Treatment for AMD can slow the decline in vision loss and, in some cases, improve it. While there is no permanent solution available, treatments can prevent advanced AMD from progressing to permanent blindness.

Dry AMD often begins when deposits known as drusen form beneath the retina. While drusen alone do not usually lead to vision loss, those living with drusen often go on to develop early AMD.

1. Fluorescein angiography

Fluorescein angiography (FA) is a photographic test designed to evaluate blood circulation in the retina (the membrane that covers the back of your eye). This helps detect conditions such as proliferative diabetic retinopathy and other wet forms of macular degeneration; retinal vein or artery occlusion; cystoid macular edema and tumors of the back of the eye. FA is noninvasive and typically takes less than 30 minutes for completion.

For this test, the patient’s pupils will be dilated using special eye drops before an angiogram series is taken with a specialized camera. A dye called sodium Fluorescein will bind to plasma proteins before reflecting light back out at wavelengths the eye can detect. As it moves throughout the system, photos are taken that show both where it passed and its blood vessels it passed through in stages.

Dye enters the body’s blood stream through capillaries in small blood vessels in the iris. From there it travels to the choroid layer behind the retina that has an abundance of densely packed blood vessels – visible within 10-15 seconds in normal eyes; leakages become noticeable quickly as well. Dye also enters macula area for identification of retinal pigment epithelium abnormalities or deposits.

Once in the eye, dye can cause a temporary feeling of warmth that typically subsides quickly as your doctor takes photos with a special camera. You should expect that the final photos to be brightly lit; however, camera flashes are not harmful to your vision.

Though wet macular degeneration cannot be reversed, its progression from intermediate to advanced stages may be stopped by using anti-VEGF injections such as Bevacizumab, Ranibizumab, Pegaptanib, and Aflibercept injections on a four-weekly basis to reduce fluid buildup, stop new blood vessel growth and slow the progression of macular degeneration. These medications should be given directly into the eye at four-weekly intervals for best results and help slow progression of macular degeneration.

2. Optical coherence tomography

Optic coherence tomography (OCT) is an imaging test that uses light beams to capture cross-section images of your retina, with very detailed images that allow your ophthalmologist to examine what is occurring within its layers and measure their thickness – an invaluable diagnostic tool in cases of glaucoma or age-related macular degeneration.

Optic coherence tomography works on the principles of interferometry, using light waves to produce an interference pattern in tissue. With this information at our disposal, Optical coherence tomography provides high-resolution images with resolution of just microns of tissue microstructure reconstructed with resolution down to submillimeter levels – perfect for medical diagnostic applications as it is noninvasive, safe, painless and does not involve radiation or ultrasound technology.

There are two forms of macular degeneration, Dry AMD and Wet AMD. With Dry AMD, the macular thins out as tiny protein clumps known as drusen form on the retina causing gradual loss of central vision. Wet AMD occurs when abnormal blood vessels form under the retina that rupture and leak fluid or blood into it which damages macula and results in permanent loss of central vision.

Wet AMD can be treated using anti-angiogenic drugs that help stop new blood vessel formation. Unfortunately, however, these treatments don’t work as quickly as natural healing processes in the eye and must be repeated monthly or even annually to be effective. Optical coherence tomography allows us to determine how long to treat you for and monitor its effectivity on you and monitor the response to treatment.

OCT provides more precise diagnosis of Neovascular AMD and provides a reliable method for gauging its treatment’s success. Spectral-domain OCT has become the go-to diagnostic tool, producing more detailed images faster than time-domain OCT. Studies have also demonstrated how using OCT angiography to guide intravitreal injections significantly improves visual outcomes in those suffering from Neovascular AMD.

Optic coherence tomography uses lightwaves to detect areas of retinal pigment epithelium damage and fluid underneath the retina, allowing doctors to then determine how much anti-VEGF medication to inject into a patient and thus slow further vision loss. Optical coherence tomography therapy is currently being explored as part of the AREDS clinical trials in order to see whether such therapies could slow further vision loss.

3. Laser surgery

People affected by central vision loss (which differs from side vision loss) may experience reading, driving and/or recognising faces difficulty, while some will also have distortions in their color perception that make it harder for them to perceive fine details and colors.

Wet macular degeneration occurs more rapidly than its dry counterpart and can result in vision loss within weeks or months. It’s caused by abnormal blood vessels leaking blood and fluid into the retina, leading to swelling, scarring and ultimately vision loss.

Wet AMD can be treated by injecting light-sensitive dyes or laser surgery to the eye or by disabling abnormal blood vessels, though even with these interventions a person may still lose vision and may require wheelchair or walker mobility aids to get around. Therefore, regular visits to an ophthalmologist for examination is especially crucial if over 60 or experiencing blurry central vision, or noticing blurriness around your central vision area. Your doctor can tell if you have wet or dry AMD and provide an Amsler grid which helps you assess your vision at home for home testing at home.

At later stages of wet AMD, an injection of verteporfin into an arm will travel through the bloodstream and directly to the eye where it adheres to new blood vessels and becomes activated by light – this treatment known as photodynamic therapy reduces new blood vessels while stopping any leakage from existing ones, slowing vision loss rates and helping patients maintain independence for longer. Photodynamic therapy treatments can be done in either a doctor’s office or clinic and should usually be quick and painless procedures that should follow the doctor’s instructions precisely – making sure all bright sunlight or indoor lights should be avoided for five days post procedure for best results.

4. Anti-VEGF injections

Vascular endothelial growth factor (VEGF), an essential molecule to wound healing and tissue development, promotes blood vessel formation. While this can be beneficial in wound healing and growth of healthy tissues, abnormally large blood vessels forming underneath the retina and leaking fluid causing macula edema or wet AMD, are particularly troublesome substances. Certain anti-VEGF medications like Avastin, Lucentis and Eylea can block this action to slow abnormal vessel growth while stopping leakage of fluid-leaking fluid-causing macula edema or wet AMD. Certain anti-VEGF medications including Avastin Lucentis and Eylea can block this action and slow abnormal blood vessel growth while stopping fluid leakage below the retina preventing macula edema or wet AMD.

However, long-term benefits of these drugs remain uncertain. Although randomized clinical trials have demonstrated improvements in visual acuity within two to three years of treatment, its impact is uncertain after this point and a significant number of patients experience geographic atrophy (GA), or loss of central vision that may even persist with regular injections and close monitoring.

Researchers are investigating strategies to ease the burden of treatment, including personalized OCT-guided dosing regimens and innovative delivery methods. Unfortunately, however, such technologies will take time before becoming widely available; until that occurs it’s still important for patients to adhere to regular injection schedules as well as visit their eye doctor regularly for monitoring purposes.

At present, patients at risk of vision deterioration should receive anti-VEGF treatments as these remain the most effective therapy currently available. As well, they may want to enroll in a clinical trial that evaluates novel ways of administering their medicines – such as microdroplets or an implanted device. And for those needing both eyes injected, it is highly advised that they use the same sterile technique and personal protective equipment used during eye surgery to minimize cross-contamination risks. Doing this will help limit potential cross-contamination risks. Sodhi asserts that pausing treatments is necessary in order to safeguard both eyes from infection, which could diminish vision acuity. Before any sweeping recommendations regarding cessation are issued, however, randomized clinical trials in larger groups must occur first.