AMD: How to Treat Age-Related Macular Degeneration
The "wet" form of AMD (age-related macular degeneration) has greatly benefited from the arrival of new anti-VEGF treatments in the form of intravitreal injections.
Other treatments are still offered, such as dynamic phototherapy and Argon Laser.
For the atrophic forms that are too advanced and the "dry" form of AMD, we can only offer dietary supplements and/or visual aids in the form of magnifying glasses and other computerized magnifying devices.
Finally, research is very active in order to develop other more innovative treatments for these macular degeneration conditions, which are becoming more and more common given the aging of the population.
Treatment of AMD: classics such as laser or phototherapy
Currently there is no effective medical treatment for the atrophic form.
When the loss of visual acuity is severe, the patient can be offered low vision orthoptic rehabilitation or visual aids.
For exudative forms, the goal of AMD treatment is to destroy the new vessels.
The argon or krypton laser is sometimes recommended to destroy the new vessels and thus avoid hemorrhages.
This allows the reapplication of the macular retinal detachment as well as a disappearance of metamorphopsias and preservation of visual acuity.
For this treatment of AMD, several sessions are often necessary and the control can be done by angiography.
This laser can cause a retinal scar.
Photodynamic therapy is a relatively recent technique for certain exudative forms when the neovascularization is not accessible to the Argon laser (non-occult neovascularization).
This consists of injecting a dye called Visudyne which attaches to the inside of the neovascularization and which will allow their occlusion by means of the laser.
Several sessions are often necessary at intervals of a few months in order to allow a stabilization of visual acuity over several years.
New operating procedures for treating age-related macular degeneration
Anti-VEGF treatments block the appearance of new vessels, VEGF being a growth factor for new vessels, by intravitreal injections.
There are several anti-VEGFs.
These treatments must be renewed regularly depending on the reappearance of new vessels.
This intravitreal injection is performed on an outpatient basis under local anesthesia and presents few complications.
Researchers have just discovered an enzyme involved in this disease, which opens the way to new research that could prove promising.
Indeed, an American team has just discovered that retinal atrophy is linked to the absence of DICER-1, an enzyme that plays a protective role.
This DICER-1 enzyme prevents the accumulation of Alu RNA, which is toxic to the cells of the eye. Thus, when the quantity of DICER-1 enzyme decreases, the Alu RNA accumulates in too great a quantity and leads to the destruction of the retina.
Scientists have therefore developed techniques to either stimulate the DICER-1 enzyme or block the Alu RNA by eliminating it.
The first trials seem conclusive, but we must now move on to clinical trials on patients suffering from age-related macular degeneration.
Visual aid rehabilitation
In the case of advanced AMD, when treatments are insufficient in terms of visual acuity, rehabilitation may be offered.
Low vision orthoptic rehabilitation aims to teach patients to use their peripheral vision to compensate for the loss of central vision. This does not improve the remaining vision but it allows an improvement in everyday gestures.
In addition to rehabilitation, visual aids can be useful such as: magnifying glasses, video magnifiers, more powerful lighting.
Dietary supplementation
Studies show the benefits that certain foods can bring to AMD, particularly zinc and Omega 3.
