Rare cases of wet macular degeneration (neovascular AMD) may benefit from having medication injected directly into their eye to stop abnormal blood vessel growth and stabilize or improve central vision.

Eylea (Aflibercept) and Lucentis (Ranibizumab) are two anti-angiogenesis drugs available that may help slow further vision loss. While they cannot restore lost vision, they can reduce further decline.

What is Macular Degeneration?

Macular degeneration is a progressive eye condition that gradually destroys the central part of your retina, the light-sensitive layer at the back of the eyeball responsible for sending images to the brain. This region, called the macula, enables you to read, drive and perceive fine details clearly. Macular degeneration is one of the leading causes of severe vision loss among people aged 50 or above but typically does not lead to complete blindness – and usually doesn’t impact peripheral (side) vision either; so you’ll still be able to use your peripheral vision while seeing things straight ahead.

Macular degeneration comes in two varieties, dry and wet. Dry macular degeneration is distinguished by the formation of drusen – tiny yellow protein-filled sacs located underneath your retina that form small clumps that eventually lead to fluid buildup under it and blurry or darkened areas in central vision. While not painful, this condition makes driving and seeing faces difficult.

At some point, damage to your central vision can progress into wet macular degeneration, which is characterized by abnormal blood vessels leaking fluid beneath the retina and destroying it – this form of macular degeneration is particularly dangerous as it can quickly lead to rapid vision loss. Wet macular degeneration may be treated using medications which stop their growth while simultaneously stopping leaks; or through laser light surgery that reduces leakage while simultaneously improving vision.

Macular degeneration can be reduced with regular eye exams, particularly if there is a family history. Dilation eye exams allow doctors to detect early changes to your retina that you might not notice, so it is essential to go for them on an annual basis. In order to determine wet macular degeneration, your eye doctor will perform an exam called fluorescein angiography, where harmless orange-yellow dye is injected into a vein and photos taken of your retina are taken as it travels through blood vessels in order to determine wet macular degeneration.

Symptoms

Macular degeneration occurs when the macula, located at the central part of your retina, begins to degenerate, leading to blurry or distorted central vision as well as difficulty reading, driving and recognising faces. While macular degeneration does usually lead to complete blindness, you should still retain good side (peripheral) vision which you can still use to get around and carry out daily tasks.

Dry macular degeneration, the more common form of the disease, occurs when deposits called drusen form beneath the retina and does not necessarily result in vision loss, but indicates a higher risk for wet forms of macular degeneration.

The wet form of macular degeneration is distinguished by abnormal blood vessels located under the retina that leak blood or fluid into the macula and cause its appearance to blurry or distort; this form is more serious than its dry counterpart and can result in rapid vision loss and even permanent blindness.

There are multiple treatments for wet macular degeneration available, including injecting anti-vascular endothelial growth factor or VEGF inhibitors directly into the eye and laser therapy treatments. Injections into vitreous humor – the gel-like substance inside your eyeball – must be repeated at regular intervals to be effective against wet macular degeneration.

Photodynamic therapy, an innovative new treatment option being studied in clinical trials for wet macular degeneration, uses special light to destroy abnormal blood vessels that contribute to this condition. Photodynamic therapy could potentially provide additional advantages over injection medications in terms of retinal health.

As well as injecting medication directly into your eye, you may require additional vitamins and minerals to halt macular degeneration’s progression. Consult your physician on which supplement regimen would work best for you.

Diagnosis

Macular degeneration is an eye condition characterized by gradual central vision loss due to macula degeneration, the part of retina that allows people to see straight ahead and in detail. It’s the leading cause of severe permanent blindness among adults over 60. Macular degeneration often doesn’t produce obvious symptoms early, making diagnosis hard until after significant vision has been lost or noticed by a doctor during a routine dilated eye exam. Signs include blurriness, dark areas or distortion of geometric shapes in central vision – not peripheral (sides of field of view) vision loss but rather making walking around or driving more challenging.

Macular degeneration comes in two forms, dry and wet forms. Dry macular degeneration is most prevalent and causes gradual vision loss over time, while wet form may involve abnormal blood vessel growth beneath the retina causing bleeding or fluid leakage underneath it resulting in fluid leakage into ARMD’s retinal pigment epithelial layer and leading to rapid loss. While less common than its dry counterpart, wet form ARMD can still result in rapid vision loss over time.

If you suffer from wet macular degeneration, treatment with an anti-VEGF drug such as Avastin, Lucentis or Visudyne will be needed on an ongoing basis to stop new blood vessels growing into your eye and leaking fluid. These drugs work by inhibiting new vessel growth while simultaneously stopping fluid leakage through existing ones; it’s an effective treatment option which can significantly slow vision loss rates.

Apart from medications, you can help slow the progression of wet macular degeneration by not smoking, eating a diet rich in green leafy vegetables and fish, exercising regularly, taking an AREDS2-based vitamin supplement daily, as well as monitoring your vision with an Amsler grid or at-home test kits in between visits to an eye doctor to detect any changes.

Treatment

An Ophthalmic Doctor will inject anesthesia into your eye to create anesthesia for this procedure, which should be completely painless. Surface irritation may arise but should dissipate within hours; for more severe pain contact Rockhampton Eye Clinic immediately and ask to speak to one of their nurses or Ophthalmic (Eye) Doctors as soon as possible.

If the disease has reached a point where distortion of central vision or decreased ability to perform certain activities is occurring, an eye doctor may advise treatment as the only solution. Laser therapy and intraocular injections are two approaches for treating macular degeneration; with intraocular injections of an anti-angiogenesis drug being the preferred way of treating wet age-related macular degeneration. These medications, known as vascular endothelial growth factor inhibitors or anti-angiogenesis drugs, are proven to stop leaky blood vessels that lead to wet macular degeneration and improve vision in some instances. However, for maximum effectiveness they must be injected monthly into the vitreous of each eye in order to control vision loss.

Laser surgery is another effective form of treatment for wet macular degeneration that may restore or improve vision. The process involves directing a high energy beam of light directly towards any new, fragile blood vessels that appear due to wet macular degeneration, thus destroying them while sparing surrounding tissue; this destroys new vessels without harming surrounding tissue, helping reduce vision loss over time – though only effective with some individuals living with wet macular degeneration.

Photodynamic Therapy is a less invasive procedure used to treat wet macular degeneration. A drug called verteporfin is injected in one arm and travels directly to the eyes where it adheres to new blood vessels, killing them off and slowing vision loss. Unfortunately, however, this form of treatment only proves successful with some patients suffering from wet macular degeneration; otherwise it would likely have more lasting results than any other form of therapy.