Treatment by Type of Macular Degeneration
While there is no cure for macular degeneration, there are various treatments available that can slow progression of the disease. The treatment your doctor recommends will depend on what type of macular degeneration you have and the stage of your condition. The treatments outlined here cover dry, wet, Stargardt disease, and myopic.
Stages of AMD
- Early dry stage AMD: There is generally no vision loss at this point. Your doctor will probably recommend that you get regular eye exams to track progression of the disease.
- Intermediate dry stage AMD: Some, but not all, may notice vision loss at this stage. Your doctor will likely recommend that you to take nutritional supplements containing the AREDS2 formulation. These vitamins have been shown to decrease the risk of progression to advanced or late stage AMD.
- Advanced dry/wet stage AMD: At this stage, vision loss is noticeable and often severe.1
Treatments for dry AMD
Dry age-related macular degeneration (AMD) is the most common type and occurs more frequently with increased age. There is currently no cure for AMD, and no treatment proven effective for early or late dry AMD.
AREDS and AREDS2
However, a large study called AREDS2 (Age-Related Eye Disease Study 2) showed that if you have intermediate dry AMD, the risk of progressing to advanced dry AMD or wet AMD may be decreased if you take the following combination of supplements1:
- Vitamin C (500 mg)
- Vitamin E (400 IU)
- Lutein (10 mg)
- Zeaxanthin (2 mg)
- Zinc (80 mg)
- Copper (2 mg)
This formulation is available as a single pill, over-the-counter or prescribed. It is usually taken twice a day.
Note: This formulation can vary between different over-the-counter products.
Treatments for wet AMD
Wet AMD is considered advanced or late AMD and occurs when abnormal blood vessels grow underneath the retina. These vessels tend to leak fluid or bleed, causing damage and distortion of the macula.
Wet AMD is treated with anti-VEGF drugs that are injected into the eye. These drugs help reduce the growth of abnormal blood vessels underneath the retina and slows any leaks from those vessels so your eye has time to resorb any existing fluid.
If wet AMD does not respond to anti-VEGF injections, your doctor may recommend photodynamic therapy (PDT) as a supplemental treatment. For PDT, a light-sensitive dye 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 blood vessels clot off and stop growing, which can slow the rate of vision loss. Older laser procedures are rarely performed for wet AMD since the development of anti-VEGF medicines but may be employed occasionally to reduce the number of abnormal blood vessels and slow leaky vessels.1,2
Treatments for Stargardt disease
Also called Stargardt macular dystrophy, juvenile macular degeneration, or fundus flavimaculatus (a variant of Stargardt disease), this form of macular degeneration is hereditary and is often first diagnosed in childhood or adolescence.There is no treatment for Stargardt disease. To slow vision loss, your doctor may recommend wearing dark sunglasses and wide-brimmed hats while outside. Smoking, as well as secondhand cigarette smoke, should be avoided.3
Treatments for myopic macular degeneration
Myopic macular degeneration may occur in people who are very near-sighted (called high myopia) and tends to run in families.4 It can be wet or dry. There is no proven treatment for dry myopic macular degeneration, but your doctor may suggest that you take the same dietary supplements used in the intermediate stage of dry AMD.5
CNV in MMD
The wet form of myopic macular degeneration is treated the same way as wet AMD, with anti-VEGF drugs. These medicines are injected into the affected eye where it helps stop or reduce the protein (VEGF) that causes abnormal blood vessels to grow and leak. When these abnormal blood vessels begin to grow and leak, it is called choroidal neovascularization (CNV). Laser procedures are rarely used to treat myopic macular degeneration as anti-VEGF drugs are more effective and have fewer side effects.
Low vision tools & techniques
Regardless of the type of macular degeneration you have, you can use a variety of low vision tools to help you make the most of the vision you have left. Such tools include:
- Magnifying spectacles which are worn like glasses
- Stand magnifiers which can hover over what you are trying to see
- Hand magnifiers which are more portable than stand magnifiers
- Telescopes or binoculars
- Video magnifiers
- Non-optical devices such as talking devices, telephones and remote controls with large numbers and high-contrast colors
- Ebooks, audiobooks and large-print books
- Smartphones and tablets
You may also need to increase the amount of light in your home and office, create more contrast in your environment, and make notes to yourself using larger letters and a bold tip pen.1
Slow progression of vision loss
No matter what type of macular degeneration you have, you can take action to reduce your symptoms and potentially slow the vision loss. Many doctors recommend lifestyle changes such as a low-fat diet, routine exercise, smoking cessation, and protecting your eyes from ultraviolet light by wearing wide-brimmed hats and sunglasses. Research is underway to try and better understand the causes of macular degeneration. The hope is that greater understanding will lead to more effective treatments, and hopefully, a cure.