By Yolanda Smith, BPharm
Although there is no cure for macular degeneration, also known as age-related macular degeneration (AMD), there are several management techniques that can aid individuals with the condition.
The appropriate treatment depends on the symptoms and form of disease, such as dry or wet macular degeneration. In some cases, medications or surgery is required to treat the condition.
Dry Macular Degeneration Management
The progression of disease with dry macular degeneration is slow, and it can be a number of years from the onset of initial symptoms before patients experience significant inhibition due to the deterioration of vision.
Visual aids are often helpful to increase ease when partaking in visual activities, such as reading and writing. This might include:
- Magnifying lenses
- Books with large print
- Bright reading lights
- Specialized software for reading on a computer screen
Additionally, a healthy and balanced diet can help to slow the progression of disease, particularly with high intake of certain vitamins. Vitamin A, C and E have been associated with a decreased risk of progression to wet macular degeneration, which is associated with more severe symptoms. Increased intake of lutein and zeaxanthin may also be beneficial.
Wet Macular Degeneration anti-VEGF Medication
Vascular endothelial growth factor (VEGF) is important in the growth and regulation of new blood vessel in the eye, which are associated with the symptoms and progression of wet macular degeneration.
Anti-VEGF medications block the growth factor and, therefore, prevent the growth of new blood vessels in the eye and the progression of disease. They are usually administered via intraocular infection, with the aid of local anesthetic eye drops, which is generally well tolerated.
Some patients may experience partial restoration of vision loss, due to the action of the medication in shrinking existing blood vessels in the eye. This is not, however, a uniform reaction for all patients.
Anti-VEGF medication include:
- Ranibzumab – one injection monthly for three months, followed by maintenance phase for monitoring
- Aflibercept – one injection monthly for three months, followed by bi-monthly injection for one year
These medications are usually reserved for use by patients that are likely to experience and improvement or valuable maintenance in vision. Patients that are most likely to benefit have a visual acuity between 6/12 and 6/96, with no permanent fovea damage and signs of worsening of symptoms. Side effects may include minor bleeding, inflammation, irritation and increased pressure in the eye.
Wet Macular Degeneration Laser Surgery
Photodynamic therapy (PDT) uses an injection of verteporfin into the arm, which is light sensitive and binds to abnormal blood vessels in the macular. A low-powered laser is then directed over a circular area into the damaged eye for approximately one minute.
The light energy is absorbed by verteporfin, which becomes activated and destroyed the abnormal vessels in the macular, with minimal damage to the other ocular tissues. The destruction of these blood vessels prevents the leakage of fluid into the eye that causes damage and vision loss.
Laser coagulation is also sometimes used when the abnormal blood vessels are not in close proximity to the fovea. This involves a powerful laser that is directed toward the retina, causing hardening in the area and preventing the abnormal blood vessels from affecting the macula. Some patients may notice permanent changes to visual following this procedure, such as a black or gray patch in the field of vision.
Other treatments for wet macular degeneration may include
- Macular translocation
- Lens implantation
Further research for macular degeneration treatments continues today, including the possibility of using stem cell therapy.
Last Updated: Nov 2, 2015