Treatments and Strategies to Maintain Vision
Because there is no cure for age-related macular degeneration (AMD), the goal is to halt or slow the disease progression, and effectively detect and manage advanced wet AMD. To achieve this goal, proper early detection, diagnosis, monitoring, and treatment must be practiced.1-5 Earlier detection allows earlier treatment, which leads to better vision outcomes. With proper care, it may be possible to prevent significant visual acuity loss.2,3
It is possible to have a different stage of AMD in each eye.1,3 Treatment will be tailored specifically for each person and each eye. Your primary care doctor can help you quit smoking, recommend a dietician, or offer tools to help maintain a healthy weight. Your care team for AMD will include your primary care and eye doctors, and may also include a retinal specialist, low vision specialist, and nutritionist.
Treatment Methods
Intravitreal Injections
Medications for the eye are often delivered using an intravitreal injection into the vitreous cavity in the middle of the eye. Usually performed in an office while reclined in a chair, the eye and eyelid are anesthetized using drops or gel, so the injection doesn’t hurt. The eye is cleaned, and an eyelid speculum is often used to hold the eyelid open. You will be asked to look in a particular direction depending on the location of the injection while the medicine is injected through the white part of the eye with a very small needle.7,9
Typically, patients feel pressure, with little or no pain during the injection. After the injection, the speculum is removed, and the eye is cleaned. The entire process takes about 10 to 15 minutes.7,9
Laser eye surgery: Commonly performed as an outpatient procedure, a local anesthetic (by eye drop or needle) is used before you receive laser surgery so you don’t feel anything. A special lens is used to focus an intense beam of light on the abnormal blood vessels under the macula. By creating these small burns, the leaky blood vessels are sealed off, helping to prevent more vision loss.4 During photodynamic therapy, a dye is injected to help to target the abnormal blood vessels.6
References
- Cunningham J. Recognizing age-related macular degeneration in primary care. JAAPA. 2017;30:18-22.
- Fernandes AR, Zielińska A, Sanchez-Lopez E, et al. Exudative versus nonexudative age-related macular degeneration: Physiopathology and treatment options. Int J Mol Sci. 2022;23:2592.
- Flaxel CJ, Adelman RA, Bailey ST, et al. Age-Related Macular Degeneration Preferred Practice Pattern®. Ophthalmology. 2020;127:P1-P65.
- Laser Photocoagulation for Age-Related Macular Degeneration. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/laser-photocoagulation-for-agerelated-macular-degeneration
- Practical Guidelines for the Treatment of AMD – Sponsored by MacuLogix – October 2017. https://www.reviewofoptometry.com/publications/ro1017-practical-guidelines-for-the-treatment-of-amd
- Raizada K, Naik M. Photodynamic Therapy for the Eye. StatPearls. Last update: August 8, 2023. http://www.ncbi.nlm.nih.gov/books/NBK560686/
- The American Society of Retina Specialists. Age-Related Macular Degeneration – Patients. https://www.asrs.org/patients/retinal-diseases/2/age-related-macular-degeneration
- Woman with eye open in hospital under the microscope. iStock. January 11, 2016. https://www.istockphoto.com/photo/eye-surgery-exam-gm503559650-82600011
- Intravitreal Injections – Patients – The American Society of Retina Specialists. https://www.asrs.org/patients/retinal-diseases/33/intravitreal-injection
- Macula Retina Vitreous Center. Photodynamic Therapy. https://macularetinavitreouscenter.com/services/surgeries-procedures/photodynamic-therapy
All URLS accessed October 1, 2024.
