Age-Related Macular Degeneration Treatment

Treatments for age-related macular degeneration (AMD) depend on the type of AMD you have and how advanced your condition is. AMD can be classified as wet or dry. Up to 9 out of 10 people have dry AMD, making it the most common type by far.¹

There are 4 stages of AMD:1

• Subclinical – There are no visible, physical changes to the eye yet, but people notice it is harder to adjust to being in the dark.
• Early-stage – There is no vision loss yet, but physical changes to the eye can be seen in a regular eye exam.
• Intermediate-stage – There is some vision loss, but some people still notice no symptoms. An eye exam shows more damage to the eye.
• Late-stage – Vision loss is noticeable and affects quality of life.

While there is no cure for AMD, there are lifestyle changes that can help slow the disease. There are also several treatments for late-stage AMD.¹

Lifestyle changes

Doctors do not understand exactly why, but a combination of genetics and lifestyle factors seem to put people at higher risk of developing age-related macular degeneration. This is why your doctor will probably suggest certain lifestyle changes that may help slow the vision loss of AMD, such as:^1-3

• Eating foods rich in antioxidants, omega-3s, and folic acid
• Taking a special combination of supplements
• Losing weight, if needed
• Maintaining a healthy blood pressure
• Exercising regularly
• Stopping smoking and avoiding secondhand smoke
• Protecting your eyes from sunlight with sunglasses and wide-brimmed hats
• Using low-vision devices to help with the tasks of daily living

Treatments for dry AMD

In early stages of dry AMD, there is no treatment other than regular eye exams to monitor its progress. In intermediate and advanced stages of dry AMD, a targeted combination of supplements has been shown to slow vision loss. The recommended supplements are:³

• 500 mg vitamin C
• 400 iu vitamin E
• 80 mg zinc oxide
• 2 mg cupric oxide
• 10 mg lutein
• 2 mg zeaxanthin
• 1 mg omega-3 fatty acids

Note that supplements are not regulated by the US Food and Drug Administration (FDA) the same way other drugs are. This means that no outside agency confirms the ingredients or suggested dose. Talk to your doctor before beginning any new supplement.

Two complement inhibitor drugs are approved to treat geographic atrophy, the last stage of dry AMD. They include:^4,5

• Syfovre™ (pegcetacoplan)
• Izervay™ (avacincaptad pegol)

Treatments for wet AMD

Even though dry AMD is more common, there are more options for treating wet AMD. These include:³

• Injectable drugs
• Photodynamic therapy
• Surgery

Injectable drugs

There are a few drugs approved by the FDA to treat wet AMD. These drugs are known as anti-VEGF therapies and are injected into the eye. VEGF stands for vascular endothelial growth factor. Anti-VEGF drugs reduce the growth of abnormal blood vessels and any leaks from these blood vessels.³

Examples of anti-VEGF drugs for AMD include:^3,6-8

• Lucentis^® (ranibizumab)
• Eylea^® (aflibercept)
• Avastin^® (bevacizumab)
• Beovu^® (brolucizumab-dbll)
• Byooviz^® (ranibizumab-nuna)
• Vabysmo™ (faricimab-svoa)
• Susvimo™ (ranibizumab)
• Cimerli™ (ranibizumab-eqrn)

Laser photocoagulation surgery

Laser photocoagulation to treat wet AMD is rarely used now because injectable drugs are more effective. But it may be an option for people who cannot take or do not respond to the VEGF drugs.³

Photodynamic therapy

Photodynamic therapy is another treatment that is used less commonly now that anti-VEGF drugs are available and provide better results. But it still may be used to treat specific complications of wet AMD.³

Devices for macular degeneration

The implantable miniature telescope is an FDA-approved device for people with end-stage AMD in both eyes. During this surgery, the lens of the eye is removed (the same as in cataract surgery) and the mini telescope is inserted. This procedure does not repair a damaged macula, but it does help improve vision.⁹

Another device, eSight electronic glasses, uses a high-speed, high-definition camera to display images on 2 screens very near the eyes. The videos play in real time and can be zoomed in. This device is worn just like a regular pair of glasses and improves vision.¹⁰

Research into new AMD treatments

Because the US population is getting older, there is great interest in finding more effective treatments and potentially a cure for AMD.

One study is looking at the use of gene therapy to treat wet AMD. There are also studies testing an artificial retina and looking at how stem cells can be used to treat the damage caused by AMD.^5,11