Skip to Accessibility Tools Skip to Content Skip to Footer

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.

Lifestyle changes for all types of AMD

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

Treatments for dry AMD

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:

  • Omega-3 fatty acids (1,000 mg)
  • Vitamin C (500 mg)
  • Vitamin E (400 IU)
  • Zinc oxide (80 mg)
  • Copper (cupric oxide) (2 mg)
  • Lutein (10 mg)
  • Zeaxanthin (2 mg)

Treatments for Wet AMD

Anti-VEGF

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:

Laser surgery

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.6 Laser photocoagulation surgery has become less common since anti-VEGF drugs and PDT became available.7

Devices to treat AMD

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 AMD

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

Alternative/complementary therapies for AMD

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.

New AMD therapies under investigation

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

Jessica Johns Pool | February 2019
  1. American Macular Degeneration Foundation. What is Macular Degeneration? Available at https://www.macular.org/what-macular-degeneration. Accessed on February 6, 2019.
  2. American Macular Degeneration Foundation. Recommended Supplements for Age-related Macular Degeneration. Available at https://www.macular.org/nutritional-supplements-article. Accessed on February 6, 2019.
  3. Rofagha S, et al. Seven-year outcomes in ranibizumab-treated patients in ANCHOR, MARINA, and HORIZON: a multicenter cohort study (SEVEN-UP). Ophthalmology. 2013 Nov;120(11):2292-9. doi: 10.1016/j.ophtha.2013.03.046.
  4. Heier JS, et al. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012 Dec;119(12):2537-48. doi: 10.1016/j.ophtha.2012.09.006.
  5. Berg K, et al. Ranibizumab or Bevacizumab for Neovascular Age-Related Macular Degeneration According to the Lucentis Compared to Avastin Study Treat-and-Extend Protocol: Two-Year Results. Ophthalmology. 2016 Jan;123(1):51-9. doi: 10.1016/j.ophtha.2015.09.018. E. pub 2015 Oct 21.
  6. Verteporfin Roundtable Participant. Guidelines for using verteporfin (Visudyne) in photodynamic therapy for choroidal neovascularization due to age-related macular degeneration and other causes: update. Retina. 2005 Feb-Mar;25(2):119-34.
  7. American Macular Degeneration Foundation. Macular Degeneration Treatments. Available at https://www.macular.org/treatments. Accessed on February 7, 2019.
  8. American Printing House for the Blind. The Implantable Miniature Telescope (IMT) for End-Stage Age-Related Macular Degeneration. Available at http://www.visionaware.org/info/your-eye-condition/age-related-macular-degeneration-amd/new-fda-approved-implantable-telescope-for-end-stage-amd/125. Accessed February 7, 2019.
  9. eSight. Available at: https://www.esighteyewear.com/. February 7, 2019.
  10. Prevent Blindness. Submacular Surgery. Available at: https://lowvision.preventblindness.org/2000/03/04/submacular-surgery/. Accessed February 7, 2019.
  11. Prevent Blindness. Macular Translocation. Available at https://lowvision.preventblindness.org/2003/11/25/macular-translocation/. February 7, 2019.
  12. Complementary and Alternative Medicine: Macular Degeneration. Available at https://www.stlukes-stl.com/health-content/medicine/33/000104.htm. February 5, 2019.
  13. Sacconi, R. A Review of Current and Future Management of Geographic Atrophy. Ophthalmol Ther. 2017 Jun; 6(1): 69–77. doi: 10.1007/s40123-017-0086-6.