Macular Degeneration medications & treatments
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Age-related macular degeneration (AMD) is an eye condition of the retina that according to the American Academy of Ophthalmology (AAO), affects 10 to 15 million people in the United States and is the leading cause of vision loss in adults over 50. The risk of developing AMD increases with age. You have a 33% chance if you are 75 or older. While these statistics can be alarming, several treatments can help protect and slow vision loss progression in eyes with AMD.
What is macular degeneration?
Age-related macular degeneration (AMD) is an eye disease that can cause your central vision to be blurry. It can occur when aging causes damage to the part of the retina (the layer at the back of the eye that is sensitive to light) called the macula, which is responsible for clear vision in your direct line of sight. Age-related macular degeneration doesn’t cause complete vision loss, but the blurring of your central vision can make it harder to see fine details. This will make it harder to read, drive, or see faces. It will not affect your peripheral vision.
There are 2 main types of AMD, including:
- Dry AMD. People with dry macular degeneration (also called atrophic AMD) have yellow deposits (drusen) in their macula. The build of these deposits can cause the thinning and death of the light-sensitive cells in your macula, which will cause changes in your vision. The changes and loss of vision in this condition are usually slow and gradual. It is the most common type of AMD. About 80% of people with AMD have the dry form.
- Wet AMD. With wet macular degeneration, abnormal blood vessels start to grow beneath the macula. They leak fluid and blood into your retina and can cause scarring, blind spots, and a permanent loss of central vision. About 20% of people with AMD have the wet form. While wet AMD is less common, it typically causes more severe vision loss than dry AMD.
Macular degeneration causes
Several risk factors increase your chances of developing AMD, including:
- Age – Over 50 and it increases as you get older.
- Race – Caucasians are at a higher risk.
- Genetics – You are at a higher risk if you have a family history of AMD.
- Smoking – If you smoke, it doubles your chance of developing AMD.
- Diet – A diet high in saturated fats and cholesterol and low in antioxidants, can increase your risk for AMD.
- Obesity – Research suggests that this may increase your chance of your condition progressing to the more severe form of the disease.
- High blood pressure (hypertension) – Any disease that affects your heart or blood vessels can increase your risk of AMD.
- UV (ultraviolet) light exposure – Long-term damage to your eyes from the sun’s UV rays may raise your chance of developing AMD.
How is macular degeneration diagnosed?
Your eye doctor or ophthalmologist can run tests for AMD during a routine eye exam and when you have your eyes dilated. These tests include:
- Vision tests. These tests include a visual acuity exam (the letter chart with an E at the top) and an Amsler grid, which looks like graph paper. The Amsler grid is used to check whether the straight lines on the graph look wavy or distorted to you, or whether areas of your visual field are missing.
- Dilated exam. Your ophthalmologist will use dilating eye drops to widen your pupil to look for the appearance of drusen (yellowish spots) or new blood vessels.
- Optical coherence tomography (OCT). In this test, your eye doctor will use a machine to scan the retina and take detailed pictures of the retina and macula.
- Fluorescein angiography. Your doctor will inject a yellow dye called fluorescein into your vein which will travel throughout your bloodstream. A special camera will take images of the retina as the dye travels through its blood vessels. This test will show if there is abnormal new blood vessel growth under the retina or any other retinal changes.
Macular degeneration symptoms
You may not have any noticeable signs of AMD in the early stages and while declining vision is normal as people age, AMD has some unique symptoms including:
- Blurred areas in your center of vision
- Straight lines appearing wavy
- Difficulty recognizing faces
- Difficulty reading the fine print
- Difficulty driving
- Difficulty doing detailed work
- Trouble seeing in low-light conditions
What are some macular degeneration treatment options?
While there is no cure for AMD or treatment for dry age-related macular degeneration, you might benefit from taking certain nutritional supplements to help slow the progression of your condition. There are several options to treat wet age-related macular degeneration including:
Anti-vascular endothelial growth factor medications (Anti-VEGF) are the first-line treatment for all stages of wet AMD. These medications, including Lucentis (ranibizumab), Avastin (bevacizumab), Beovu (brolucizumab), Eylea (aflibercept), and Macugen (pegaptanib), are injected directly into the affected eye by your doctor. While this sounds uncomfortable, it is typically done with a fine needle after you have been given numbing (anesthetic) eye drops. These eye injections help stop the growth of new blood vessels by blocking the effects of the high VEGF levels in the eye. It may also keep the retina free of leakage. With these treatments, most patients will see a slower progression of the disease, and in some cases, improvements in vision. In some parts of the world, anti-VEGF treatments have reduced the incidence of legal blindness by 50 percent.
Your doctor injects a photosensitizing agent Visudyne (verteporfin) into your bloodstream and it selectively binds to the inner lining of the abnormal blood vessels. Your doctor will then shine a laser into your eye to trigger the medication to damage and block those blood vessels.
Laser photocoagulation is a type of laser treatment for the eyes to treat AMD. Prior to the surgery, you are typically given eye drops to dilate your pupils as well as numb them. A laser is then aimed at the affected areas of the retina to prevent abnormal vessels from growing and shrink those that are already present. It can also be used to seal off any leaky blood vessels. This therapy is used to slow down the damage due to your condition.
If you have severe vision loss, you can learn several techniques from a low vision rehabilitation specialist, eye doctor, or others trained in low vision rehabilitation. This will help you perform daily activities with your remaining vision.
Low vision aids
These are devices that have special lenses or electronic systems that create larger images of nearby objects. These aids include:
- Handheld or electronic reading magnifiers
- Magnifiers mounted on your eyeglasses or a headband
- Handheld or eyeglass-mounted telescopes
- Electronic glasses
- Phone apps
- Large type books, magazines, and newspapers
What is the best medication for macular degeneration?
The best medication for the treatment of macular degeneration will depend on the individual’s specific medical macular degeneration, medical history, medications that the individual is already taking that may potentially interact with macular degeneration medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter macular degeneration medications approved by the Food and Drug Administration (FDA).
Best medications for macular degeneration
|Drug name||Drug class||Administration route||Standard dosage||Common side effects
|Macugen (pegaptanib)||VEGF inhibitor||Injection||0.3mg injected into the eye every 6 weeks.||Eye discharge, pain, irritation, blurred vision, cataract, eye floaters
|Lucentis (ranibizumab)||VEGF inhibitor||Injection||0.5mg injected into the eye every 4 weeks.||Eye pain, irritation, bloodshot eyes, blurred vision, headache
|Beovu (brolucizumab)||VEGF inhibitor||Injection||6mg injected into the eye every 4 weeks for 3 doses, then 6mg every 8 to 12 weeks thereafter.||Blurred vision, cataract, bloodshot eyes, eye pain, eye floaters
|Eylea (aflibercept)||VEGF inhibitor||Injection||2mg injected into the eye every 4 weeks for 3 doses, then 2mg every 8 weeks thereafter.||Eye pain, cataract, bloodshot eyes, eye floaters
|Avastin (bevacizumab)||VEGF inhibitor||Injection||1.25mg injected into the eye every 4 to 6 weeks.||Eye pain, blurred vision, eye floaters
|Susvimo (ranibizumab)||VEGF inhibitor||Injection||2mg continuously delivered via eye implant every 6 months.||Eye inflammation, pain, irritation, bloodshot eyes, eye floaters
|Vabysmo (faricimab)||VEGF inhibitor||Injection||6mg injected into the eye every 4 weeks for 4 doses, then reevaluate.||Bloodshot eyes, eye floaters, eye pain, irritation
|Visudyne (verteporfin)||VEGF inhibitor||Injection||The dose is calculated based on your body surface area and then infused via IV over 10 minutes.||Injection site reactions, blurred vision, cataract
Your healthcare provider will determine the right dosage based on your response to the treatment, medical macular degeneration, weight, and age. Other possible side effects may exist; this is not a complete list.
What are the most common side effects of macular degeneration medications?
As with all medicines, those used for macular degeneration will have some side effects, depending on the class you are taking. The most common side effects you may see include:
- Blurred vision
- Eye pain
- Bloodshot eyes
- Eye floaters
- Increased eye pressure (IOP)
What are some home remedies for macular degeneration?
While there is no cure for macular degeneration, its progress can be slowed and the risk of vision loss reduced by making dietary and lifestyle changes.
Macular degeneration prevention
Try some of the following self-care tips to help manage your CF:
- Dietary supplements. Some people with dry AMD have had success slowing the disease progression by taking nutritional supplements. The AREDS 2 combination, which includes vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper, can be purchased over the counter.
- Eat a healthy diet. Eating a diet high in antioxidants and vitamins from fruits, and vegetables, such as kale, squash, spinach, and broccoli can benefit people with AMD.
- Wear UV-protective sunglasses. Repeated eye exposure to UV light can increase your risk of AMD.
- Stop smoking. Smoking almost doubles your chance of developing AMD.
- Exercise regularly. This can help your overall health as well as slow the progression of AMD.
Frequently asked questions about macular degeneration
Can macular degeneration be cured?
While there is no cure, there are treatments for dry and wet AMD that can prevent the worsening of your vision loss and in some cases, even improve your vision.
What vision-related symptoms should I look out for if I think I have AMD?
If you notice any of the following symptoms, make sure to mention them to your doctor:
- Blurred areas in the center of your visual field
- Straight lines appearing wavy
- You need more light for tasks such as reading
- You have difficulty recognizing familiar faces
- You have difficulty driving
What foods should I avoid if I have AMD?
To protect your vision, you should eat a healthy diet high in antioxidants. You should avoid fast foods and also limit or avoid the following, especially if you have high cholesterol:
- Processed foods
- Foods high in trans fats
- Tropical oils, like palm oil
- Lard, vegetable shortening, and margarine
- High-fat dairy foods
- Fatty beef, pork, and lamb
Related resources for macular degeneration
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.