What Treatments Are Available for Dry and Wet Macular Degeneration?

Dry Macular Degeneration Treatments

In dry age-related macular degeneration, small white or yellowish deposits, called drusen, form on the retina beneath the macula, causing it to deteriorate or degenerate over time.

There is no mainstay treatment for dry AMD. However, depending on the stage of dry AMD, taking a particular supplement can help slow the progression of dry AMD.

AREDS2

This supplement is called AREDS2. Studies have found that the following formulation can help decrease the progression of dry AMD: 500 milligrams (mg) of vitamin C, 400 international units of vitamin E, 80 mg zinc as zinc oxide, 2 mg copper as cupric oxide (to avoid anemia with high zinc intake), 10 mg lutein and 2 mg zeaxanthin. However, ask your doctor before taking this supplement, as the AREDS2 clinical trial has shown no benefit for mild stages of AMD.

Modifiable Risk Factors

Studies suggest that modifiable risk factors may help slow the progression of AMD or prevent worsening. The most studied and proven modifiable risk factor is smoking. Studies have shown that smokers have an increased risk of dry AMD than nonsmokers. Also, ex-smokers have a decreased risk of dry AMD than current smokers. By stopping smoking, you will help prevent the progression of dry AMD

Certain vegetables contain lutein, which protects the macula from further damage. Thus studies have shown that increasing the quantity of antioxidant-rich foods, such as fresh fruits and dark green leafy vegetables (kale, collard greens, and spinach, for example). Other studies have also suggested eating fatty fish to reduce the severity of dry AMD as these fish are high in omega-3 fatty acids which help decrease inflammation.

Obesity and uncontrolled hypertension are two known risk factors that worsen the disease progression of AMD. Because of this, incorporate regular exercise and following with your primary care provider about combatting obesity and hypertension.

Meet Author Ed Henkler and His Mother Jane, Who Has Macular Degeneration

author Ed Henkler and his mother Jane

When Ed Henkler’s mother, Jane, was diagnosed with age-related macular degeneration (AMD), she agreed to leave her full life in Florida to move closer to her son in Pennsylvania. But the family was apprehensive. Would Jane become homebound – trapped in a safe but restrictive cocoon? Would Ed and his wife sacrifice their own freedom to become caregivers?

Read Ed’s story and learn about the many ways he and his mother learned to cope, including:

  • Recognizing the stages of grief and the importance of emotional support
  • Learning to get around safely indoors and outdoors
  • Making helpful, low-cost modifications throughout the home.
  • Check out our Getting Started 2020: A Guide for People New to Vision Loss – VisionAware for more ideas to help you live well with low vision.

What Treatments Are Available for Wet Macular Degeneration?

Treatments

In wet (neovascular/exudative) age-related macular degeneration (AMD), abnormal blood vessels develop under the macula and break, bleed, and leak fluid. This damages the macula and, if left untreated, can result in rapid and severe loss of central vision.

Targeting Vascular Endothelial Growth Factor (VEGF)

The most effective treatments to date for wet AMD are medications that target the protein that causes the abnormal blood vessels to form, Vascular endothelial growth factor (VEGF), a protein produced by a damaged retina that causes the production of abnormal blood vessels. However, these blood vessels damage your eye more by causing worsening swelling and bleeding and can cause scars that can pull on your retina and cause a retinal detachment.

Injections

In these cases, your doctor may treat you with an injection of anti-VEGF medicine. Anti-VEGF medicine blocks VEGF which prevents the growth of new blood vessels in the eye. Although the main role of anti-VEGF injections is to prevent your vision from getting worse, this medication can sometimes improve your vision. Your ophthalmologist may give you three types of anti-VEGF medications – Avastin, Lucentis, and Eylea.

Laser

In some very aggressive wet AMD scenarios, your doctor may also recommend laser treatment called photodynamic therapy (cold laser). The purpose of this laser is to slow down progression. Although this laser does not prevent significant vision loss, it may be used in some rare instances of exudative AMD.

Surgical

If there is still a concern for worsening wet AMD, your doctor may suggest surgical treatment. However, these surgical procedures were developed before the invention of anti-VEGF treatments. For the most part, these surgical treatments are rarely used.

By Lylas G. Mogk, M.D., Updated by Sefy Paulose, M.D., March. 2022

Deanne Jackson: From Despair to Hope with Wet Macular Degeneration

head shot of Deanne Jackson

Deanne Jackson was “emotionally devastated” after receiving a diagnosis of macular degeneration, believing that her independent life was over. “When I got home after I’d heard the news that I had wet macular degeneration in my left eye with 20/400 vision, it was like an overnight devastation. I thought my life was over because I am very independent. I take care of myself and my family.”

Listen to Deanne’s story and learn how she realized the importance of reaching out for help as she learned to cope with her diagnosis and the many changes in her everyday life.

The Getting Started 2020: A Guide for People New to Vision Loss – VisionAware can give you more ideas about how to live well with low vision.

Clinical Trials for Macular Degeneration

To receive approval from the U.S. Food and Drug Administration (FDA), a new drug or treatment must be proven safe and effective by undergoing a rigorous series of controlled unbiased studies. To prevent bias, neither the patient nor the examiners can know which patients received the actual treatment and which were the untreated (or “control”) subjects.

These are called “double-blind” or “double-masked” studies and usually yield the most reliable results. The medication is coded and patients are placed at random into either the treatment or control group. When the study is concluded, the code is revealed and it is then possible to determine who received the actual drug and who received the inactive substance or placebo.

As defined by the U.S. National Institutes of Health, most clinical trials are designated as Phase I, II, or III, based on the questions the study is seeking to answer:

  • In Phase I clinical trials, researchers test a new drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe and effective dosage range, and identify possible side effects.
  • In Phase II clinical trials, the study drug or treatment is given to a larger group of people (100-300) to determine if it is effective and to evaluate its safety further.
  • In Phase III studies, the study drug or treatment is given to even larger groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
  • In Phase IV studies, after the Food and Drug Administration has approved the drug, continuing studies will determine additional information, such as the drug’s risks, side effects, benefits, and optimal use.

To learn more about clinical research on treatments for macular degeneration, you can visit the following resources:

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