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Diagnosis and Treatment of wet AMD

Your treatment team

When it comes to vision, there are a few different types of eye doctors. The type of eye doctor that you visit may depend on a few things: how old you are, other health conditions you may have, and how your vision is. So if your vision is impaired, you may visit a more specialized eye doctor, like an ophthalmologist or retina specialist.

Optometrist (ahp-TAHM-uh-trist)
An optometrist is a medical specialist trained to examine, diagnose, treat and manage some disorders and diseases of the eye. Although they do not perform surgery nor are they trained to treat all diseases of the eye, they are trained to detect diseases such as glaucoma, retinal diseases and cataracts.

Ophthalmologist (ahf-thal-MAH-loh-jist)
An ophthalmologist is a doctor that specializes in the medical and surgical care of the eye. They can be either doctors of medicine (MD) or doctors or osteopathy (OD). Ophthalmologists often treat conditions of the front of the eye, including cataracts and glaucoma.

If an ophthalmologist thinks you have wet AMD, they will refer to a retina specialist for additional exams and possible treatment.

Retina specialist (RET-ih-nuh)
A retina specialist is a medical doctor trained as an ophthalmologist. However, they have received additional fellowship training in diseases and surgery of the retina.

If you think you have AMD, it's important to make an appointment with a retina specialist.

Eye exams and Tests

If you've noticed changes in your vision that seem like symptoms of AMD, make an appointment with an eye doctor or retina specialist. To diagnose AMD, you need to have your eyes dilated so he or she can see the back of your eye. And be sure to review your medical history. If there are signs of AMD, your ophthalmologist will refer you to a retina specialist if you don't already have one.

How is dry AMD diagnosed? When diagnosing dry AMD, your ophthalmologist or retina specialist will be looking for the small yellow deposits, or drusen, found under the retina — and right near the macula. Normally, the macula has a reddish color. If there are signs of AMD, the macula may look patchy and pale.

How is wet AMD diagnosed?
To see if you have wet AMD, your retina specialist will be looking for different signs. He or she will be looking for the growth of abnormal blood vessels and the leaking of fluid in the back of your eye.

Eye tests that may be performed include:

Visual Acuity test-the Snellen Eye Chart
The Snellen Eye Chart measures how well each eye can see. It's a group of letters on different lines. The bottom of the chart has the smallest letters. And each line has bigger and bigger letters. At the top of the chart is a big "E". The lower down you see on the eye chart (the smaller letters) the better your vision.

Amsler grid
This looks like a checkerboard with a black dot in the middle. You cover 1 eye and stare at the black dot. While staring at the dot, you may notice that the straight lines seem wavy. Or, it may seem like some of the lines are missing. If the grid seems blurry or wavy, it may mean that you have AMD. Click here to see the Amsler grid

Dilated eye exam
First, drops are put in your eye. The drops help to widen (dilate) the pupils. Then, using a special magnifying lens, your eye doctor can look at your retina and optic nerve. Once the exam is over, your vision may be blurry. This will go away after a few hours. This test is important to diagnose AMD.

Tonometry
This test is done to determine the pressure within the eye, or the intraocular pressure (IOP). A tonometer exerts a little pressure to the front of the eye to do so. This is usually included as part of a full eye exam.

Fluorescein angiography (FA)
For this test, a special dye is injected into your arm. As the dye passes through the blood vessels in your retina, pictures are taken of the back of your eye. This test lets an eye doctor see the blood vessels of the retina, which is critical to assessing your AMD. Since it's abnormal blood vessels that grow under the center of your retina in AMD, this test is often very helpful. Most people do not experience any pain with FA.

Optical coherence tomography (OCT)
This test is similar to an ultrasound but it uses light instead of sound to create detailed images of your retina tissue. The pictures that are created in OCT are incredibly clear and detailed. With OCT, your eye doctor can see any changes in eye tissues, including the macula, and determine treatment. Most people do not experience any pain with OCT.

If you find out you have wet AMD

If you find out you have wet AMD, there are some things you can do. First, make sure you are seeing a retina specialist. These are the doctors that specialize in treating wet AMD. Then, get educated about AMD and its treatments. These days, your eye doctor can do even more to help your vision from getting worse. In many cases, he or she can offer you a treatment that may help improve your vision. Finally, ask for help. Reach out to family and friends who want to help you. If you need to be driven to an appointment, be direct and ask someone to drive you. There may be support groups in your area. Your eye doctor may be able to put you in contact with support groups and other assistance programs.

Treatment Options

If your eye doctor thinks you have macular degeneration, you will most likely be referred to a retina specialist.

With early diagnosis and proper treatment, the progression of AMD may be delayed. And, the earlier it is detected, the better your chances are of keeping your vision. However, for some people, damage caused by macular degeneration can't be fully reversed.

Your retina specialist will determine your treatment by looking at the growth of abnormal blood vessels and by looking at the damage to the macula. There are several different treatment options available for AMD. And, they are done as outpatient procedures — so you can go home the same day. The available treatments include:

Biologics. Biologics for AMD are often called "intravitreal injections" or "anti-VEGF" treatments. They may even be referred to as "VEGF-inhibitors." Biologics for wet AMD are injected in the eye. They target and block proteins. These proteins — called VEGF — are known to be a cause in the growth of abnormal blood vessels, which are a cause of wet AMD.

Photocoagulation. With this treatment, a hot laser is beamed into the eye to burn away the abnormal blood vessels that have formed under the macula. It can help prevent further damage to the macula and further vision loss. However, abnormal blood vessels, even after being destroyed, may recur.

Photodynamic therapy (PDT). This therapy is for treating abnormal blood vessels that are located under the fovea. The fovea is at the center of your macula and provides your sharpest vision. PDT combines a cold laser with a light sensitive drug that is injected into your bloodstream. When the cold laser is focused on the macula, the drug releases substances that act to close off the blood vessels without damaging the macula.

Preventative measures. The Age-Related Eye Disease Study (AREDS) showed that taking certain supplements may reduce some risks of getting advanced AMD.

Taking a daily supplement of vitamins C, E and A — along with beta carotene, zinc and copper — may help. Smokers should not take beta carotene supplements. Talk to your doctor to see if supplements are right for you.

Be sure to discuss any medical conditions you may have, and the medications you take to treat them. And be sure to discuss your AMD treatment options with your retina specialist. He or she will determine which treatment is right for you.

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