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How Is Macular Degeneration Treated?

How Is Macular Degeneration Treated?

 

There is currently no cure from dry AMD and lost vision cannot be reversed, but there are a few things that you can do to slow the progression of the disease.

Change Habits:  There are several factors that cannot be controlled that put you at a higher risk of developing macular degeneration such as age, heredity, sex, eye color, and race, but there are several lifestyle changes that can lower your risk that you can control.   For example, smokers are two to five times more likely to develop AMD.  Even if you quit, the risk factor is present for up to twenty years.  A poor diet that is high in fat and low in fruits and vegetables is also associated with a higher risk of AMD development.  High blood pressure, high cholesterol, and obesity contribute to the risk of developing the condition.  Those with a BMI over 30 are two-and-a-half times more likely to develop AMD. [1]

AREDS Formulation: The National Institutes of Health’s National Eye Institute conducted a ten-year study on the effects of antioxidants and zinc on macular degeneration and found that taken in the right combination, the vitamins slowed the progression of the disease.  The Age-Related Eye Disease Study (AREDS) created a formulation that includes vitamin C, vitamin E, beta-carotene, zinc oxide, and cupric oxide. [2]

Telescopic Implants: For some with advanced macular degeneration, a telescopic implant may be a treatment option to improve vision.  In this procedure, a telescopic lens is surgically implanted in one eye, which will serve to magnify the field of vision.  This is the only surgical option available that will restore vision and has several criteria for candidacy including good peripheral vision in the eye not receiving the implant and no other diseases of the eye. [3]

Treating Wet Macular Degeneration

With this condition, abnormal blood vessels form rapidly in back of the retina. At some point, they begin leaking fluid and blood, damaging the macula, which controls central vision. The recommended treatment is based on both the location and quantity of those abnormal blood vessels. There are several treatment options available for wet macular degeneration that include drugs and laser therapies that have been successful in certain situations. [4]

Medications: Currently anti-VEGF treatments are the primary line of defense for wet macular degeneration.  VEGF is a protein that stimulates the growth of new blood vessels.  This therapy involves injecting drugs directly into the eye that will inhibit the stimulation of the protein to slow the growth of new blood vessels.  In some cases, treatment has improved vision. [5]

Photocoagulation: This procedure involves using a laser to directly seal off leaking blood vessels that contribute to wet macular degeneration. Laser therapy is successful in 10%-20% of the cases. [6]

Photodynamic Therapy: In this procedure, a cold laser is used to active a drug that is injected into a vein. The drug, verteporfin, will travel through the blood vessels including those in the eyes, where the physician can activate the drug with the laser, which will then destroy the blood vessels.  [7]

Outlook for the Future

The National Eye Institute is sponsoring and conducting numerous clinical studies to gather more information regarding AMD. As part of their work, those involved in the research are:

  • Studying the feasibility of transplanting new cells into a damaged retina
  • Analyzing families that have a history of the disease to evaluate the various hereditary and genetic factors that may cause it
  • Considering certain anti-inflammatory remedies for those who have the wet form of macular degeneration

Sources:

[1][5] American Federation for Aging Research
Age-related Macular Degeneration
http://www.afar.org/docs/120503_Macular_Degeneration(FR).pdf

[2] [7] National Eye Institute [NEI], of the U.S. National Institutes of Health
“Facts About Age-Related Macular Degeneration [NEI Health Information]”
http://www.nei.nih.gov/health/maculardegen/armd_facts.asp

[3] UC Davis Health System
Telescopic Implant Restores Vision in Patient with Advanced Macular Degeneration
http://www.ucdmc.ucdavis.edu/publish/news/newsroom/6949

[4] Mayo Clinic: Medical Treatment and Research Centers
“Macular degeneration — Treatment at Mayo Clinic”
http://www.mayoclinic.org

[6]WebMD
Age-related Macular Degeneration Treatment
http://www.webmd.com/eye-health/macular-degeneration/age-related-macular-degeneration-treatment

Resource: Mayo Clinic
Dry Macular Degeneration Treatments and Drugs
http://www.mayoclinic.com/health/macular-degeneration/DS00284/DSECTION=treatments-and-drugs

Glossary of Terms

Macula: small and highly sensitive part of the retina responsible for detailed central vision.
St. Luke’s Cataract and Laser Institute

Photocoagulation: uses the heat from a laser to seal or destroy abnormal, leaking blood vessels in the retina.
WebMD

Photodynamic: treatment that uses special drugs, called photosensitizing agents, along with light.
American Cancer Society 

Expert Opinion

“Very new surgical treatments to relocate retinal tissue away from the areas of damage are showing some promise.  These are used only in extreme cases of bleeding under the retina.”

Age-related Macular Degeneration  American Federation for Aging Research

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