Age-Related Macular Degeneration Treatment
If you have been diagnosed with age-related macular degeneration (AMD), the treatment your doctor recommends will depend on your type of AMD. AMD can be wet or dry. Dry AMD is the most common type. Treatment also depends on how advanced your condition is.
Doctors don’t exactly understand why, but it seems that high fat levels in the blood (high cholesterol), diabetes and obesity all tend to make AMD worse. Therefore, if you are diagnosed with AMD, your doctor will likely suggest a series of lifestyle changes that may help slow the disease, and also promote overall health. These include:
- Eating foods rich in antioxidants, omega-3s and folic acid
- Losing weight
- Maintaining a healthy blood pressure
- Exercising regularly
Other common lifestyle recommendations include:
- Smoking cessation and avoiding secondhand smoke
- Protecting the eyes from sunlight with sunglasses and wide-brimmed hats
- Using low-vision devices1,2
Treatment for dry macular degeneration
Dry age-related macular degeneration (AMD) is the most common type and occurs when the macula thins as a person gets older. There is currently no cure for AMD. However, there is a nutritional supplement formula your doctor may recommend which can slow progression of the disease in those with intermediate dry AMD.
AREDS and AREDS2
Two large studies called AREDS (Age-Related Eye Disease Study 1) and AREDS 2 (Age-Related Eye Disease Study 2) showed the risk of progression to advanced dry AMD or wet AMD may be decreased if you take the following supplements2:
- Vitamin C (500 mg)
- Vitamin E (400 IU)
- Lutein (10 mg)
- Zeaxanthin (2 mg)
- Zinc (80 mg)
- Copper (cupric oxide) (2 mg)
Note: This formulation can vary between different over-the-counter products.
Treatment for wet macular degeneration
Anti-VEGF drugs are the first line of defense in treating wet AMD. These drugs help reduce the growth of abnormal blood vessels and decrease any leaks from your eye’s blood vessels. These medicines are injected into the eye through a very small needle. Some commonly prescribed anti-VEGF drugs are:
For AMD that is not responsive to anti-VEGF medicines, your doctor may recommend photodynamic therapy (PDT) as a supplemental treatment. For PDT, a light-sensitive dye called Visudyne (verteporfin) is injected into your arm. This dye then travels to the blood vessels in the eye. When your doctor shines a laser light into your eye, the abnormal vessels clot off and stop growing, which slows the rate of vision loss.6Laser photocoagulation surgery has become less common since anti-VEGF drugs and PDT became available.7
Devices for macular degeneration
The implantable miniature telescope is an FDA-approved device for people with end-stage AMD in both eyes. During surgery, the lens of the eye is removed (the same as cataract surgery) and a mini-telescope is inserted. This procedure does not repair a damaged macula, but it does help the eye use the healthy parts of the retina. The result is improved vision.
eSight electronic glasses house a high-speed, high-definition camera that displays images on two screens very near the eyes. The videos display in real-time with much greater clarity than the wearer’s regular vision, and the images can be zoomed. This device is worn just like a regular pair of glasses.8,9
Surgery for macular degeneration
In the early 2000s, doctors attempted submacular surgery in an effort to restore vision in eyes with advanced wet AMD or macular scars. The goal of this surgery was to remove subfoveal choroidal neovascularization (CNV) or scar tissue underneath the retina. Studies found that this surgery only worked in about half of AMD patients.10
Another investigational surgery from the early 2000s was retinal translocation, which simply meant that the surgeon removed a portion of the retina and relocated it to a healthier portion of the eye. This surgery was only recommended for early-stage wet AMD. While some patients gained vision, others lost vision due to this procedure.11
Complementary and alternative medicine
In addition to the AREDS2 supplements mentioned earlier, researchers are investigating a few herbal supplements that have been traditionally recommended for visual health. These include:
- Ginkgo biloba, 160 to 240 mg per day
- Bilberry (Vaccinium myrtillus ), 120 to 240 mg, 2 times per day
- Grape seed (Vitis vinifera ), 50 to 150 mg per day)
- Milk thistle, 150mg, 2 to 3 times per day12
It is important to recognize that nutritional supplements are not regulated by the FDA, and have no proven benefit for those with AMD, other than the AREDS2 supplement combination.
Macular degeneration research
Because the U.S. population is getting older, there is growing interest in finding more effective treatments and potentially a cure for AMD. For instance, many new drugs are being studied to help people with dry AMD. Classes of medications called anti-inflammatory drugs and vasodilators show particular promise and several are under investigation in phase II/III studies. The potential for stem cell therapy also generates much excitement.13