How Is Age-Related Macular Degeneration Typically Treated?
Age-related macular degeneration (AMD) is a progressive retinal disorder that primarily affects the macula—the central portion of the retina responsible for sharp, detailed vision. Treatment strategie
Age-related macular degeneration (AMD) is a progressive retinal disorder that primarily affects the macula—the central portion of the retina responsible for sharp, detailed vision. Treatment strategies depend on the disease subtype: dry (atrophic) AMD or wet (neovascular) AMD.
Dry AMD, which accounts for approximately 80–90% of cases, currently has no FDA-approved pharmacologic therapy. Management centers on risk reduction and disease monitoring. The Age-Related Eye Disease Study 2 (AREDS2) formulation—a specific combination of antioxidants (vitamin C, vitamin E), zinc, copper, lutein, and zeaxanthin—has been shown to slow progression to advanced AMD in individuals with intermediate disease or unilateral advanced AMD. Lifestyle modifications—including smoking cessation, UV protection, cardiovascular risk control, and a diet rich in leafy greens and omega-3 fatty acids—are also evidence-based components of care.
In contrast, wet AMD is characterized by choroidal neovascularization (CNV), where abnormal blood vessels grow beneath the retina and leak fluid or blood, causing rapid central vision loss. First-line treatment involves intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents such as aflibercept, ranibizumab, or faricimab. These therapies inhibit pathological angiogenesis and vascular permeability, often stabilizing vision and, in many cases, improving visual acuity. Treatment typically begins with monthly injections followed by individualized extension of dosing intervals based on clinical response—commonly guided by optical coherence tomography (OCT) imaging and visual acuity assessments.
Emerging approaches include sustained-release drug delivery systems, gene therapies targeting long-term VEGF suppression, and complement inhibitors under investigation for geographic atrophy—a late-stage form of dry AMD. Regular comprehensive ophthalmologic evaluation remains essential for early detection, accurate classification, and timely intervention.