How Age-Related Macular Degeneration Is Treated

There are several treatments for macular degeneration, or what's more commonly referred to as age-related macular degeneration (AMD)—a condition that gradually wipes out the central vision. In general, these treatments can prevent and slow the worsening of vision by preventing damage to the retina. Unfortunately, they do not usually repair damage to the macula or recover vision that is already lost. Depending on the extent of your case, vitamins, medications, surgery, and/or therapies may be considered.

Over-the-Counter Therapies

According to the American Academy of Ophthalmology, vitamin supplementation may slow the progression of intermediate non-exudative AMD, which is often referred to as the dry form of AMD. 

The Age-Related Eye Disease Study was a major National Eye Institute-sponsored clinical trial that followed about 3,600 people with varying stages of AMD. Researchers found that taking high levels of antioxidants and zinc daily reduced the risk of developing advanced AMD by about 25 percent.

Recommendations based on the Age Related Eye Disease Study 2 (AREDS 2):

• 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
• 2 mg of Zeaxanthin
  

Medications

Blood vessel overgrowth in the eye is a large part of macular degeneration, and activity of vascular endothelial growth factor (VEGF)—a protein—may play a role in that. 

Anti-VEGF medications include:

• Lucentis (ranibizumab)
• Avastin used off-label (bevacizumab)
• Eylea (aflibercept)
• Beovu (brolicuzumab)

Each is given via an injection into the eye, which is performed by an ophthalmologist. Your ophthalmologist will anesthetize the injection site prior to your injection with anti-VEGF. Most people are able to tolerate the procedure well and without pain or discomfort.

The effects of anti-VEGF procedure typically last for approximately one month, although recent studies show that treatments can be extended in some individuals. You may need repeat procedures if your eye examination shows recurrent blood vessel overgrowth. 

There are also emerging treatments on the horizon that are being studied, such as gene therapy.

Specialist-Driven Procedures

There are several surgical and therapeutic procedures that can prevent and slow down the progression of macular degeneration. Your eye doctor or a retinal specialist will examine your eyes and vision carefully to determine whether or not you would benefit from and tolerate these procedures; the decision is a complex one.

The procedures used for macular degeneration include:

Laser Surgery: Laser surgery procedures use targeted lasers to prevent the proliferation of fragile blood vessels in the eye. This is typically performed in an outpatient setting, and the effect should last for more than a year. That said, the procedure may be repeated years later in some cases if needed.

Photodynamic Therapy: This outpatient treatment involves an intravenous injection of medication that causes the small blood vessels in the eye to constrict so that they are less likely to leak. The medication is activated by light, which is targeted toward the fragile blood vessels with a laser. You should expect to be awake during the procedure and to receive a local anesthetic for comfort and pain control. After the treatment is injected, your eyes may be more sensitive to light than usual, and you will be given instructions on how to protect your eyes. 

Macular Degeneration Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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Lifestyle

There are several lifestyle factors that may reduce your risk of developing AMD, and they should also be part of your complete AMD treatment plan:

• Follow a diet rich in antioxidants
• Get regular eye exams
• Wear sunglasses when outdoors during daylight hours
• Avoid smoking
• Keep your blood pressure at optimal levels
• Keep your cholesterol level at optimal levels
• Exercise regularly

Your eye doctor may give you an Amsler grid to monitor changes in your vision at home. You will learn how to use it and how to tell your eye doctor's office about the results. If you have vision changes or changes as measured by the Amsler grid before your next scheduled appointment, you can be seen sooner.

Additionally, you can see a vision rehab specialist, who can provide you with resources to help safely navigate your environment and manage activities of daily living. Joining a support group can be helpful. And your family can also learn how to support you as you cope with vision loss.