In the early stages of macular degeneration, regular eye check-ups, attention to diet, in-home monitoring of vision and possibly nutritional supplements may be all that is required.
Diet and nutritional supplements
There has been active research (age-related eye disease studies) on the use of vitamins and nutritional supplements called antioxidants to try to prevent or slow macular degeneration. Antioxidants are thought to protect against the damaging effects of oxygen-charged molecules called free radicals. A potentially important group of antioxidants are called carotenoids. These are the pigments that give fruits and vegetables their color. Two carotenoids that occur naturally in the macula are lutein and zeaxanthin. Some research studies suggest that people who have diets high in lutein and zeaxanthin may have a lower risk of developing macular degeneration. Kale, raw spinach, and collard greens are vegetables with the highest amount of lutein and zeaxanthin. You can also buy over the counter nutritional supplements that are high in these and other antioxidants.
An intravitreal injection is a procedure to place medication directly into the cavity in the back of the eye. The cavity in the back of the eye is filled with a fluid called the vitreous humor. The most common and effective treatment for wet macular degeneration is an intravitreal injection of medications called anti-vascular endothelial growth factors (anti-VEGF). In macular degeneration, vascular endothelial growth factors promote the growth of abnormal blood vessels, which leak into the retina, causing damage. The anti-VEGF drugs inhibit the formation of these new abnormal blood vessels and can decrease retinal swelling. These injections are usually given on a monthly or bimonthly basis until the retina has stabilized. Commonly used anti-VEGF medications are bevacizumab (Avastin), ranibizumab (Lucentis), and aflibercept (Eylea).
In some cases of wet macular degeneration, we may recommend laser treatment. This involves the use of painless laser light to destroy abnormal, leaking blood vessels under the retina. When laser treatment is possible, it may slow or stop the progression of the disease. Still, it is generally not expected to bring back any vision that has already been lost.
Photodynamic therapy (PDT)
Photodynamic therapy (PDT) is a treatment for some cases of the wet form of age-related macular degeneration.
PDT involves injecting a light-sensitive chemical into the arm. The chemical travels to abnormal blood vessels in the retina where it is activated with a special light. The activated chemical destroys the abnormal blood vessels without causing damage to the normal retinal tissues nearby. This allows PDT to be used in some cases where conventional laser treatment would cause too much damage to surrounding retinal tissue.
PDT can slow the loss of vision and sometimes improve vision.
Low vision aids
Unfortunately, macular degeneration may still progress to severe vision loss. In these cases, low vision aids may help make it easier to live with the decreased vision of macular degeneration. Low vision aids range from hand-held magnifying glasses to sophisticated systems that use video cameras to enlarge a printed page. Lifestyle aids such as large print books, tape-recorded books or magazines, large print playing cards, talking clocks and scales and many other devices are available.