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Treating Wet Age-Related Macular Degeneration

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How to Tell When to Step Up Wet AMD Treatment

Medically Reviewed By Jenna Stoddard, OD

Vision changes or the development of blank spots in your field of vision are prompts to talk with a doctor about age-related macular degeneration (AMD).

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AMD, a chronic eye condition that can lead to severe vision loss, takes two forms: wet and dry. Wet AMD is less common and represents the more serious stages of the disorder. It occurs when vessels leak blood or fluid into the macula, a part of the retina in the back of the eye.

Several treatments can help improve wet AMD symptoms and slow or halt its progression. However, when symptoms worsen, you may be able to step up your treatment regimen. The key is to talk with a doctor when you notice vision changes or other symptoms.

Why treatment changes are needed

Common symptoms of wet AMD include changes in your central field of vision. Images look blurry and straight lines appear crooked or curvy. Colors can appear less vivid, and seeing in low or dim light becomes more difficult. These vision changes may improve or remain unchanged for a long time if you undergo regular treatment.

However, even with treatment, symptoms may still worsen.

For example, injections of medications that can protect blood vessels in the eye and keep new ones from forming work for only short periods, so an ongoing series of shots is required.

People who don’t keep up with their treatment may experience disease progression. For others, the medications may not be enough to prevent further leakage in the macula.

Photodynamic therapy (PDT) can also require multiple sessions to be effective. It’s common to experience slight improvement or even continued disease progression after only one round of PDT.

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If you are getting treatment and notice that images are becoming blurrier and lines are becoming more crooked, it’s time to contact a doctor and ask about new or additional treatment options.

Also, if the blurry area in your field of vision becomes larger or blank spots develop, it may be time to explore new wet AMD treatments.

Anti-VEGF injections

A mainstay of wet AMD treatment are anti-VEGF drugs, which are injected into the eye. VEGF stands for vascular endothelial growth factor, which is a protein that can promote the growth of new, abnormal blood vessels in the eye. VEGF can also injure existing blood vessels, causing them to leak and worsen wet AMD.

Anti-VEGF drugs stop VEGF production. There are several anti-VEGF drugs, and each works differently to stabilize blood vessel health in the eye.

Sometimes, when a particular medication doesn’t seem effective, your doctor may want to try a different anti-VEGF drug. A 2021 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source suggests that switching anti-VEGF drugs may help improve retinal health in people with wet AMD.

There are other reasons to be optimistic about wet AMD treatment. Research from 2022 Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source into new anti-VEGF drugs has led to the development of several medications, including faricimab, which has been approved to treat AMD and diabetic macular edema.

Also offering hope for improved wet AMD treatment is the development of gene therapies, which are administered similarly to anti-VEGF drugs. But instead of interfering with the action of the VEGF protein, these medications — also injected into the eye — will modify a person’s genes so that the body will essentially create its own anti-VEGF medication.

Early trials suggest that a one-time injection of gene therapy medications may provide a lifetime’s protection.

Photodynamic therapy

In addition to anti-VEGF injections, the other current wet AMD treatment is photodynamic therapy. It’s a multistep procedure that starts with an injection in your arm of the medication verteporfin.

You are then fitted with a special contact lens, which will guide a laser light to the blood vessels in the macula. The light, called a “cold laser,” causes the photo-sensitive verteporfin to break down the leaky vessels causing your vision problems.

Photodynamic therapy is often used as an accompaniment to anti-VEGF injections.

Takeaway

There is currently no cure for wet AMD, but treating this chronic eye disorder is an active area of research. Clinical trials of new drugs and treatments offer promising findings.

If you are living with wet AMD and your vision worsens, contact a doctor. Something as simple as switching medications may help. You may also want to talk with your doctor about new treatments or get involved with a clinical trial testing the latest therapies.

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    1. Granstam, E., et al. Switching anti-VEGF agent for wet AMD: Evaluation of impact on visual acuity, treatment frequency and retinal morphology in a real-world clinical setting. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352837/
    2. Hussain, R., et al. (2021). Vascular endothelial growth factor antagonists: Promising players in the treatment of neovascular age-related macular degeneration. https://www.dovepress.com/vascular-endothelial-growth-factor-antagonists-promising-players-in-th-peer-reviewed-fulltext-article-DDDT
    3. Nair, A., et al. (2022). Spotlight on faricimab in the treatment of wet age-related macular degeneration: Design, development and place in therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529225/
    4. Treatments for wet AMD (advanced neovascular AMD). (2021). https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration/treatments-wet-amd-advanced-neovascular-amd


Medical Reviewer: Jenna Stoddard, OD
Last Review Date: 2023 Mar 22
View All Treating Wet Age-Related Macular Degeneration Articles
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