Macular degeneration typically takes the form of dry degeneration, in which the macula thins and protein deposits called drusen grow, leading to vision loss. Rarer cases involve abnormal blood vessels developing that leak fluid into the retina and cause vision impairment.

Treatment for this disease typically includes monthly injections of drugs to block VEGF and stop new blood vessel formation. Unfortunately, however, these are only temporary solutions; patients must visit their physician regularly in order for these medication to work effectively.

Medications

Medication may help slow the progression of wet age-related macular degeneration (AMD), which leads to severe vision loss. Pharmacists can assist their patients in understanding what treatments may be available and provide education about these medications.

AMD can be divided into two clinical subtypes, non-neovascular or dry AMD accounting for 85 to 90% of cases; and wet form, also referred to as exudative AMD, where abnormal blood vessels grow beneath the retina and leak blood and fluid into the macula causing severe visual loss in 90-95% of cases. The latter form accounts for 90% of severe visual loss associated with AMD.

Newer medications used to treat wet AMD involve suppressing vascular endothelial growth factor, or VEGF, which may contribute to abnormal blood vessel growth in this condition. Regeneron’s Eylea (aflibercept), Genentech’s Lucentis (ranibizumab), Novartis Beovu/Brioluczumab (bevacizumab), and Vabysmo/faricimab-svoa by Genentech can all be administered directly into eye. Pegaptanib (Macugen) has also been approved as treatment; additional off-label uses may include treating colorectal cancers.

Studies show that these medications are highly effective, helping most patients stabilize or improve their vision, according to studies. Unfortunately, however, these aren’t cures – continuation is required like with treating high blood pressure.

As wet AMD progresses, it is vital to monitor changes to vision and schedule regular visits with an eye doctor. Changes may be subtle, such as difficulty seeing fine print or details or having blank spots in their central field of vision or straight lines appearing crookedly; any of these symptoms should prompt patients to visit an eye care professional as soon as possible, especially if taking medications described herein.

Though macular degeneration cannot be avoided entirely, eating healthily, engaging in regular physical activity, and not smoking can significantly lower the risk. Patients should discuss other potential modifiable and nonmodifiable risk factors with their physician including family history, ethnicity and age as these may all increase the chances of wet AMD development.

Laser Treatment

Laser treatment involves an eye care professional using painless laser light to destroy new blood vessels that are leaking under the retina in wet macular degeneration, slowing vision loss while not restoring any lost vision. Only a select group of those suffering from wet macular degeneration qualify for laser therapy; otherwise they may use fluorescein angiography or optical coherence tomography (OCT) scans instead to examine your retina and macula for leaky vessels that could be harming vision further.

These special tests involve injecting yellow dye into a vein in your arm, which then travels throughout your eye’s blood vessels before being detected by a special camera. As it passes through, pictures will be taken of both retina and macula to reveal any abnormal new blood vessels leaking under macula and any abnormal new blood vessel growth that has formed under macula. Your eye care professional can use this data to assess wet macular degeneration status as they decide if laser treatment should be undertaken or not.

Since the 1970s, investigators have reported that laser photocoagulation can reliably clear away large drusen. Studies of its effect in preventing later complications of macular degeneration have yielded mixed results and tend to involve small numbers of patients. To evaluate whether laser treatment works as intended in protecting central vision from further loss, the Center for Age-Related Macular Degeneration Prevention Trial (CAPT) is enrolling those at high risk for advanced macular degeneration due to large drusen on both eyes at risk due to large drusen being present on both eyes at risk due to large drusen being present on two eyes being at risk as part of their risk analysis.

Vereporfin, which differs from medications used to treat dry AMD, may also help treat wet macular degeneration. Once administered intravenously, this drug enters your bloodstream and travels directly to where new, fragile blood vessels have formed under your retina, before light is shone into your eyes for about 90 seconds to activate and stick the drug on their surfaces – once the new blood vessels have been destroyed they cannot regrow resulting in decreased vision for you and no improvement for anyone.

Photodynamic Therapy

Wet macular degeneration occurs when abnormal blood vessels proliferate and leak fluid into the macula from underneath, eventually leading to permanent vision loss. Diagnosing this condition typically requires a thorough eye exam with special retinal tests called dilated eye exams. Wet macular degeneration is typically quickly diagnosed when symptoms such as blurring of central vision, difficulty seeing straight objects and blind spots appear within your field of vision develop quickly; often quickly followed by significant vision loss.

People living with wet macular degeneration experience abnormal blood vessel growth between layers of cells in their retina at the back of the eye, known as choroidal neovascularization (CNV), which accounts for 90% of legal blindness caused by macular degeneration. CNV growth is driven by vascular endothelial growth factor (VEGF). Regular injections of anti-VEGF medications, known as anit-VEGF medications, may help slow or stop this phenomenon and avoid sudden vision losses.

Photodynamic Therapy (PDT) utilizes Verteporfin dye, a light-sensitive light sensitive dye, to identify and target abnormal blood vessels under the retina. A non-thermal laser then activates this dye which releases free radicals which destroy these abnormal vessels while leaving normal retina and blood vessels alone. The procedure takes only minutes in office and is painless.

PDT may help improve vision in some people with wet macular degeneration, though it won’t restore what has already been lost. PDT stands out among treatments for wet AMD as it can be administered early-on for those without severe vision loss yet.

Macular degeneration requires prompt diagnosis to determine the most suitable treatment option. In most cases, this will involve undergoing tests and exams in order to assess its severity and determine which course of treatment would work best. Low vision aids may help mitigate some of its impact, from simple hand-held magnifying glasses up to more sophisticated systems that enlarge written text as well as taped books or magazines.

Other Options

Medication may help slow down vision loss caused by wet AMD by controlling the formation of abnormal blood vessels that form beneath the retina. This condition is caused by an excess of vascular endothelial growth factor protein, which produces blood vessels that leak fluids into the eye and damage photoreceptor cells resulting in permanent vision loss if left untreated. Options available to treat wet AMD include intraocular injections with Avastin, Lucentis or Eylea which reduce new vessel growth or swelling – these medications have proven highly successful at saving thousands from blindness due to wet macular degeneration!

These medications are typically given as regular monthly injections into the eye. Though somewhat uncomfortable, these injections have proven very effective at halting further vision loss. Furthermore, faricimab was recently approved by the FDA for use by those suffering wet macular degeneration; it may significantly lower their treatment burden by decreasing the frequency of injections needed.

No pharmacological treatment or laser therapy can reverse or cure macular degeneration; however, these interventions can delay its progression and allow an individual to remain independent for longer. Lifestyle changes and visual aids may be effective ways of helping an individual with macular degeneration cope with reduced vision quality; various devices available include magnifying glasses, tape-recorded books or magazines, talking clocks and scales, large print playing cards etc.

Age-related macular degeneration is one of the leading causes of irreversible blindness among those aged 50 or over in industrialized countries, manifested by gradual central vision deterioration with symptoms including blurry colors perception and loss of central sharpness or blurriness. While dry macular degeneration is common and most patients will eventually experience symptoms at some point during their lives, it’s essential that symptoms be closely monitored so early intervention can occur and treated effectively.