AMD Treatment

There is no known cure for either wet or dry forms of AMD; however, most patients with the dry (or non-neovascular) form of AMD do not experience severe visual loss.

Dry AMD

Certain patients with intermediate forms of dry AMD may benefit from a specific vitamin formulation that has been shown in clinical trials to decrease the chance of developing the more advanced stages of AMD. Please note that the Age Related Eye Diseases Study (AREDS) tested the benefit of a defined vitamin formulation that may be different from that included in many over-the-counter supplements. You should consult with your ophthalmologist or retina specialist to verify whether you are a candidate for AREDS vitamins, and to determine which formulation is right for you.

If you have the early form of AMD, studies have shown that you can reduce your chances of loss of vision by not smoking, maintaining a healthy diet including fruits and vegetables rich in antioxidants, and working with your doctors to control your blood pressure and lipids. Colorful fruits and vegetables, fish rich in omega-3 fatty acids, and nuts are all considered to be beneficial with regard to prevention of the advanced form of AMD.

Wet AMD

There have been great strides in the treatment of the wet, or neovascular, form of AMD in the past few years. Most patients who begin to experience loss of vision as a result of the presence of abnormal new vessels in AMD can maintain stable vision or perhaps even experience improvement in vision following prompt treatment with a new class of medications which block a molecule named Vascular Endothelial Growth Factor (VEGF). This molecule was shown to be a key player in stimulating abnormal blood vessel growth in ocular diseases by work conducted by researchers at Mass. Eye and Ear and Harvard Medical School.

Anti-VEGF Medications

Anti-VEGF treatments seek to stop the abnormal blood vessel growth of wet AMD, leading to vision loss.  The most common anti-VEGF agents used at this time include ranibizumab (Lucentis™), approved for the treatment of wet AMD by the FDA in 2006, and bevacizumab (Avastin™). These medications are delivered via injection into the eye affected by neovascular AMD. Injections are generally performed monthly or at sometimes less frequent intervals – your retinal specialist will explain the dosing schedule and rationale. Injections of anti-VEGF agents are performed in an outpatient office setting and are generally well-tolerated. Most patients are able to resume their daily activities immediately. You will be instructed to use antibiotic eye drops for several days following your injection. While anti-VEGF agents are relatively safe, there are rare associated risks – you will have the opportunity to discuss the risks and benefits of anti-VEGF treatment with a retinal specialist. If you experience worsening vision, pain, or progressive eye irritation and redness following an injection, contact your retinal specialist immediately.

Laser Treatment

Prior to the advent of anti-VEGF agents for AMD, many patients with the wet form of AMD were treated with Photodynamic Therapy (PDT), a type of ‘cold laser’ therapy using the photosensitizing drug verteporfin (Visudyne™), developed in a collaborative effort between Massachusetts Eye and Ear and Massachusetts General Hospital. PDT is rarely used as a stand-alone therapy for wet AMD at present, but is under investigation as one component of so-called combination therapies for wet AMD.

Thermal laser photocoagulation, or ‘hot laser’, is also rarely used in the treatment of wet AMD at this time, but researchers continue to investigate the role of novel laser technologies in AMD.

Ancillary Treatment

Patients who have lost vision in one or both eyes from AMD or any other cause may benefit from evaluation by the Vision Rehabilitation Service of Mass. Eye and Ear. This Center has offered vision rehabilitation services for over 25 years to patients with eye conditions that restrict daily activities, mobility, productivity, or independence. The goal of vision rehabilitation is to assist patients to effectively use all of their remaining vision. It is part of the continuum of ophthalmic care, just as stroke rehabilitation or cardiac rehabilitation is part of the continuum of health care. Patients continue to receive treatment from a retinal specialist while participating in rehabilitation.

Cutting-Edge Therapy and Clinical Trials

Your retinal specialist at Mass. Eye and Ear has access to the full complement of treatment options shown to be beneficial in the treatment of AMD. In addition, you may qualify to enter a clinical trial investigating new agents or refinements to existing therapies. Please make an appointment with one of our retina specialists to learn more about ongoing clinical trials.