Macular Degeneration : Treatment Options


There is no treatment currently available to reverse dry macular degeneration. This condition normally progresses slowly, and many people are able to live relatively normal lives, especially if vision is affected only minimally. The good news is that the progression can be slowed by taking high doses of vitamins A, C, E and the mineral Zinc.
In wet macular degeneration, new abnormal blood vessels behind the retina begin forming at a rapid rate. These vessels begin to leak blood and fluid, causing damage to the macula, the region of the retina responsible for central vision. The doctor will prescribe treatment based on the location and extent of the abnormal blood vessels.

Anti-angiogenic medicine is a drug treatment that directly targets the growing blood vessels in patients with wet macular degeneration. After the ophthalmologist numbs the eye with an anesthetic, the drug, called pegaptanib sodium (Macugen®) is injected into the affected eye. The medicine stops or slows the blood vessels from growing, leaking and bleeding. The treatment is given every six weeks to prevent the blood vessels from causing more vision loss. This therapy causes less damage to the retina than the laser treatments described below.

Photocoagulation, also known as laser treatment, uses a high-energy laser beam to create small burns in areas of the retina with abnormal blood vessels. This treatment is used when the abnormal blood vessels are not yet under the area of central vision (fovea). Because it is uncommon for the blood vessels to spare the fovea, only a small number of patients are candidates for the procedure. The doctor determines who may benefit from the treatment based on the location and appearance of the blood vessels, the amount of blood leakage, and the overall health of the macula.

Photodynamic Therapy: The location of the abnormal blood vessels often determines which treatment is selected. In this treatment, a drug called verteporfin (Visudyne®) is injected into the bloodstream. The drug concentrates in the abnormal blood vessels under the macula. The doctor then focuses cold-laser light at the macula, which activates the drug and leads to the closing off of the abnormal vessels without damage to the macula.

Macular Translocation Surgery ia a procedure used in rare circumstances for patients with recent visual loss associated with wet macular degeneration and who still have healthy tissue around the fovea. It is especially useful when there is a large amount of bleeding under the macula (an uncommon complication of wet macular degeneration) In this procedure, the surgeon detaches the retina, shifts the fovea away from the abnormal blood vessels and relocates it over healthy tissue. With the abnormal vessels exposed (previously under the fovea), the surgeon can remove them with tiny instruments. Since the fovea has been shifted to a new location, it can function without interference from the macular degeneration changes.

Submacular surgery, transpapillary thermotherapy and radiation therapy were once thought to be promising treatments. Unfortunately, vigorous scientific study finally proved that these treatments have very limited value for age-related macular degeneration treatment.

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