There is no cure, but age-related macular degeneration treatments may prevent severe vision loss or slow the progression of the disease considerably. Several treatment options are available, including:
Anti-angiogenic drugs. These medications -- injected into the eye -- block the development of new blood vessels and leakage from the abnormal vessels within the eye that cause wet macular degeneration. This treatment has been a major change in the treatment of this condition and many patients have actually regained vision that was lost. The treatment may need to be repeated on follow-up visits.
Laser therapy. High-energy laser light can sometimes be used to destroy actively growing abnormal blood vessels that occur in age-related macular degeneration.
Photodynamic laser therapy. A two-step treatment in which a light-sensitive drug is used to damage the abnormal blood vessels. A medication is injected into the bloodstream to be absorbed by the abnormal blood vessels in the eye. The doctor then shines a cold laser into the eye to activate the drug, damaging the abnormal blood vessels.
Vitamins . A large study performed by the National Eye Institute of the National Institutes of Health, called AREDS -- Age-Related Eye Disease Study -- showed that for certain individuals, vitamins C, E, beta-carotene, zinc, and copper can decrease the risk of vision loss in patients with intermediate to advanced dry age-related macular degeneration.
However, the ingredients of vision supplements may change with the completion of the AREDS2 study. This study sought to see if adding other vitamins and mineral to the supplement would improve results of the AREDS. The first addition was omega-3 fatty acids (fish oil), and the second was a combination of two carotenoids, lutein and zeaxanthin, which are found in leafy green vegetables and highly colored fruits and vegetables. The research showed:
- Beta-carotene did not reduce the risk of progression of AMD.
- Adding omega-3 to the AREDS formula did not reduce risk of progression of AMD.
- The AREDS formula was still found to be protective with less zinc added.
- People that took a formula with lutein and zeaxanthin and who may not have been taking enough in their diet showed further improve with the new AREDS formula.
- In general, people who took lutein and zeaxanthin instead of beta-carotene had more of a benefit.
Low vision aids. Devices that have special lenses or electronic systems that produce enlarged images of nearby objects. They help people who have vision loss from macular degeneration make the most of their remaining vision.
Researchers are studying new age-related macular degeneration treatments. The following treatments are considered experimental.
- Submacular surgery. Surgery to remove the abnormal blood vessels or blood.
- Retinal translocation. A surgical procedure used to destroy abnormal blood vessels that are located directly under the center of the macula, where a laser beam cannot be placed safely. In the procedure, the macular center is rotated away from the abnormal blood vessels to a healthy area of the retina, thus preventing the formation of scar tissue and further damage to the retina. Once moved away from the abnormal blood vessels, a laser is used to treat the abnormal blood vessels.
Next Steps for Macular Degeneration
Because some people with the dry form of age-related macular degeneration may develop the wet form, those with the dry form should monitor their vision daily and notify their ophthalmologist of any changes in their vision.
If you have the wet form of macular degeneration, even if it's been treated, you should test your vision to see if any blind spots grow bigger or if any new blind spots appear. New blood vessels can emerge months or years after you have had successful injections or laser treatment.
If only one eye is affected, your ophthalmologist will perform regular eye exams on your other eye to discover any sign of new problems.
What Is the Outlook for People With Age-Related Macular Degeneration?
People rarely lose all of their vision from age-related macular degeneration. They may have poor central vision, but they are still able to perform many normal daily activities.
The wet form of macular degeneration is a leading cause of irreversible legal blindness. When both eyes are affected, you may lose significant quality of life.
The dry form of age-related macular degeneration is much more common and tends to progress more slowly, allowing you to keep most of your vision.
Unfortunately, even after macular degeneration treatment, the condition can recur. Because of this, individuals with macular degeneration must test their own vision regularly and follow the recommendations of their ophthalmologist. Proper and timely treatment, however, cannot only slow the rate of vision loss but often improve vision.
Age-Related Macular Degeneration Prevention
Macular degeneration cannot be prevented, but it may be controlled with the help of your ophthalmologist. The best way to minimize vision loss is to get prompt attention by your ophthalmologist. The earlier you have macular degeneration diagnosed, the better the chance that treatment will help.
See your eye doctor if you have any symptoms of age-related macular degeneration and make sure you keep regularly scheduled eye exams.
- People older than 45 years with a family history of age-related macular degeneration have a greater chance of developing the disease.
- Using the Amsler grid may help detect subtle changes in your vision. You can monitor your vision daily by posting an Amsler grid on your refrigerator.
- Ophthalmologists recommend that you stop smoking, eat a balanced diet that includes leafy green vegetables, and protect your eyes from sun exposure with sunglasses that block ultraviolet (UV) sun rays. It is a good preventive measure not to smoke. A recent literature review found a two- to three-fold higher risk for developing age-related macular degeneration in smokers.
- The Age-Related Eye Disease Study found that supplementation with antioxidants plus zinc decreased the likelihood of developing advanced age-related macular degeneration in some people.
- Vision exams for those older than 65 should include age-related macular degeneration screening.