Age related macular degeneration (AMD), is an incurable eye disease that gradually destroys central vision. AMD affects the macula, an area in the retina responsible for seeing straight ahead, reading, driving and recognising faces and colors.

Ninety percent of cases can be classified as dry macular degeneration, which usually progresses slowly; while 10 percent develop the more serious “wet” form caused by abnormal blood vessels beneath the retina resulting in severe vision loss and increased risks.

Anti-VEGF Injections

Anti-vascular endothelial growth factor or VEGF injections can effectively treat wet macular degeneration. These injections decrease abnormal blood vessel growth while slowing leakage of fluid from them, thus slowing vision loss in 90% of patients. They are given using an eyedropper placed at the back of your eye, with an eye patch placed over top to minimize pain during numbing procedures; overall it’s quick and painless!

FDA has granted these medications FDA approval for treating AMD. Studies have demonstrated their ability to extend the length of time an individual can maintain their best-corrected visual acuity by at least two years. It should be noted, however, that these are not cures for macular degeneration and must continue long term in order to be effective.

Research indicates that if you have been diagnosed with wet macular degeneration, taking VEGF inhibitor medication may help stop or slow its progress and preserve your vision. These eyedrops contain molecules designed to diminish abnormal blood vessel growth while slowing leakage of fluid from retina. They may also be used for other retinal conditions like macular edema, branch retinal vein occlusion and diabetic retinopathy.

These medications should be injected once every month into each eye, usually combined with laser surgery or prescription drugs called luteinizing hormone-releasing peptides (LHRP), which help strengthen retinas by decreasing fluid accumulation and vision loss.

As per previous randomized controlled trials supporting these medications, their use has resulted in significant improvements to vision over 2 to 3 years; however, real world clinical outcomes are less encouraging due to frequent treatment and monitoring, which may interfere with patients’ ability or willingness to follow their management plans. Therefore, the current study examined data from patients diagnosed with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME), in order to ascertain what impact frequent anti-VEGF intravitreal injections has had on real world outcomes.

Photodynamic Therapy (PDT)

Treatment typically entails applying a cream containing light-sensitive drugs directly onto the face or hands, activating them with laser light therapy that is targeted specifically to where treatment should take place. As its application requires minimally-invasive efforts, many prefer it over surgery or radiation therapy, although other therapies can still be employed concurrently.

PDT can reach tumours that would be difficult for radiation or surgery to access, making it a popular therapy choice in treating premalignant conditions like squamous cell carcinoma of the head and neck and mucosal neoplasia, early gastrointestinal cancers and some lung cancers which obstruct esophageal function or cannot be removed through surgery. PDT is also effective against wet AMD; two major trials–Treatment of Age-related Macular Degeneration with Photodynamic Therapy (TAP trial) and Verteporfin in Photodynamic Therapy (VIP trial) demonstrated significantly reduced visual acuity loss at both 1st and 2nd year compared with placebo treatments.

However, these studies were not replicated across other trials, nor were their benefits limited to patients with exudative AMD; rather, new anti-VEGF therapies have since taken precedence as treatment options for this phenotype of AMD.

PDT stands out as an advantageous radiation or surgical treatment as it can be carried out concurrently with chemotherapy or ionising radiation without altering their efficacy or decreasing efficacy. PDT can be particularly useful when used to target tumours located near organ linings like those found in the lungs and esophagus where exposure risks to normal tissue are high.

PDT side effects depend on how much medication is absorbed by your body. Common reactions of PDT include temporary discomfort in the treatment area (burning sensations) and skin photosensitivity, usually mild and resolved within several days. To protect against further sunburns following PDT treatments, be sure to stay indoors during daylight hours, even on cloudy days, for several weeks post treatment.

Vascular Endothelial Growth Factor (VEGF) Blockers

The macula is responsible for our central vision, enabling us to drive, read, recognize faces and colors, work on computers or smartphones, see fine details of objects and so much more. Unfortunately, as we age we may experience photoreceptor cells disintegrating within the macula which results in loss of central vision – eventually leading to blindness. Luckily there are treatments for macular degeneration available that may help slow or reverse this progression of vision loss; even improve it altogether in certain instances!

At present, treatments for wet macular degeneration generally focus on suppressing vascular endothelial growth factor (VEGF), the protein that promotes new blood vessels. Most macular degeneration medications come in form of intravitreal injections administered on a regular schedule – typically once every month – which block VEGF from stimulating new vessel growth and may reduce fluid leakage under the retina.

Laser photocoagulation may provide more aggressive treatments, using painless laser light to destroy abnormal leaking blood vessels underneath the retina and slow progression. While this may result in small improvements to visual acuity and sometimes results in slowing macular degeneration progression, it cannot restore lost vision.

New treatments for wet macular degeneration have recently become available that have proven more successful at improving vision with less injections and treatments than previous therapies. Faricimab-svoa, commonly referred to as Vabysmo, an anti-VEGF medication has shown to benefit patients suffering from both neovascular age-related macular degeneration and diabetic macular edema.

Bevacizumab, ranibizumab, and pegaptanib injections have been shown to slow the progression of wet macular degeneration; however, they do not provide a permanent cure. They help prevent fluid leakage while shrinking abnormal blood vessels that contribute to wet macular degeneration; however they require monthly injections; to extend their effectiveness even further efforts are underway such as implanting a reservoir into the eye that slowly releases medication over time – an approach which has shown promise during ongoing studies.

Surgery

Macular degeneration is the breakdown or deterioration of the macula at the back of your eye that causes blurriness or dark areas in your central vision. This condition often makes daily tasks such as threading a needle and driving more challenging; it is the leading cause of central blindness among people over 50 in the United States; however it usually does not affect peripheral (side) vision.

Macular degeneration comes in two varieties: wet and dry. Of these forms, the former develops faster and can cause serious vision loss within months due to abnormal blood vessels forming under the retina around the macula, leading to scarring and fluid build-up that obstruct your forward vision – this form can occur in either or both eyes.

In some instances, wet macular degeneration may be treated by using painless laser light to destroy abnormal blood vessels. This approach works when abnormal leaking vessels are far enough from the macula to not cause damage and have not formed large macular detachments; it could slow or stop progression but will not restore central vision lost due to wet macular degeneration.

Visudyne can also be used to treat wet macular degeneration, blocking VEGF growth factor that encourages blood vessel and scar tissue formation under the retina. Treatment typically entails injecting Visudyne into one arm and shining a low-powered laser beam into your eye to activate it; this activates its chemical reaction that destroys abnormal blood vessels while stopping their further growth; this procedure has proven successful for 15% of patients suffering from wet macular degeneration.

Macular degeneration can be prevented by refraining from smoking and receiving regular eye exams. An eye exam will check for early symptoms of macular degeneration such as reduced fine detail vision or color changes, so that when any symptoms first emerge it can be caught before it worsens. Your doctor will use a grid of black lines arranged in a pattern to test your central vision as well as other tests to gauge its severity.