Macular Degeneration Treatment
Macular degeneration is the leading cause of irreversible central vision loss, affecting approximately 10 million Americans. It is the most common degenerative eye condition in people over 60. It damages central vision, which is essential reading, driving and recognizing faces.
What is macular degeneration?
Often referred to as AMD, or age-related macular degeneration, the condition is caused by the deterioration of light sensitive nerve cells in the macula, which is the central part of the retina, at the back of the eye. The macula is responsible for sending signals to the brain which are translated into images by the brain. Deterioration of the macula results in a blind spot in the middle of the visual field. There are two types of macular degeneration: dry AMD and wet AMD.
Dry age-related macular degeneration is the most common type, affecting 80% of people with AMD. With age, clumps of proteins called drusen form on the macula causing it to thin and dry out. The macula deteriorates, resulting dimming of the central vision. It is less severe than wet AMD. progresses more slowly.
Wet AMD, while not as common, is more serious. Approximately 10-20% of dry AMD cases turn into wet AMD. Wet AMD is caused by the abnormal growth of blood vessels in the macula that leak fluid or blood scarring of the macula and causing a total loss of central vision.
How is macular degeneration treated?
Treatment for AMD depends on the type and stage of the condition. There are three stages of AMD:
- Early – Changes to the macular are occurring, but vision is not affected
- Intermediate – Vision may get blurry or wavy
- Late (advanced) – Central vision fails completely
Currently, there is no treatment for early AMD, so your Union Square Eye Care ophthalmologist will closely watch your eyes and monitor any progression of the condition with regular eye exams. Eating healthy, getting regular exercise and quitting smoking can all help combat AMD. Your ophthalmologist may discuss how some of these lifestyle changes may help you in your specific situation.
If you have intermediate AMD, special dietary supplements (vitamins and minerals) can be effective in preventing late-stage AMD. If you have late AMD in only one eye, these supplements may help slow down the condition in your other eye.
In a large human clinical trial called the Age-Related Eye Disease Study (AREDS) conducted by the National Eye Institute Researchers, lutein and zeaxanthin, omega 3, vitamin C, vitamin E and zinc were found to reduce the risk of AMD.
Low Vision Rehabilitation
While AMD reduces or eliminates your central vision, side (peripheral) vision often remains. It may be beneficial for patients with AMD to work with a low vision rehabilitation specialist, an occupational therapist or others trained in low vision rehabilitation, as they can help you find ways to adapt to changing vision associated with AMD.
Treatments for Wet AMD
If your macular degeneration becomes wet AMD, there are various medications and treatments that help slow the progression of complete vision loss.
Medications are designed to stop the growth of new blood vessels. They block the body’s growth signals to generate new blood vessels. For all stages of wet AMD, these drugs are considered the first line treatment.
Medications used to treat wet macular degeneration include Bevacizumab (Avastin), Ranibizumab (Lucentis), Aflibercept (Eylea) or Brolucizumab (Beovu). After numbing your eye, your ophthalmologist will inject these medications into the affected eye. Injections are often scheduled every four to six weeks. In some instances, patients partially recover some of their vision, as the blood vessels shrink and the fluid under the retina absorbs.
Though more rarely used, this procedure treats abnormal blood vessels at the center of your macula using photodynamic therapy. During the procedure, your doctor injects a drug called verteporfin (Visudyne) into a vein in your arm, which travels to blood vessels in the eye. Your doctor will then shine a light from a special laser on the abnormal blood vessels in your eye, activating the drug and causing the abnormal blood vessels to close.
Photodynamic therapy can improve vision and reduce the rate of vision loss, but repeated treatments will likely be needed over time as the blood vessels can open back up.
Following photodynamic therapy, you’ll need to avoid direct sunlight and bright lights for a few days, until the drug has cleared your body.
During photocoagulation therapy, your ophthalmologist will use a high-energy laser beam to seal abnormal blood vessels under the macula. The laser causes scarring that can create a blind spot, but the procedure is used to stop the vessels from bleeding with the aim of minimizing further damage to the macula. Blood vessels can regrow, making further treatment required.
Few people with wet AMD are candidates for this treatment, as it typically won’t work with those who have abnormal blood vessels directly under the center of the macula. The more damaged the macula is, the less effective this procedure will be.
If you have dry or wet AMD, speak with your Union Square Eye Care ophthalmologist about treatments that may be tailored to your specific needs to address the condition. We are here to help you navigate the condition while maintaining the best quality of life possible.