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.
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 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, and working with your doctors to control your blood pressure and lipids. Colorful fruits and vegetables rich in antioxidants, 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.
There have been great strides in the treatment of the wet, or neovascular, form of AMD in the past few years. For instance, researchers at Mass. Eye and Ear and Harvard Medical School found that Vascular Endothelial Growth Factor (VEGF) is involved with stimulating abnormal blood vessel growth in ocular diseases. Because of this knowledge, most patients who begin to experience vision loss due to the abnormal growth of new vessels in AMD can maintain stable vision, or perhaps even experience improvement, in vision following prompt treatment with a new class of medications that block this new blood vessel growth.
Anti-VEGF treatments seek to stop the abnormal blood vessel growth of wet AMD and prevent vision loss. Currently, the most commonly used anti-VEGF agents are 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 degenerating eye. Injections are generally performed monthly, but may occur at 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.
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 by a collaborative effort between Mass. Eye and Ear and Massachusetts General Hospital. Currently, PDT is rarely used as a stand-alone therapy for wet AMD, but is under investigation as one component of "combination therapies" for wet AMD. Thermal laser photocoagulation, or "hot laser," is also uncommonly used, but researchers continue to investigate the role of novel laser technologies in AMD.
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 so that they can 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.
Your retinal specialist at Mass. Eye and Ear has access to the full array of treatment options for AMD. 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.