Treating age-related macular degeneration

Age-related macular degeneration, or AMD, is a medical condition affecting the eyes that leads to vision loss. This article will give you a brief overview of the treatment options available to those suffering from AMD.

AMD occurs in two forms: "dry" and "wet."

In dry AMD – the more common form – small areas of fatty deposits called "drusen" accumulate in the retinal cells under the macula. They make the macula thin, leading to gradual impairment of central vision. Fortunately, dry AMD develops slowly and the changes are usually quite mild, rarely leading to total loss of vision. At the moment there is no treatment for dry AMD, although researchers are investigating whether antioxidant vitamin supplements might slow down its progression. If you suffer from dry AMD, you must keep up to date with your eye exams, since dry AMD can develop into the more serious – but treatable – wet form.

Only 10 to 15 percent of AMD cases constitute the more aggressive wet AMD, in which tiny, fragile blood vessels develop under the macula. These then leak behind the retina, causing scarring and damage to sight in a matter of weeks or months. Blind spots appear in the centre of the visual field and gradually become larger until eyesight is virtually destroyed. But if wet AMD is identified at an early enough stage of development, one of the following 3 treatments may slow down or even reverse the damage.

Suitable for only a minority of patients, photodynamic therapy involves injecting a light-sensitive drug into the arm. The drug travels through the bloodstream to the blood vessels in the eye, causing the abnormal ones to show up. A low-energy "cold laser" is then beamed into the eye and activates the drug, which destroys the vessels without harming surrounding tissue.

Surgical relocation of the macula is a very specialized operation that is suitable for relatively few AMD patients, but it has a reasonably good record of success.

This relatively new treatment approach is based on drugs that inhibit a protein called vascular endothelial growth factor (VEGF), which is involved in the formation of new blood vessels in the macula. The drugs, which are injected into the eye, reduce the growth of new leaky blood vessels. Treatment is carried out under the close supervision of an ophthalmologist and treatment should be repeated every one to six weeks for up to two years.

Anti-VEGF therapy has dramatically changed the outlook for patients with wet AMD. It halts the deterioration of sight in more than 90 percent of patients. In about a quarter of cases eyesight actually improves, suggesting that treatment can reverse existing damage.

AMD is a serious medical condition and can have significant implications for your quality of life. However, with early diagnosis and intervention, the impact of wet AMD and any vision loss that you may suffer can often be minimized.