Macular degeneration treatment suitability criteria
We will diagnose your condition by reviewing your medical and family history and conducting a complete eye exam.
How macular degeneration treatment works
Depending on the type of AMD you have, treatments may help slow disease progression (as in the case of dry AMD) or alternatively, preserve existing vision and recover some lost vision if started early enough (as in the case of wet AMD).
Currently, there is no treatment for dry AMD. However, you can slow its progression by taking vitamin supplements, eating a healthy and well-balanced diet, and not smoking.
If your dry AMD is advanced and vision has already been impacted, you may benefit from:
- Low vision rehabilitation to help you find ways to adapt to your changing vision
- Certain surgeries (eg. implanting a telescopic lens which will help magnify your field of vision)
Anti-VEGF injections can slow the growth of new abnormal and leaking blood vessels. They do this by hindering the effects of growth hormone signals that are generated in the eye due to wet AMD. When these blood vessels are unable to leak, the fluid that has entered the macula can resolve and macular function can resume. This may help to stabilise and improve vision. Injections are performed on an anaesthetised eye and there is no significant discomfort associated with this procedure.
Anti-VEGF agents are controlling treatments and are not considered a cure. Therefore, regular treatments are required for continuous control of the condition and to allow vision to be maintained.
Initially, we usually administer anti-VEGFtreatments on a four weekly regime for an induction period of approximately three months. Following the induction period and successful response to the medication, we may extend the treatment over proceeding intervals. Some patients may then only require treatment at 12 weekly intervals.
We need to readminister anti-VEGF medications at these intervals due to the ongoing production of the VEGF growth hormone that is produced by the body. When the injected medication has been completely used up, abnormal vessels may regrow and leak, and this is an indication that further treatment is required. Ultimately, the rate of intervals for treatment depends on the rate your body produces the growth hormone, in relation to how fast the medication is used up.
Advantages and disadvantages
- Stabilised and improved eyesight
- Usually maintained independence
- Quick and comfortable procedure
- Ongoing treatment is required
Macular degeneration treatment risks
There are some risks associated with having these injections. These include minor complications such as a small surface bleed from a burst blood vessel at the site of the injection (this has no impact on vision and self-resolves), mild eye irritation, or a small floater in the vision usually caused by a bubble of air being pushed through from the syringe.
There is a low risk of less than 1% of cases having a serious complication. These risks are infection in the eye known as endophthalmitis and retinal detachment. Symptoms of endophthalmitis include loss of vision and commonly (but not always) pain. Those experiencing a retinal detachment often note symptoms such as an arc of flashing light in the peripheral area of vision, multiple floating spots/lines/“clumps” in the vision that seem to move around, and on occasion a “curtain” coming across the field of vision. If you notice any of these symptoms following the injections, we recommend you call the OKKO Eye Specialist Centre immediately.
Other risks include the accelerated formation of cataract if you have not already had cataract surgery.
There is also a risk of your condition being unresponsive to medication.
Options and alternatives
Wet age-Related Macular Degeneration (AMD) is almost always treated with intravitreous anti-VEGF injections, however other options could also include:
- Laser treatments
- Eye surgery (pars plana vitrectomy — this is where we remove the vitreous gel in the eye. In the case of wet AMD, this is done when there has been a bleed into the vitreous causing loss of vision)
Macular degeneration treatment steps
Step 1: We apply a local anaesthetic to numb the eye, and clean the eye with antiseptic substances
Step 2: We use a tiny needle (0.31mm in size) attached to a syringe of medication for the injection.
Macular degeneration treatment results
These medicines are effective in preventing further central vision loss in up to 90% of treated eyes.