Hope for Macular Degeneration

There is currently no known cure for age-related macular degeneration (AMD). But treatment and lifestyle changes may slow progression of the disease. There are new treatments in development.

There are two types of macular degeneration: dry AMD and wet AMD.

• Dry AMD. This is the most common type. It is sometimes called atrophic or non-neovascular macular degeneration.
• Wet AMD. This more serious type is less common. It is called exudative or neovascular macular degeneration.

People who lose their central vision to macular degeneration can often be helped by low-vision specialists. With the help of special low-vision aids, such as magnifying devices, large-print reading materials, and closed-circuit computers, people with macular degeneration can learn to use their remaining vision. Community organizations and support groups can help people with AMD and their families deal with vision loss and learn about other available resources.

High doses of certain vitamins may slow the vision loss caused by AMD. A study by the National Institutes of Health's National Eye Institute (NEI) showed that people at risk for developing advanced AMD may slow vision loss progression by taking certain supplements. The supplement combination tested was a daily dose of:

• 500 mg of vitamin C
• 400 IU of vitamin E
• 80 mg of zinc (as zinc oxide)
• 10 mg of lutein
• 2 mg of zeaxanthin
• 2 mg of copper (as cupric oxide)

Talk with your doctor about possible health risks before taking these supplements.

If you have dry AMD, the NEI advises that you have a complete eye exam at least once a year. Ask your eye doctor if supplements might help delay the advancement of the condition.

Dry AMD can turn into wet AMD at any time. The American Academy of Ophthalmology advises you get an Amsler grid from your eye doctor and use it every day to test your vision for signs of wet AMD. Check each eye separately. Cover one eye and look at the grid. Then cover your other eye and look at the grid. Do this with your reading glasses or bifocals, if you normally use them for reading. If you find any changes in how the grid looks (lines that are wavy, broken, or missing) or in your everyday vision, call your eye doctor.

If you have wet AMD, regularly check your vision with the Amsler grid. If you find any changes, schedule an eye exam right away. If your doctor advises treatment, don't wait. Realize that treatments are generally ongoing. After treatment, you should have eye exams often to find any recurrence of leaking blood vessels. If you smoke, try to quit. Smoking is linked to a greater risk of recurrence.

Damage from wet AMD sometimes can't be reversed. But treatment can prevent more damage. These treatments have been used for some types of wet AMD:

• Photocoagulation. A high-energy laser beam is used to destroy the new abnormal blood vessels.
• Photodynamic therapy. A cold laser is combined with a light-sensitizing medicine (verteporfin) to close new abnormal blood vessels.
• Surgery. This is a treatment choice for some types of wet AMD. Surgery is rarely needed.

Newer treatments involve medicines (called VEGF inhibitors) that are injected into the eye. Injections are the most commonly used treatment for wet AMD. These medicines help reduce the growth of abnormal blood vessels. They do this by stopping a substance called VEGF (vascular endothelial growth factor). VEGF helps with blood vessel growth. It is found in higher levels in eyes with wet AMD. These medicines are injected every few weeks to months. Studies show that these new medicines work better than the other treatments above.

In the future, more treatments may be available. For example, scientists are also studying the idea of transplanting healthy cells into diseased eyes. They are also studying the genetic or hereditary factors that cause AMD.