WHAT WE TREAT
Age-Related Macular Degeneration
AMD is a degenerative condition that damages the macula in older adults.
About Age-Related Macular Degeneration
Overview
Age-related macular degeneration (AMD) is a degenerative condition of the macula, the central portion of the retina responsible for sharp, detailed vision. It is one of the leading causes of vision loss in adults over age 50.
There are two primary types of AMD:
dry (non-neovascular) and wet (neovascular).
Causes
Dry AMD
Dry AMD accounts for approximately 90% of all cases. It can range from very mild to severe and is characterized by:
- The presence of drusen—small yellow deposits of metabolic waste beneath the macula
- Changes or thinning of the retinal pigment epithelium (RPE), the support layer beneath the retina
A subset of patients with dry AMD may develop geographic atrophy (GA), in which the RPE and overlying photoreceptors degenerate. This process can cause central vision loss if it involves the fovea.
Wet AMD
Wet AMD develops in a smaller percentage of eyes that previously had dry AMD. It occurs when abnormal blood vessels (choroidal neovascularization) grow under the macula and leak fluid or blood, leading to rapid and often severe damage. If left untreated, wet AMD can result in significant and permanent vision loss, including legal blindness.
Treatment Options From LRR
Treatments
Wet AMD
The primary treatment for wet AMD is intravitreal injection of medications known as anti-VEGF (vascular endothelial growth factor) agents. These injections are performed in the office with minimal discomfort.
Anti-VEGF medications block the growth of abnormal blood vessels and reduce fluid leakage, helping stabilize or improve vision. While not curative, they have transformed wet AMD from a blinding disease into a manageable chronic condition.
Commonly used anti-VEGF medications include:
- Aflibercept (Eylea®)
- Faricimab (Vabysmo®)
- Ranibizumab (Lucentis®)
- Bevacizumab (Avastin®)—Not approved by the FDA, but used off-label in some cases
Treatment intervals range from every 4 to 12 weeks, depending on disease activity and individual response. Laser treatment may occasionally be used to seal leaking vessels, though this approach has largely been replaced by injection therapy.
Dry AMD
Although there is no cure for dry AMD, progression can often be slowed. The AREDS 2 (Age-Related Eye Disease Study 2) formula—a specific blend of vitamins and minerals—has been shown to reduce the risk of progression to advanced AMD in patients with intermediate disease or advanced AMD in one eye.
AREDS 2 formulation:
- Vitamin C (500 mg)
- Vitamin E (400 IU)
- Copper (2 mg)
- Zinc (80 mg)
- Lutein (10 mg)
- Zeaxanthin (2 mg)
More To Know
Diagnostic Tests for AMD
These imaging tests help evaluate the macula for drusen, fluid, atrophy, or abnormal blood vessel growth. Your physician may perform one or more of the following to diagnose and monitor AMD:
- Comprehensive dilated eye examination
- Optical Coherence Tomography (OCT)
- OCT-Angiography (OCT-A)
- Fundus Autofluorescence (FAF)
- Fluorescein Angiography (FA)
- Indocyanine Green Angiography (ICG)
Risk Factors
The most significant risk factor for AMD is age, with prevalence increasing after 50 and rising with each decade. Other risk factors include:
- Family history or genetic predisposition
- Cigarette smoking
- High blood pressure or cholesterol
- Obesity or poor diet
Reduce Risk
While some risks are not modifiable, several steps can help reduce risk and slow progression:
- Eat a balanced diet rich in fruits, leafy greens, and omega-3 fatty acids
- Maintain a healthy weight and exercise regularly
- Avoid smoking
- Manage blood pressure and cholesterol
- Protect eyes from UV light with sunglasses and wide-brimmed hats
- Schedule regular eye exams, especially after age 50
Geographic Atrophy (GA)
Geographic atrophy is an advanced form of dry AMD. Two FDA-approved treatments—Syfovre® (pegcetacoplan) and Izervay® (avacincaptad pegol)—are administered by intravitreal injection. These medications inhibit the complement system, a part of the immune response that, when overactive, contributes to retinal cell damage. Geographic atrophy is an advanced form of dry AMD. Two FDA-approved treatments—Syfovre® (pegcetacoplan) and Izervay® (avacincaptad pegol)—are administered by intravitreal injection. These medications inhibit the complement system, a part of the immune response that, when overactive, contributes to retinal cell damage.
In clinical trials, both Syfovre and Izervay significantly slowed the progression of atrophy compared to placebo. While these treatments cannot restore lost vision, they can help preserve remaining retinal tissue and slow further degeneration.
Your retina specialist will determine whether these therapies are appropriate based on the extent and location of your atrophy.
Prepare For Your Visit
If you already have an appointment made, we look forward to providing your care! If you need an appointment or have questions, please reach out to the Lakes Region Retina care team.
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