Treating Macular Degeneration (AMD)


Dry AMD is very difficult to treat.  Some eye experts do advocate nutrients such as zinc, lutein, zeaxanthin and vitamins A, C and E to prevent or slow down the development of dry and wet macular degeneration.  Omega-3 fatty acids found in cold-water fish seem to combat AMD and omega-6 fatty acids, which can be found in vegetable oils are believed to increase the risk of developing AMD.  It is advisable to wear sunglasses with good UV protection as sun damage may affect the condition or promote it. 

Magnifiers together with bright lights can be used to see things more clearly.  It is also possible to use specialised aids, which move images to the periphery to enable you to see things clearly.     

There are a number of procedures to treat wet AMD but there is no cure for it: 

  • Laser Photocoagulation - Wet AMD has been treatment in the past with laser surgery.  This method can only be used when blood vessels leak at some distance away from the fovea of the eye.  The laser works by destroying or sealing new blood vessels so that they can’t leak.  Scaring may result from laser surgery and you may experience blind spots. 
  • Photo Dynamic Therapy (PDT) - An invisible laser can be used to treat wet macular degeneration.  The vessels are initially filled with a special photosensitive dye known as Verteporfin/Visudyne.  This is a drug-based procedure similar to fluorescein angiogram.  It can only be used when there is new blood vessel growth (known as neovascularization) in a clear distinctive pattern.  This is termed "predominantly classic’ wet MD.  The dye is injected into a vein usually in the arm and the laser will selectively close the affected leaking vessels by activating them when they are in the blood stream.  The injected dye identifies new blood vessels, which are growing in the wrong place, and the cold laser stops these blood vessels from growing so that the macular is not damaged any further.  This chemical reaction and the procedure as a whole, is relatively painless. 
  • VEGF Treatment - A number of drugs have been used to target VEGF protein, which is thought to contribute to the development of AMD by promoting the growth of abnormal blood vessels in the retina.  There are numerous drugs, which can be injected into the eye to prevent the growth of leaking vessels.  Such drugs include Macugen and Lucentis.  This procedure involves an injection into the vitreous jelly inside of the eye.  New blood vessels are then stopped from growing, which stops the progression of macular degeneration and even improves vision of sufferers.  The drugs are injected over a number of months and continuous monitoring will determine the best course of treatment. 

With this treatment option the eye is numbed with a local anaesthetic, which helps prevent infection, as well as control discomfort.  The pressure in the eye is monitored as it can increase with the eye drops.  Vision may become blurry as the pupil dilates and may remain unclear for a few days.  Other side effects of the procedure include severe inflammation (known as endophthalmitis), traumatic cataract or retinal detachment.  Further, eyes may often tear.  Macugen has shown to slow down the rate of vision loss but there are serious side effects such as eye floaters and increased eye discomfort.

  • Macular Translocation / MT 360 – This is a surgical procedure where a healthy piece of undamaged retinal pigment epithelium is used to replace damaged tissue.  The eye surgeon first creates a retinal detachment, then moves the underlying RPE and then re-attaches the retina.  This enables the fovea to be placed in a healthy RPE.  Alternatively, a shorter cut is made in the retina and the outer layers are folded (scleral imbrication) so that the underlying choroid is moved ever so slightly, relative to the macula.  This is very complex surgery for which there are serious risks. 

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For further information and support on macular disease, contact:

Macular Disease Society

PO Box 1870
Andover
SP10 9AD
Registered Charity No. 1001198
Tel: O845 241 2041
Fax: 01264 350558
Email: info@maculardisease.org
Web: www.maculardisease.org


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