How Age-Related Macular Degeneration Is Treated

There are several treatments for macular degeneration, or what's more commonly referred to as age-related macular degeneration (AMD)—a condition that gradually wipes out the central vision. In general, these treatments can prevent and slow the worsening of vision by preventing damage to the retina. Unfortunately, they do not usually repair damage to the macula or recover vision that is already lost.

Depending on the extent of your case, vitamins, medications, surgery, and/or therapies may be considered.

Over-the-Counter Therapies

According to the American Academy of Ophthalmology, vitamin supplementation may slow the progression of early, mild AMD, which is usually the dry form of AMD. 

In the Age-Related Eye Disease Study (a major National Eye Institute-sponsored clinical trial that followed about 3,600 people with varying stages of AMD), researchers found that taking high levels of antioxidants and zinc daily reduced the risk of developing advanced AMD by about 25 percent. The study's vitamin formulation consists of:

  • 500 mg of vitamin C
  • 400 IU of vitamin E
  • 15 mg of beta-carotene
  • 80 mg of zinc (as zinc oxide)
  • 2 mg of copper (as cupric oxide)

What supplements and doses are right for you, if any, must be determined by your ophthalmologist. Follow the advice and regimen recommended for you.

Medications

Blood vessel overgrowth in the eye is a large part of macular degeneration, and activity of vascular endothelial growth factor (VEGF)—a protein—may play a role in that.

 Anti-VEGF medications have been shown to be effective in preventing the proliferation of fragile blood vessels that can leak and cause further damage to the macula.

Anti-VEGF medications include:

  • Lucentis (ranibizumab)
  • Avastin used off-label (bevacizumab)
  • Eylea (aflibercept)

Each is given via an injection into the eye, which is performed by an ophthalmologist.

You should expect to receive an injection of local anesthetic prior to your injection with anti-VEGF. Most people are able to tolerate the procedure well and without pain or discomfort.

The effects of anti-VEGF procedure typically last for approximately one month. You may need repeat procedures if your eye examination shows recurrent blood vessel overgrowth. 

Specialist-Driven Procedures

There are several surgical and therapeutic procedures that can prevent and slow down the progression of macular degeneration. Your eye doctor or a retinal specialist will examine your eyes and vision carefully to determine whether or not you would benefit from and tolerate these procedures; the decision is a complex one.

The procedures used for macular degeneration include:

Laser Surgery: Laser surgery procedures use targeted lasers to prevent the proliferation of fragile blood vessels in the eye. This is typically performed in an outpatient setting, and the effect should last for years. That said, the procedure may be repeated years later in some cases if needed.

Photodynamic Therapy: This outpatient treatment involves an intravenous injection of medication that causes the small blood vessels in the eye to constrict so that they are less likely to leak.

The medication is activated by light, which is targeted toward the fragile blood vessels with a laser. You should expect to be awake during it and to receive a local anesthetic for comfort and pain control. After the procedure, your eyes may be more sensitive to light than usual, and you will be given instructions on how to protect your eyes. 

Retinal Implant: Retinal implants have been used for several conditions. When used for AMD, the device is implanted behind the iris of the eye. The implant works by a magnifying central vision and sending images to the healthy part of the retina. It has been used, but it is not widely available.

Complementary Medicine (CAM)

While there is evidence to suggest that some vitamins may prevent progression of AMD, there is limited evidence supporting the use of herbs. Here are some alternative treatments you may hear about. If these options interest you, speak to your ophthalmologist before incorporating any into your treatment plan.

  • Lutein and Zeaxanthin: A growing number of studies show that these two antioxidants may play a role in reducing the development and progression of AMD. Available in supplement form, lutein and zeaxanthin are also found naturally in dark green leafy vegetables, broccoli, Brussels sprouts, and other foods.
  • Ginkgo Biloba: Several small studiessuggest that ginkgo biloba (an herb said to stimulate circulation) may help preserve vision in people with AMD.
  • Bilberry: In animal research studies, researchers found that long-term supplementation with bilberry extract helped prevent AMD. However, it's important to remember that the results of animal studies cannot be equally applied to humans.

Lifestyle

There are several lifestyle factors that may reduce your risk of developing AMD, and they should also be part of your complete AMD treatment plan:

  • Follow a diet rich in antioxidants
  • Get regular eye exams
  • Wear sunglasses when outdoors during daylight hours
  • Avoid smoking
  • Exercise regularly

Sources:

Aruna Gorusupudi, Kelly Nelson, and Paul S Bernstein. The Age-Related Eye Disease 2 Study: Micronutrients in the Treatment of Macular Degeneration. Adv Nutr. 2017 Jan; 8(1): 40–53. Published online 2017 Jan 11. doi:  10.3945/an.116.013177

Bahadorani S, Singer M. Recent advances in the management and understanding of macular degeneration. 2017 Apr 20;6:519. doi: 10.12688/f1000research.10998.1. eCollection 2017, DOI:10.12688/f1000research.10664.1

Evans JR.Ginkgo biloba extract for age-related macular degeneration. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD001775. doi: 10.1002/14651858.CD001775.pub2.

Hernández-Zimbrón LF, Zamora-Alvarado R, Ochoa-De la Paz L, et al. Age-Related Macular Degeneration: New Paradigms for Treatment and Management of AMD. Oxid Med Cell Longev. 2018 Feb 1;2018:8374647. doi: 10.1155/2018/8374647. eCollection 2018.

Korobelnik JF, Rougier MB, Delyfer MN, et al. Effect of Dietary Supplementation With Lutein, Zeaxanthin, and ω-3 on Macular Pigment: A Randomized Clinical Trial. JAMA Ophthalmol. 2017 Nov 1;135(11):1259-1266. doi: 10.1001/jamaophthalmol.2017.3398.

Shusheng Wang and Khrishen Cunnusamy. Traditional Chinese Medicine (TCM) for the treatment of Age-related Macular Degeneration—Evaluation of WO2012079419. Expert Opin Ther Pat. 2013 Feb; 23(2): 269–272.Published online 2012 Dec 10. doi:  10.1517/13543776.2013.751972

Wang Y, Zhao L, Lu F, et al. Retinoprotective Effects of Bilberry Anthocyanins via Antioxidant, Anti-Inflammatory, and Anti-Apoptotic Mechanisms in a Visible Light-Induced Retinal Degeneration Model in Pigmented Rabbits. Molecules. 2015 Dec 14;20(12):22395-410. doi: 10.3390/molecules201219785.

Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.