Treatment options for AMD

Is there treatment for age-related macular degeneration?

There is no cure for age-related macular degeneration (AMD). However, there is effective, sight-saving treatment for the most aggressive form of the disease: wet (neovascular) age-related macular degeneration.

Treatment for wet age-related macular degeneration

There is highly effective treatment for wet (neovascular) AMD. This is most commonly delivered in the form of regular injections to the eye.

Anti-VEGF injections

In wet (neovascular) AMD, the protein vascular endothelial growth factor (VEGF) is predominantly responsible for the abnormal growth of blood vessels and fluid leakage under the retina.

Anti-VEGF medication can block the activity of this VEGF protein, thereby stopping the growth of abnormal blood vessels and fluid leakage.

Standard treatment for wet AMD involves an injection of anti-VEGF medication into the clear, jelly-like substance (called the vitreous) inside the eye.

Eye injections are also called intravitreal injections or IVI.

The way ophthalmologists do injections may vary slightly. Generally, however, after a series of diagnostic tests, which may include an OCT to monitor each eye, your ophthalmologist will use a small eyelid speculum. This is a type of medical instrument to keeps your eyelid open and stop you from blinking. Your eye health professional will then apply local anaesthetic to numb the eye. They’ll also use antiseptic to prevent infection.

An ophthalmologist will inject the medication using a very fine needle.

The eye injections shouldn’t be painful, but you may feel some minimal discomfort.

For most people, treatment usually begins with injections at monthly intervals. Your injection schedule will depend on how you respond to the treatment. Your ophthalmologist may extend the time between treatment. But, typically, you’ll receive injections every four to 12 weeks.

What are the side effects of anti-VEGF injections?

After an eye injection, your eyes may feel gritty or sore for a couple of days. You may also see small floaters in your vision. There may be redness (blood) on the white part of your eye (the conjunctiva) where the needle enters. This usually resolves within a week or two.

Are there risks to anti-VEGF treatment?

Yes, there are risks associated with anti-VEGF treatment, but they are very rare.

The risks of injecting medication into the eye may include:

• increased pressure inside the eye
• inflammation inside the eye
• infection inside the eye
• bleeding inside the eye
• retinal tear or detachment.

If you do experience these or any other unusual symptoms following your anti-VEGF treatment, contact your eye health professional as soon as possible.

Other wet AMD treatments

Laser photocoagulation and photodynamic therapy (PDT) are now rarely used to treat wet (neovascular) AMD.

Ophthalmologists sometimes use these treatments in an addition to eye injections, usually for a type of new blood vessels called polypoidal choroidal vasculopathy (PCV).

In some people, treatment can improve vision. However, these treatments don’t cure the disease.

Things to remember

If you are being treated for wet (neovascular) AMD

• try not to miss your appointment with your ophthalmologist
• tell your ophthalmologist about any problems you have after an injection
• continue to monitor your vision each day using an Amsler grid, one eye at at time
• immediately report any sudden changes in your vision
• never stop your treatment unless on the advice of your ophthalmologist.

And, as MDFA National Research Advisor Professor Paul Mitchell AO explains, if you need treatment for wet AMD, don’t delay!

Is there treatment for early and intermediate AMD?

Currently, there are no medical treatments for early or intermediate AMD. However, researchers are trying to develop treatments that stop or slow progression to late AMD.

Although there are no treatments, studies show that diet and lifestyle changes may help slow down the disease. Consult with a doctor, before you make any changes to your diet or lifestyle.

If you have intermediate AMD, you should also ask your eye health professional whether AREDS2 supplements are right for you. A number of brands sell supplements based on the AREDS2 formula.

Is there treatment for dry age-related macular degeneration?

Currently there are no medical treatments available for dry (atrophic) AMD, however research is ongoing to develop treatments.