While there's no cure for wet age-related macular degeneration (AMD), there are ways to slow the disease and help you see better for longer. But early detection and timely treatment hold the key to saving your sight.
Wet AMD can distort or damage your vision (usually in one eye at a time) in a matter of days or weeks, sometimes faster. Work with your doctor to monitor your vision. They’ll let you know what wet AMD treatment plan is best for you.
Why Does Wet AMD Cause Vision Loss So Fast?
Your body makes certain proteins to help you grow new blood vessels. The main one is called vascular endothelial growth factor (VEGF). When you have wet AMD, your cells make too much VEGF. This causes abnormal blood vessels to form under the back of your eye.
Also called choroidal neovascularization (CNV), these abnormal blood vessels are weak and break easily.
As a result, blood and fluid can leak into your eye. If left untreated, wet AMD creates swelling and scar tissue under the center of your retina. This can permanently damage the light-sensitive cells of your eye (macula).
How Soon Should You Start Treatment for Wet AMD?
Your eye doctor will create a specific plan for you. But once you know you have wet AMD, you should start treatment as soon as possible. Early detection and management are the best ways to slow vision loss and prevent permanent damage to your retina.
The most common way to treat wet AMD is with injections of drugs that stop the growth of new blood vessels, called anti-angiogenic drugs. They block VEGF, the main protein involved in helping new blood vessels to form. Your doctor gives you these shots in your eye using a tiny needle. You'll need a series of shots. Some people have to keep getting them.
If you start these treatments within the first month of your visual symptoms, studies show you have a better chance of preserving your eyesight over the long run.
Types of anti-angiogenic medicines used most often to treat wet AMD are:
- Aflibercept (Eylea)
- Bevacizumab (Avastin)
- Brolucizumab (Beovu)
- Ranibizumab (Lucentis)
Another injectable medication, faricimab-svoa (Vabysmo), not only blocks VEGF but also stops another protein involved in forming blood vessels called angiopoietin-2 (Ang-2). People on faricimab-svoa may be able to go longer between shots.
Less commonly, your doctor might suggest other treatments in addition to or instead of these drugs. These include laser surgeries such as:
- Photodynamic therapy (PDT). Your doctor will give you a shot of a light-sensitive medicine (verteporfin) in your arm. Then they’ll numb your eye, put in a special contact lens, and shine a “cold” laser on the back of your eye. This activates the medicine, which breaks down abnormal blood vessels.
- Laser photocoagulation. This is a type of “hot” laser treatment. It uses a strong laser beam to seal leaky blood vessels. Doctors don’t use this type of surgery to treat wet AMD much anymore because newer treatments work better and have fewer side effects.
What to Expect From Wet AMD Treatment
The goal of any treatment for wet macular degeneration is to quickly stop blood and fluid from leaking into your eye. Right now, the best way to do that is with anti-angiogenic therapy. This can slow or stop vision loss from abnormal blood vessel growth, even improving eyesight for some people.
During treatment, your doctor will:
- Clean your eye to prevent infection
- Put numbing medication into your eye so the shot doesn’t hurt
- Put a device in place to hold your eyelids open
- Use a small needle to inject the medicine into the white part of your eye
The shot itself only takes a few seconds. And you probably won’t even see the needle. You may be able to go back to your normal activities right after treatment. But it may take a few visits for you to know how you’ll feel afterward.
You may not have any problems with your treatment. But shots for wet AMD may cause short-term side effects. These are usually mild and go away in 1-2 days. You may:
- Feel like you have sand in your eye
- See air bubbles that look like floaters
After you get the shot, tell your doctor right away if your eye starts to hurt or you have vision problems that get worse. This could be a sign of a serious complication like infection.
How Long Do You Need Treatment for Wet AMD?
Everyone’s treatment schedule is a little different.
With anti-angiogenic therapy, most folks need shots every 4-8 weeks to get the most benefit. You may be able to go up to 12 weeks or longer between injections. But the timing depends on how you respond to the medicine and which medicine you use.
According to one small study, up to 30% of people with wet AMD may be able to pause or stop getting shots after 1 year of treatment. Researchers are trying to come up with a test to pinpoint who can do this safely, but we’re not there yet.
For now, most people can expect to get regular wet AMD treatments for the rest of their lives. But scientists continue to work on longer-lasting treatments that may cut down how many shots you need.
How Do You Know When Dry AMD Turns Wet?
Most folks with macular degeneration will have the dry type for their whole life. This form of AMD affects your vision slowly over time. But around 10%-15% of people with dry AMD will get wet AMD at some point.
There are steps you can take to spot wet AMD early on so you can get fast treatment. Some are:
- Get regular eye exams to check whether your AMD is getting worse.
- Tell your doctor any time your vision gets more blurry or distorted.
- Keep a weekly journal of any eyesight changes.
- Regularly check for vision changes at home with an Amsler grid.
If you have dry AMD, it’s a good idea to look at the Amsler grid once a day. This simple testing tool uses a grid of horizontal and vertical lines to reveal central vision problems that may not be obvious in daily life. Contact your eye doctor right away if any of its straight lines look wavy, blurry, dark, or blank.
If you’re very likely to get wet AMD, you may benefit from an FDA-approved home monitoring device. Ask your doctor if this tool is something you should use.
Show Sources
Photo Credit: iStock / Getty Images
SOURCES:
National Eye Institute: “Treatment for Age-Related Macular Degeneration,” “Injections to Treat Eye Conditions.”
Harvard Health Publishing: “Age-related macular degeneration: Early detection and timely treatment may help preserve vision.”
Merck Manual: “Age-Related Macular Degeneration (AMD or ARMD).”
Retina: “Time to first treatment: The significance of early treatment of exudative age-related macular degeneration.”
Mayo Clinic: “Wet macular degeneration.”
American Macular Degeneration Foundation: “Macular Degeneration Treatments,” “Monitoring your Macular Degeneration.”
American Academy of Ophthalmology: “Anti-VEGF Treatments,” “New Treatments for Age-Related Macular Degeneration,” “Have AMD? Save Your Sight with Amsler Grid.”
Journal of Clinical Investigations: “Aqueous proteins help predict the response of patients with neovascular age-related macular degeneration to anti-VEGF therapy.”
Johns Hopkins Medicine: “Study Finds Up to 30% of Patients with Wet Macular Degeneration Can Safely Stop Eye Injections.”
Bright Focus Foundation: “Monitoring the Progression of Dry Age-Related Macular Degeneration.”
