Age Related Macular Degeneration (ARMD) is a progressive eye condition that erodes the central portion of our retina known as the macula, responsible for our ability to see fine detail, read, drive safely and recognize faces and colors while seeing straight ahead.

AMD symptoms include distortion of straight lines on an Amsler test grid chart or grid, as well as progressive haziness in the center of vision. There are two forms of AMD; Dry and Wet.

Anti-VEGF Injections

Vitamins and laser treatments have proven useful, but anti-VEGF injections remain the most effective means of treating wet macular degeneration – the primary cause of vision loss for many affected individuals – the most. These drugs are injected directly into the eye to block an abnormal blood vessel growth protein known as VEGF, thus decreasing fluid leakage while slowing progression of wet macular degeneration. Unfortunately they’re no cure – and require frequent office visits; even multiple sessions on any one day might be required for successful results.

Macugen was the first drug of this class approved for use in the United States when it was released for public sale in December 2004. Subsequent agents including Avastin and Lucentis soon followed, and clinical trials proved these medications could slow the rate of vision loss while even restoring some lost vision among people diagnosed with neovascular age-related macular degeneration (nAMD).

VEGF, or Vascular Endothelial Growth Factor, is a protein that promotes the formation of new blood vessels, and this has many uses in healing wounds and developing our circulatory systems. But too much VEGF production leads to fluid leakage and abnormal vessel growth in certain eye diseases; wet macular degeneration, for instance, involves abnormal vessels growing under the retina that leak fluid that blurs or eliminates central vision; symptoms include dark spots in the central field of vision, distortion of geometric shapes and difficulty adapting to dim light levels.

As well as blocking VEGF, these medications also work by slowing the progression of macular degeneration and decreasing risk for geographic atrophy (GA) in affected eyes. Recent studies have indicated that patients receiving frequent anti-VEGF intravitreal injections are more likely to develop GA than those receiving their injections at shorter or less frequent intervals.

To administer an anti-VEGF injection, doctors apply topical anesthesia to numb the surface of the eye before using a fine needle to inject medication into the vitreous cavity of your eyeball. Saline solution may be added to make injection easier. Patients will return for follow up appointments to evaluate progress and monitor any visual acuity degradation or signs of complications such as subconjunctival hemorrhage or retinal tears that arise after receiving their anti-VEGF shot.

Photodynamic Therapy

Macular degeneration is an eye condition affecting the central part of the retina called the macula, which allows people to see straight ahead while driving, reading or engaging in other activities. Over time it gradually degrades central vision progressively. Most cases occur as dry form macular degeneration; when parts of the retina thin and small protein deposits known as drusen develop. Another 20% have more serious wet form macular degeneration caused by abnormal blood vessels that leak blood or fluid under retina and scar it permanently resulting in scarring macula.

Macular degeneration’s cause remains poorly understood; however, age is the main contributor. Macular degeneration typically does not show symptoms early on and must be detected with a dilated eye exam for diagnosis. One telltale sign of wet macular degeneration is distortion in straight lines that leads to blind spots as well as vision loss in certain areas.

Laser treatment was once the main therapy for wet macular degeneration; however, it often resulted in retina damage and provided only marginal improvement to vision. Today, more effective medications that block vascular endothelial growth factor (VEGF) have proven more successful; injections into the eye with these VEGF blockers prevent abnormal blood vessels that form and lead to macular degeneration – medications like Lucentis, Avastin and Eylea provide significantly greater visual results than earlier therapies.

Photodynamic Therapy (PDT) is an outpatient procedure often combined with anti-VEGF injections in treating wet macular degeneration. The process requires special light filters to protect eyes from blue light used during treatment, after a photosensitizing liquid has been applied around the eyelid. Next, after lying still for roughly sixty minutes in darkness for seventeen minutes of blue light exposure by their doctor, these areas coagulate or kill off abnormal blood vessels exposed to its light beams.

Dr. Rowan recommends that patients with macular degeneration over 50 receive routine dilated eye exams to reduce the risk of advanced macular degeneration by eating healthy and exercising regularly, in addition to receiving eye examinations.

Laser Treatment

Macular degeneration causes central vision loss without leading to total blindness, as peripheral vision remains functional. The disease progresses gradually through several stages with few early and intermediate stage symptoms; eye exams can detect drusen – small yellow protein deposits under the retina which are easily identifiable using an Amsler grid or through optical coherence tomography (OCT)/fluorescein angiography testing instruments.

Wet macular degeneration (WMD), also known as advanced macular degeneration, occurs when abnormal blood vessels form beneath the retina and leak fluid into your macula, disrupting its function and creating blurriness or dark areas in your center of vision. This stage often follows dry form ARMD and can result in permanent loss of central vision – but typically doesn’t impact side vision as greatly.

Macular degeneration generally manifests itself through dry AMD, where gradually thinned and damaged retinal tissue gradually thins and breaks down over time. Only approximately 10% of late stage macular degeneration cases show signs of wet AMD development.

In its wet form, abnormal blood vessels form and bleed under the retina before they leak fluids that create fluid build-up and distort retinal tissue. Over time, this damage to macula leads to vision loss.

Laser treatment of wet AMD can destroy abnormal blood vessels that cause it. A surgeon uses a high-energy beam of light to break apart delicate, leaky blood vessels leaking fluid into the retina, thus decreasing fluid leakage into it and potentially slowing further vision loss. Unfortunately, however, laser procedures cannot restore lost vision; they’re only effective if leaky blood vessels lie near the center of macula (fovea).

Before surgery, your eye care provider will administer drops to dilate your pupil and place a contact lens that allows them to target a laser beam directly at your retina. They then create a grid pattern of 60 micron-thin burns around your fovea area in your retina – using laser technology if necessary.

Surgery

Age related macular degeneration (AMD) is a progressive eye condition that gradually impairs central vision, typically at differing rates in both eyes. Central vision is essential for seeing fine details like clock faces or faces of friends and family members clearly as well as driving and other activities requiring central vision – its loss can interfere with driving, but peripheral (side and distance vision) remains unaffected.

Macular degeneration comes in two varieties, wet and dry. The former forms result from abnormal blood vessel formation beneath the retina that leak blood and fluid into the macula, distorting it and disrupting its ability to see straight ahead. Unfortunately, wet AMD is more severe than dry macular degeneration and often leads to much faster vision loss resulting in blindness more quickly than its counterpart.

Early signs and symptoms of wet ARMD include distortion of straight lines and dark spots in the center of vision. A doctor may identify this condition during a routine eye exam; regular dilated exams should be scheduled due to how quickly its signs and symptoms may progress.

Some cases of wet macular degeneration may be treated using laser surgery, in which a doctor uses painless laser light to destroy leaky blood vessels and seal off leaks in the macular region. Although laser surgery should provide some relief, it’s unlikely to bring back lost vision.

New treatments for wet macular degeneration are currently under investigation. Some of these similar to anti-angiogenic drug treatments but administered via injection could possibly slow or restore some vision loss, although their widespread availability remains to be determined.

Macular degeneration cannot be treated, but there are ways to decrease your risk and enhance quality of life. Regular dilated eye examinations if at increased risk can help detect any early warning signs before vision loss becomes an issue; speak to your eye care provider about what options may best fit for you.