures, and photodynamic therapy are aimed at slowing the progression of wet AMD, with the goal of preventing further vision loss.

Preserving and promoting quality of life

Quality of life (QoL) is important for patients with macular degeneration because impaired vision can have significant effects on life, including personally, professionally, and socially. Occupational therapy or assistive devices may help individuals with macular degeneration maintain independence, continue doing things that they enjoy, and aid them in performing essential activities of daily living. These resources may help reduce feelings of helplessness and depression when coping with a chronic vision-threatening disease and help shift focus to enjoying life.

QoL and AMD

Vision impairment in the earlier stages of AMD might include reduced contrast sensitivity, trouble adjusting to dark environments after being in bright areas, or blank spots when looking at something or someone.3 While frustrating and annoying, these may not be very detrimental to QoL at first. As AMD progresses, severe impairment to central vision and acuity may occur, ability to see in dimly lit environments may be markedly reduced, and vision loss may become significant enough to severely limit activities that were previously enjoyed.3

Risks and complications of AMD

Patients living with AMD are at risk for developing clinical depression, not only because of how the condition affects daily activities, but also because AMD can affect your ability to take care of yourself in various ways, impact your social interactions, and increase your risk of falls or fractures.3 Individuals with AMD have shown levels of emotional distress that are similar to those suffering from other disabling chronic illnesses, making it especially important to get assistance with promoting and maintaining good QoL.3

Talk to your doctor

If you have been diagnosed with AMD, talk with your eye doctor about possible treatment options for your type and stage of AMD, and what might be most beneficial at this time. Think about the things you would like your treatment to achieve, and the goals of treatment you have in mind and check with your doctor to see if those goals are achievable. Expectations of treatment can vary, therefore it’s important to know the limitations of different treatments and the expected outcomes so that there are no surprises and everyone can work together towards your wellness goals.

Jaime R. Herndon | January 2019
  1. Facts About Stargardt Disease. National Eye Institute website. 2015. https://nei.nih.gov/health/stargardt/star_facts. Accessed January 28, 2019.
  2. National Institutes of Health: National Eye Institute. Facts About Age-Related Macular Degeneration. 2018. https://nei.nih.gov/health/maculardegen/armd_facts. Accessed December 28, 2018.
  3. Sacconi R, Corbelli E, Querques L, Bandello F, Querques G. A review of current and future management of geographic atrophy. Ophthalmol Ther. 2017; 6(1): 69-77. Doi: 10.1007/s40123-017-0086-6.