Age-Related Macular Degeneration: Other Treatment

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Other Treatment

Photodynamic therapy (PDT) is another treatment for age-related macular degeneration (AMD). Photodynamic therapy uses a light-sensitive dye that produces blood clots to stop the growth of abnormal new blood vessels under the macula. But PDT has only recently begun to be widely used, and its effectiveness and long-term consequences are still being studied. Most people need multiple treatments to get the full benefits of the therapy.

Currently, no treatment has proven effective for dry AMD, so the search for other treatments continues. Not all cases of wet AMD can be treated with laser photocoagulation surgery or PDT. And only about 15 out of 100 people can be effectively treated with laser photocoagulation surgery. PDT can only be used for a minority of cases as well. ⁴

Other Treatment Choices

• Photodynamic therapy (PDT) is used to treat wet AMD. PDT is a procedure in which light from a laser activates a drug that has been injected into your bloodstream. The drug, reacting to the light from the laser, seals off abnormal blood vessels caused by wet AMD.

Surgeries and treatments under investigation

Experts are currently studying possible surgeries for AMD. These include:

• Macular translocation surgery. In this procedure, surgeons detach the macula and move it to a more healthy area of the eye. Unlike most other AMD treatments, this treatment may even be able to restore some vision. But there are serious risks involved, and researchers need to study the treatment more to see if it is safe and effective.
• Submacular surgery. In this procedure, surgeons remove abnormal blood vessels from beneath the macula. This treatment might help maintain vision in some people, but studies show that this type of surgery has significant risks and may not be very effective.

Researchers are studying several possible treatments for wet AMD. These include:

• Laser therapy to remove deposits in the eye called drusen. Although the treatment may improve vision, it also may increase the growth of abnormal vessels under the macula that eventually lead to vision loss. More research is needed to determine whether this treatment is effective.
• Electronic devices to restore vision. Researchers are investigating tiny implants in the retina and other devices that replace damaged cells that capture light and send information to the brain. It likely will be several years before we know what role these devices will play in treating AMD. But promising results from initial studies indicate that these devices may someday be used to restore lost vision.
• Steroids injected into the eye. Steroids, such as triamcinolone, may slow the progress of vision loss or even help improve vision.

What To Think About

The most recent treatment that has been developed for wet AMD are the anti-VEGF medicines. These medicines are injected into the eye.

Laser treatment almost always causes some immediate, permanent central vision loss (a central blind spot), and it does not prevent future growth of abnormal blood vessels. Some experts think that photodynamic therapy (PDT) and radiation therapy could prove to be more effective and less destructive than laser surgery because they are more precise. These procedures may be better able to target the blood vessels without damaging the nerve cells in the retina and macula. But the effectiveness and long-term consequences of PDT are still being studied.

Many treatments for AMD are costly, need to be repeated, and may have limited effectiveness. Some treatments may even make your AMD worse or cause vision loss. Talk with your doctor to make sure that you understand the possible benefits, risks, and side effects of your treatment choices.

Last updated:	August 13, 2007
Author:	Robin Parks, MS
Reviewed By:	Kathleen Romito, MD - Family Medicine, Carol L. Karp, MD - Ophthalmology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC