Currently, no treatment exists for early AMD, which in many people shows no symptoms or loss of vision. Your doctor may recommend that you get a comprehensive dilated eye exam at least once a year. The exam will help determine if your condition is advancing.
As for prevention, AMD occurs less often in people who exercise, avoid smoking, and eat nutritious foods including green leafy vegetables and fish. If you already have AMD, adopting some of these habits may help you keep your vision longer.
Intermediate and late AMD
Researchers at the National Eye Institute tested whether taking nutritional supplements could protect against AMD in the Age-Related Eye Disease Studies (AREDS and AREDS2). They found that daily intake of certain high-dose vitamins and minerals can slow progression of the disease in people who have intermediate AMD, and those who have late AMD in one eye.
Here are the clinically effective doses tested in AREDS and AREDS2:
- 500 milligrams (mg) of vitamin C
- 400 international units of vitamin E
- 80 mg zinc as zinc oxide (25 mg in AREDS2)
- 2 mg copper as cupric oxide
- 15 mg beta-carotene, OR 10 mg lutein and 2 mg zeaxanthin
A number of manufacturers offer nutritional supplements that were formulated based on these studies. If you have intermediate or late AMD, you might benefit from taking such supplements. Your doctor can advise which supplements are recommended for you.
Even if you take a daily multivitamin, you should consider taking an AREDS supplement if you are at risk for late AMD. The formulations tested in the AREDS trials contain much higher doses of vitamins and minerals than what is found in multivitamins. Tell your doctor about any multivitamins you are taking when you are discussing possible AREDS formulations.
Finally, remember that the AREDS formulation is not a cure. It does not help people with early AMD, and will not restore vision already lost from AMD. But it may delay the onset of late AMD. It also may help slow vision loss in people who already have late AMD.
Advanced neovascular AMD
Neovascular AMD typically results in severe vision loss. However, doctors can try different therapies to stop further vision loss. You should remember that the therapies described below are not a cure. The condition may progress even with treatment.
- Injections. One option to slow the progression of neovascular AMD is to inject drugs into the eye. With neovascular AMD, abnormally high levels of vascular endothelial growth factor (VEGF) are secreted in your eyes. VEGF is a protein that promotes the growth of new abnormal blood vessels. Anti-VEGF injection therapy blocks this growth. If you get this treatment, you may need multiple monthly injections. Before each injection, your eye will be numbed and cleaned with antiseptics. To further reduce the risk of infection, you may be prescribed antibiotic drops.
- Photodynamic therapy. This technique involves laser treatment of select areas of the retina. First, a drug called verteporfin will be injected into a vein in your arm. The drug travels through the blood vessels in your body, and is absorbed by new, growing blood vessels. Your retinal specialist then shines a laser beam into your eye to activate the drug in the new abnormal blood vessels, while sparing normal ones. Once activated, the drug closes off the new blood vessels, slows their growth, and slows the rate of vision loss. This procedure is less common than anti-VEGF injections, and is often used in combination with them for specific types of neovascular AMD.
- Laser surgery. Retinal specialists treat certain cases of neovascular AMD with laser surgery, though this is less common than other treatments. It involves aiming an intense “hot” laser at the abnormal blood vessels in your eyes to destroy them. This laser is not the same one used in photodynamic therapy which may be referred to as a “cold” laser. This treatment is more likely to be used when blood vessel growth is limited to a compact area in your eye, away from the center of the macula, that can be easily targeted with the laser. Even so, laser treatment also may destroy some surrounding healthy tissue. This often results in a small blind spot where the laser has scarred the retina. In some cases, vision immediately after the surgery may be worse than it was before. But the surgery may also help prevent more severe vision loss from occurring years later.