Treatment of age-related macular degeneration

Adopting a healthier lifestyle 

The fast pace of modern life, stress, smoking, poor diet, lack of exercise, etc. lead to the body's premature aging, affecting all the systems, not just the eye.

Discontinuation of smoking, a balanced diet (with fish, fruit, vegetables) and generally the adoption of a more healthy lifestyle, seems to also contribute to the prevention of age-related macular degeneration, beyond the obvious benefits to the patient's overall health.

Nutritional Supplements

A major scientific study (AREDS) showed that patients with moderate dry-form, age-related degeneration in one or both eyes, or advanced dry or wet form in one eye, can reduce the risk of the disease deteriorating by taking a daily combination of antioxidants, vitamins and zinc.

A more recent study, which is currently in progress (AREDS2) is studying the potential benefits of lutein and omega-3 fatty acids in this therapy.

Although these "vitamins" may delay the disease in the above cases, they are by no means a cure, nor will they restore the lost vision.

Moreover, despite their usefulness in some patients, they may be harmful to others. For example, the administration of beta-carotene to active or ex smokers appears to cause increased risk of lung cancer, which precludes its use in age-related macular degeneration.

In any event, all these preparations should only be administered a specialist ophthalmologist and should not be taken lightly and without thought.

Training of the patient in making better use of the maintained vision

Although age-related macular degeneration is potentially a very serious disease, it does not lead to complete blindness. In fact, with the proper training, the patient can learn to use another, healthier, peripheral area of the central fovea, for demanding detailed activities such as reading, etc.

One of the machines that we use to assess the functionality of the central region of the retina, the Maia (microperimetry examination), may contribute to this transition to a new "center of vision". Not only does it identify the most suitable point for this role, but through a series of short sessions lasting only a few minutes, the patient is trained to use it in everyday life.

Low Vision Aids

Low vision aids such as special glasses or magnifying lenses, and the application of modern technology can help people, whose central vision has declined because of age-related macular degeneration.

Anti-VEGF therapy

The most common form of treatment in "wet form " age-related degeneration involves the administration of drugs that stop the development of pathological neovascularization and hemorrhage.

These drugs, called "antiangiogenic factors" (Anti-VEGFs), are directed against a chemical compound (VEGF) that is produced by the body when cells do not receive enough oxygen. Such drugs are Avastin, Lucentis is etc.

Administration is performed with the direct injection into the eyeball, a process that lasts a few seconds and is very simple and painless.

With the introduction of these antiangiogenesis drugs, most patients do not only retain the vision that they have, but an improvement in their vision often occurs, with beneficial effects on patients' lives.

In recent years, recognizing that the age-related macular degeneration is a multifactorial disease, Combo Treatments, which include combinations of anti-VEGFs, the steroids and photodynamics (PDT) have been constantly gaining ground.

Laser Photocoagulation

Some cases of "wet" age-related macular degeneration are treated by targeting and destroying of neovascular membranes with special Laser beams.

This too is a very simple procedure, and after the application does not need hospitalization or other special care on the patient's part.

Nowadays it is all the more rarely because the thermal damage that it causes is not suitable for the improvement of vision, but only to curb the disease.

Photodynamic therapy (PDT) 

Photodynamic therapy is a combination of medication administration (Visudyne) and Laser application. By taking energy from the Laser, this drug produces short-lived compounds that destroy and obstruct the pathological new vessels, thereby preventing leakage of fluid and blood, which is harmful to vision.

Its excels compared to Laser photocoagulation, because milder Laser used does not cause thermal damage to the central fovea.

This too is a simple procedure that does not require hospitalization, but due to the interaction that the medicine has with sunlight, it is recommended that patients are not exposed to the sun for 48 hours after taking the drug.

Surgical treatment 

Some patients may be eligible for surgical treatment of disease. These are patients with wet, age-related degeneration, who have lost their central vision in both eyes, with one of the 2 not having the disease for over 6 months.

The Athens Eye Hospital pioneers in these interventions, where the shifting of the healthy segments of the retina in the macula, or the removal of abnormal vessels located beneath it in another location are performed so as to addressed these issues.