eye disorders
Age Related Macular Degeneration (AMD or ARMD)
Treatment of AMD
Dietary supplements for high-risk dry or unilateral wet age-related macular degeneration (AMD) Intravitreal antivascular endothelial growth factor drugs or laser treatments for wet AMD Supportive measures There is no way to reverse damage caused by dry AMD. Patients with extensive drusen, pigment changes, and/or geographic atrophy can reduce the risk of developing advanced AMD by 25% by taking daily supplements of the following: Zinc oxide80 mg Copper2 mg Vitamin C 500 mg Vitamin E400 IU units Lutein 10 mg/zeaxanthin 2 mg (or beta-carotene 15 mg orvitamin A28,000 units for patients who have not smoked) In current and former smokers, beta-carotene can increase the risk of lung cancer. Substitution of beta-carotene with lutein plus zeaxanthin has been shown to have comparable efficacy ( Treatment references ). Therefore, such a substitution should be considered in current or former smokers. Beta-carotene yellows the skin in some patients. The zinc component of these supplements increases risk of hospitalization for genitourinary tract disorders. Reducing cardiovascular risk factors as well as regularly eating foods high in omega-3 fatty acids and dark green leafy vegetables may help slow disease progression; however, recent large trials have not shown that taking supplements of omega-3 fatty acids reduces disease progression. became available for the treatment of wet AMD ( Treatment references ). This is a surgically placed permanent refillable ocular implant that continuously delivers became available for the treatment of wet AMD ( Treatment references ); however, early reports ( In a small subset of patients, thermal laser photocoagulation of neovascularization outside the fovea may prevent severe vision loss. Photodynamic therapy, a type of laser treatment, also helps under specific circumstances. Corticosteroids (eg,triamcinolone) are sometimes injected intraocularly along with an anti-VEGF drug. Other treatments, including transpupillary thermotherapy, subretinal surgery, and macular translocation surgery, are seldom used. 1.Age-Related Eye Disease Study 2 Research Group: Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The age-related eye disease study 2 (AREDS2) randomized clinical trial.JAMA309(19):2005-2015, 2013. doi: 10.1001/jama.2013.4997. Clarification and additional information.JAMA310(2):208, 2013. doi:10.1001/jama.2013.6403 2.Holekamp NM, Campochiaro PA, Chang MA, all Archway Investigators: Archway randomized phase 3 trial of the port delivery system withranibizumabfor neovascular age-related macular degeneration.OphthalmologyS0161-6420(21)00734-X, 2021 3.Dugel PU, Koh A, Ogura Y, HAWK and HARRIER Study Investigators: HAWK and HARRIER: Phase 3, multicenter, randomized, double-masked trials ofbrolucizumabfor neovascular age-related macular degeneration.Ophthalmology127(1): 72-84, 2020. doi: 10.1016/j.ophtha.2019.04.017 4.Haug SJ, Hien DL, Uludag G, et al: Retinal arterial occlusive vasculitis following intravitrealbrolucizumabadministration.Am J Ophthalmol Case Rep18:100680, 2020. doi: 10.1016/j.ajoc.2020.100680 For patients who have lost central vision, low-vision devices such as magnifiers, high-power reading glasses, large computer monitors, and telescopic lenses are available. Also, certain types of software can display computer data in large print or read information aloud in a synthetic voice. Low-vision counseling is advised. 