Macular degeneration refers to any condition whereby there is a progressive breakdown of the macula, an area at the back of your eye that provides central vision, leading to blurriness or distortion in vision.

AMD may progress slowly or more quickly depending on a person’s family history of it, while some cases involve abnormal blood vessels growing under the retina (“wet” form of AMD) which may eventually leak and lead to vision loss.

Anti-VEGF Drugs

Anti-VEGF drugs have proven transformative for patients suffering from vision-threatening diseases, revolutionizing treatment for the wet form of age-related macular degeneration. Such anti-VEGF agents as ranibizumab (Lucentis) and aflibercept (Eylea HD) help decrease fluid buildup while slowing disease progression; however, monthly intraocular injections must take place in order for their effects to last effectively.

Anti-VEGF treatments may increase the risk of Glaucoma (GA), a condition associated with worsening visual acuity in individuals living with Neovascular AMD and retinal diseases. Researchers are working hard to prevent or reduce its occurrence from anti-VEGF therapies – particularly among those who already possess preexisting risk factors like GA in one eye, multiple scattered drusen spots, retinal angiomatous proliferation or pseudodrusen.

Genzyme’s gene therapy agent AAV2 sFLT01, which encodes an anti-VEGF protein and would be administered via intravitreal injection, is being studied as one possible approach. A clinical trial is being conducted to see whether this treatment can eliminate or significantly reduce macular edema among wet AMD patients.

Novartis’ brolucizumab could provide another option with its intravitreal injection that blocks VEGF to reduce retinal blood flow and IOP, treating wet AMD, diabetic macular edema and nonproliferative diabetic retinopathy – among others. Furthermore, ranibizumab and aflibercept are two FDA-approved anti-VEGF agents which may provide additional effectiveness against specific cases of disease.

Optometrists must closely monitor IOP levels during an anti-VEGF therapy course and inform patients of its benefits; however, such medication may increase risk for developing glaucoma; further investigation must take place in this regard to assess how much of this increased risk can be attributed to treatment itself and how much can be attributed to natural disease progression of neovascular AMD.

Photodynamic Therapy (PDT)

The macula is a small area located at the back of your retina that provides sharp central vision necessary for reading and driving. Age-related macular degeneration (ARMD) is a condition in which the macula gradually deteriorates or breaks down over time, eventually resulting in blurriness or dark areas in central vision that makes daily tasks like threading a needle difficult or reading harder than before. Wet macular degeneration occurs when abnormal blood vessels and scar tissue form beneath your retina leading to rapid vision loss.

Numerous medications exist to slow or stop this progression by suppressing vascular endothelial growth factor (VEGF), a protein responsible for stimulating abnormal blood vessel formation. Unfortunately, however, injections into the eye must be repeated every month or more frequently for these therapies to work effectively. A new therapy called photodynamic therapy (PDT), however, offers longer-acting and less frequent solutions by activating photosensitizing drugs with light before unleashing an oxygen molecule to destroy nearby cells – an approach already utilized to treat certain cancers as well as skin conditions and acne and can be performed either in physician offices or outpatient settings.

UVA researchers conducted a study that demonstrated how injections of a molecular compound similar to one used against HIV could halt wet macular degeneration progression in animal models, suggesting this therapy might provide a viable treatment approach for treating wet AMD, which accounts for 10% of cases worldwide.

Dr. Arshad Khanani of UT Southwestern and his research team implanted retinal cells into animals suffering from wet AMD. These transplanted cells produced molecular factors which communicated with surrounding native retinal cells to make them act more like healthy transplanted ones; eventually this allowed UT Southwestern researchers to produce and harvest these factors for use in therapeutic injections that may prevent or treat wet macular degeneration.

Surgical Procedures

Surgical procedures may be used to address certain complications of dry age-related macular degeneration, including fluid accumulation under the retina (macular edema), abnormal blood vessels beneath it (choroidal neovascularization), and geographic atrophy.

Vitrectomy, a vascular procedure, can help drain fluid out of the eye and decrease macular edema due to diabetic macular edema and branch retinal vein occlusion. Furthermore, vitrectomy may also be used to treat development of large central blurry spots or blind areas caused by abnormally growing blood vessels (neovascular macular degeneration).

Laser photocoagulation surgery is another viable solution for wet age-related macular degeneration, helping to shrink and close leaky blood vessels that form. Furthermore, new medications and surgical procedures for wet macular degeneration are currently under trial.

Macular degeneration sufferers should maintain regular eye exams, even if no visual problems are currently occurring, in order to allow doctors to detect any changes that might arise in their vision. Doing this allows doctors to quickly address any changes that might emerge as the disease progresses.

Researchers still aren’t exactly sure what causes macular degeneration, although it is most prevalent among those over 60. Risk factors may include family history of macular degeneration, smoking cigarettes, cardiovascular disease and obesity as potential triggers.

Macular degeneration causes gradual vision loss that makes reading or driving difficult, as well as colors appearing less vibrant. People suffering from wet macular degeneration may suffer an abrupt loss of vision; should this occur, seek medical assistance immediately. If any symptoms appear that could point towards macular degeneration, seek professional medical advice immediately.

Macular degeneration is best prevented with early intervention and preventative care, including eating healthily, not smoking and getting plenty of physical activity. Regular eye examinations to detect early signs are advised as are vitamin regimens with antioxidants and zinc that may slow its progress; regular check-ups with your physician who may administer fundus photography tests that take photographs inside your eyes in order to ascertain how far along it has progressed are also essential for early diagnosis and monitoring of macular degeneration progression.

Nutritional Supplements

Nutritional supplements are products added to one’s diet for various purposes. According to the Natural Foods Association, worldwide nutritional supplement sales totaled $19.8 billion in 2003 – this figure includes vitamins ($6.6 billion), herbs ($4.2 billion), meal supplements ($2.5 billion), sports nutrition products ($2.0 billion) and minerals ($1.8 billion).

About 85 percent of macular degeneration cases fall under the category of dry form macular degeneration, in which deposits known as drusen slowly build up behind the retina. Meanwhile, 15 percent are classified as wet form cases, where abnormal blood vessels form (neovascularization) beneath the retina and leak fluid into the macula causing vision to rapidly degrade.

Although no cure exists for either wet or dry macular degeneration, new treatments do offer hope. Since anti-angiogenic drugs such as Lucentis, Avastin and Eylea were released to market 15 years ago in large clinical trials they have demonstrated significant improvements over previous treatments with regards to visual results. They work by counteracting proteins which cause abnormal blood vessel growth associated with wet macular degeneration through eye injections administered directly into your eye to counteract protein stimulation which stimulates their formation.

Individuals at risk or experiencing early symptoms of macular degeneration may notice difficulty seeing small details, or straight lines may seem bent or crooked. If this describes you, make an appointment with an eye doctor right away.

People can lower their risk for macular degeneration by eating a healthy diet that features leafy green vegetables and blueberries in particular. Smoking must be avoided to reduce macular degeneration risks, as nicotine constricts blood vessels in the eyes, hastening its progression. Other risks of macular degeneration include having a family history, high cholesterol and blood pressure levels, overweight status and excessive sunlight exposure. Regular appointments and vitamin therapy are vitally important for those living with AMD or at risk for it. UT Southwestern ophthalmologists participate in the Age-Related Eye Diseases Study and its successor AREDS2, and have found that a vitamin formula containing antioxidants, zinc, and fish oil significantly slows progression of some eye conditions in certain patients.