Age-related macular degeneration (AMD) can slowly rob you of your sight, but there are ways to fight back. While there is no cure for AMD, several treatment options exist to prevent further vision loss by protecting the retina. However, restoring lost vision or repairing macular damage is generally not possible. Treatment recommendations may include a combination of vitamins, medications, surgeries, and/or therapies, tailored to the individual’s condition and severity of symptoms.
Over-the-Counter Therapies
The dry form of AMD, also known as intermediate non-exudative AMD, may be slowed down by vitamin supplementation, according to the American Academy of Ophthalmology. This was observed in the Age-Related Eye Disease Study, a clinical trial sponsored by the National Eye Institute that tracked the health of approximately 3,600 individuals with varying degrees of AMD. The study showed that consuming high levels of antioxidants and zinc on a daily basis reduced the risk of advanced AMD by around 25%.
The recommended daily intake, based on the AREDS study, is:
- 500 mg of vitamin C,
- 400 IU of vitamin E,
- 80 mg of zinc (as zinc oxide),
- 2 mg of copper (as cupric oxide),
- 10 mg of Lutein, and
- 2 mg of Zeaxanthin.
However, it is essential to consult with an ophthalmologist to determine which supplements and dosages are appropriate for your specific condition.
Follow the recommended advice and regimen prescribed by your doctor.
Medications
The growth of blood vessels in the eye is a significant contributor to macular degeneration, and the activity of a protein called vascular endothelial growth factor (VEGF) may be involved. Anti-VEGF medications have been found to effectively halt the formation of fragile blood vessels that can rupture and cause additional damage to the macula.
Anti-VEGF medications include:
- Lucentis (ranibizumab)
- Avastin used off-label (bevacizumab)
- Eylea (aflibercept)
- Beovu (brolicuzumab)
Anti-VEGF injections are administered directly into the eye by an ophthalmologist, who will first numb the injection site. The procedure is usually well-tolerated, and patients generally experience little to no pain or discomfort. The effects of the treatment usually last for about a month, although recent research has indicated that some individuals may be able to extend the time between treatments. If recurrent blood vessel growth is detected during an eye examination, additional injections may be necessary.
Research is currently underway on potential new treatments for macular degeneration, including gene therapy.
Specialist-Driven Procedures
Various surgical and therapeutic procedures are available to prevent and slow the progression of macular degeneration. However, whether these procedures are appropriate for a patient depends on several factors, and is a decision that should be made by an eye doctor or retinal specialist after carefully examining the patient’s eyes and vision.
The procedures used for macular degeneration include:
Laser Surgery:
Procedures involving the use of targeted lasers can help prevent the proliferation of fragile blood vessels in the eye. This outpatient treatment can have effects that last for over a year, although some patients may require repeat procedures in the future. The decision to undergo laser surgery should be made in consultation with a medical professional.
Photodynamic Therapy:
This outpatient treatment involves an intravenous injection of medication that constricts small blood vessels in the eye to make them less likely to leak. A laser is then used to activate the medication and target fragile blood vessels. Patients typically receive a local anesthetic for comfort and pain control, and should expect to be awake during the procedure. After treatment, the eyes may be more sensitive to light than usual, and patients will receive instructions on how to protect their eyes. The decision to undergo photodynamic therapy should be made in consultation with a medical professional.
Lifestyle
There are various lifestyle factors that could reduce the risk of developing AMD, and they should be included in your comprehensive AMD treatment plan. These factors include maintaining a diet that is rich in antioxidants, regular eye check-ups, wearing sunglasses during daylight hours, quitting smoking, keeping blood pressure and cholesterol levels at optimal levels, and exercising regularly.
To monitor any changes in your vision at home, your eye doctor may provide you with an Amsler grid. You will be taught how to use it and how to report the results to your eye doctor’s office. If there are any changes in your vision or Amsler grid readings before your scheduled appointment, you may be able to see your eye doctor sooner.
In addition, it is possible to consult a vision rehab specialist who can provide you with resources to navigate your environment safely and manage daily activities. Joining a support group can also be beneficial, and your family can learn how to support you as you adjust to vision loss.
Conclusion
In conclusion, macular degeneration is a common eye condition that can lead to vision loss, particularly in older adults. While there is no cure for macular degeneration, there are several treatments available that can slow down the progression of the disease and help preserve vision. These treatments include anti-VEGF injections, laser surgery, and photodynamic therapy. Additionally, maintaining a healthy lifestyle by following a diet rich in antioxidants, getting regular eye exams, wearing sunglasses, avoiding smoking, and keeping blood pressure and cholesterol levels optimal may reduce the risk of developing macular degeneration or slow down its progression. It is important to work with your eye doctor or retinal specialist to develop a treatment plan that is tailored to your specific needs and to monitor any changes in your vision with an Amsler grid or other methods. Support from vision rehab specialists and support groups can also be helpful in managing the effects of macular degeneration on daily life.
FREQUENTLY ASKED QUESTIONS
- How is wet macular degeneration treated?
Abnormal blood vessel growth in the back of the eye is caused by a protein called vascular endothelial growth factor (VEGF) in wet macular degeneration. The primary treatment is an injection of anti-VEGF, which helps to prevent the blood vessels from leaking. Photodynamic therapy is sometimes used in combination with anti-VEGF medication as a treatment.
- In what ways does diet impact the progression of macular degeneration?
According to a review study, consuming a healthy diet may have a positive impact on the prognosis of AMD. The study suggests that a Mediterranean diet, including fatty fish that are high in omega-3 fatty acids, and vegetables that are rich in carotenoids may be beneficial for those who are at risk of developing AMD. Conversely, consuming a Western diet consisting of red meats, vegetable oils, animal fats, and more than two alcoholic drinks per day has been associated with an increased risk of AMD progression.
Disclaimer & References:
The information provided by TGH Urgent Care powered by Fast Track is backed by credible sources, such as peer-reviewed studies, to ensure accuracy and reliability. It is intended for educational and informational purposes only and is not a replacement for professional medical advice. For any concerns or inquiries about a medical condition, it is recommended to seek advice from a qualified healthcare provider.
- Gorusupudi A, Nelson K, Bernstein PS. The Age-Related Eye Disease 2 Study: Micronutrients in the Treatment of Macular Degeneration. Adv Nutr. 2017;8(1):40-53. doi:10.3945/an.116.013177
- Macular Degeneration Treatments – AMDF. American Macular Degeneration Foundation.
- Age-Related Macular Degeneration. National Eye Institute.
- National Eye Institute. Treatments for wet AMD (advanced neovascular AMD).
- Chapman N, Jacobs R, Braakhuis A. Role of diet and food intake in age-related macular degeneration: a systematic review. Clin Exp Ophthalmol. 2018;47(1):106-127. doi:10.1111/ceo.13343
Additional Reading
- Aruna Gorusupudi, Kelly Nelson, and Paul S Bernstein. The Age-Related Eye Disease 2 Study: Micronutrients in the Treatment of Macular Degeneration. Adv Nutr. 2017 Jan; 8(1): 40–53. Published online 2017 Jan 11. doi: 10.3945/an.116.013177
- Bahadorani S, Singer M. Recent advances in the management and understanding of macular degeneration. 2017 Apr 20;6:519. doi: 10.12688/f1000research.10998.1. eCollection 2017, DOI:10.12688/f1000research.10664.1
- Evans JR.Ginkgo biloba extract for age-related macular degeneration. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD001775. doi: 10.1002/14651858.CD001775.pub2.
- Hernández-Zimbrón LF, Zamora-Alvarado R, Ochoa-De la Paz L, et al. Age-Related Macular Degeneration: New Paradigms for Treatment and Management of AMD. Oxid Med Cell Longev. 2018 Feb 1;2018:8374647. doi: 10.1155/2018/8374647. eCollection 2018.
- Korobelnik JF, Rougier MB, Delyfer MN, et al. Effect of Dietary Supplementation With Lutein, Zeaxanthin, and ω-3 on Macular Pigment: A Randomized Clinical Trial. JAMA Ophthalmol. 2017 Nov 1;135(11):1259-1266. doi: 10.1001/jamaophthalmol.2017.3398.
- Shusheng Wang and Khrishen Cunnusamy. Traditional Chinese Medicine (TCM) for the treatment of Age-related Macular Degeneration—Evaluation of WO2012079419. Expert Opin Ther Pat. 2013 Feb; 23(2): 269–272.Published online 2012 Dec 10. doi: 10.1517/13543776.2013.751972
- Wang Y, Zhao L, Lu F, et al. Retinoprotective Effects of Bilberry Anthocyanins via Antioxidant, Anti-Inflammatory, and Anti-Apoptotic Mechanisms in a Visible Light-Induced Retinal Degeneration Model in Pigmented Rabbits. Molecules. 2015 Dec 14;20(12):22395-410. doi: 10.3390/molecules201219785.
Disclaimer
The blogs presented by TGH Urgent Care in partnership with Fast Track are not a replacement for medical care and are exclusively intended for educational purposes. The content provided here should not be construed as medical guidance. If you are encountering any symptoms, we strongly recommend that you seek an appointment with a duly qualified medical practitioner at our nearest facility.