How Dry Age-Related Macular Degeneration (AMD) Is Treated
Dry age-related macular degeneration (AMD) develops because the macula, the central portion of the retina, becomes thinner and tiny clumps of protein, called drusen, grow as a result of retinal waste product buildup. As drusen accumulates and the macula thins out, seeing in low light and identifying details clearly become more difficult. Straight lines may also appear wavy.
Treatment for AMD depends on the stage and type. There are three stages of dry AMD: early, intermediate, and late. The condition usually progresses slowly over several years.
Home Remedies and Lifestyle Changes
The risk factors for macular degeneration are similar to those of heart disease and stroke. For this reason, lifestyle changes that benefit your heart may also benefit your vision. Lifestyle modifications to consider include:
- Quitting smoking
- Making dietary changes, such as limiting foods high in saturated fats (meat, butter, and cheese) and eating a heart-healthy diet full of whole grains, fruits, and vegetables
- Maintaining weight, since obesity is also a risk factor of dry AMD
- Managing blood pressure
- Using sun protection, such as wearing wide-brimmed hats and sunglasses
- Getting regular exercise (at least 30 minutes of physical activity every day)
There are myths associated with eye and vision diseases like dry macular degeneration that are not accurate, including:
- Eating carrots can improve vision: Carrots contain vitamin A, but vitamin A is not important to eye health. Eating a diet that includes dark, leafy green vegetables, yellow vegetables and fruits, plus fish is better for eye health. These foods contain carotenoids, or antioxidants, that keep the macula healthy.
- Reading in low light hurts your eyes: Low or dim lighting does not hurt your eyes, but good lighting does reduce eye strain. One of the symptoms of dry AMD is having a reduced ability to see in low light. If you have this symptom, you should be evaluated by eye specialists like an ophthalmologist or optometrist.
- Losing vision is a part of aging: Dry AMD does occur with aging, but this condition doesn’t cause complete blindness. Losing your central vision can make it hard to drive or do close-up work. Getting a routine annual eye exam with an ophthalmologist or optometrist can help identify and treat the condition early, which can slow or halt the progression of dry AMD.
Over-the-Counter (OTC) Therapies
The Age-Related Eye Diseases Study (AREDS) suggests specific dietary modifications, including include taking specific vitamins and minerals, can slow dry macular degeneration. It identified specific vitamins and minerals that can reduce the risk of developing advanced dry macular degeneration by 25%. These include:
- Vitamin C (500 milligrams)
- Vitamin E (400 international units)
- Lutein (10 milligrams)
- Zeaxanthin (2 milligrams)
- Zinc (80 milligrams)
- Copper (2 milligrams)
These are usually recommended for people with intermediate-stage dry AMD. You should consult with your eye specialist about which of these supplements might be right for you.
Dry AMD and the Immune System
A part of the immune system called the complement cascade has long been associated with AMD. Two new drugs that target it and stop it from attacking the retina are being studied. One (pegcetacoplan, APL-2) targets a complement protein called C3. The other drug candidate (Zimura, avacincaptad pegol) targets a different protein in the cascade, C5. Already proven safe in people, these drugs are being studied regarding whether they can substantially improve vision.
Surgeries and Specialist-Driven Procedures
As of now, there are no surgeries that can cure dry AMD. There are, however, ways to cope as the condition progresses, and scientists are investigating new treatments for dry AMD.
For example, researchers are looking into the possibility of replacing some cells that begin to die in late-stage dry AMD. Doctors are coming up with ways to transplant these stem cells into the eye. One strategy is to layer the stem cells on thin scaffolds. Another is to put the cells into a fluid suspension that can be injected under the retina.
As central vision declines in late-stage dry AMD, you can use low-vision tools, such as magnifying tools and handheld computers, to help with daily activities. Low-vision techniques, like using high-lumen light sources, reducing glare, and increasing contrast, can also help compensate for central vision loss.
Dry AMD impacts central vision but not peripheral vision. A vision rehabilitation specialist can teach you how to leverage your peripheral vision to read, shop, and even cook. They can also point you to other services, such as mobility services or performing home assessments to minimize hazards and injury risk.
Complementary and Alternative Therapies
A few alternative therapies that have been studied to treat or slow down dry AMD disease are:
- Acupuncture: The use of acupuncture to treat dry AMD has been studied for many years. In fact, the American Academy of Ophthalmology (AAO) reviewed studies conducted over an almost 40-year period and concluded that there is insufficient evidence to support the use of acupuncture to treat dry AMD.
- Microcurrent stimulation: This is the use of a small amount of electrical current to stimulate increased central vision. Several studies have shown mixed results, but without strong evidence, the AAO concluded that microcurrent stimulation is not an effective treatment for dry AMD.
- Rheopheresis: Similar to hemodialysis for kidney failure, rheopheresis is a procedure in which a specific amount of blood is removed, filtered to remove large molecules suspected to worsen dry AMD, then safely infused back into you. Several studies have failed to show that it has a statistically significant effect on dry AMD. Considering the length of time per session, which ranges from two to four hours, and the need for 10 or more sessions a year, the evidence does not support the use of rheopheresis to treat dry AMD.
Dry macular degeneration causes central vision loss. Right now, there’s no treatment that can cure it. However, there are lifestyle changes you can make to slow or prevent disease progression if you have dry AMD.
Certain vitamins and minerals may be able to help with dry AMD, such as vitamin C, vitamin E, lutein, zeaxanthin, zinc, and copper. There are alternative therapies that may be helpful, such as acupuncture, but there isn’t enough research to back up their use for dry AMD.
A Word From Verywell
A diagnosis of dry macular degeneration can be overwhelming. Understanding available treatments, expert resources, and methods to manage dry AMD are important to learning to live and maintain personal independence with dry AMD.
Frequently Asked Questions
What is the best treatment for dry macular degeneration?
There is no known treatment for dry AMD. However, certain lifestyle changes can be made to slow or stop the progression of dry AMD, such as quitting smoking, consuming a diet low in saturated fats, maintaining a healthy weight, and managing your blood pressure. Certain vitamins and minerals may also help slow dry macular degeneration, such as vitamin C, zinc, and copper.
Where can I find medical experts in the treatment of dry macular degeneration?
Eye specialists like optometrists and ophthalmologists can treat dry AMD. An ophthalmologist is a physician who has completed medical school and then completed eight years of residency training. Ophthalmologists are licensed to practice both medicine and surgery.
An optometrist has completed four years of optometry training. Optometrists perform eye exams, vision tests, prescribe corrective lenses, as well as detect certain eye abnormalities and eye diseases.
How long does it take to lose your vision with dry macular degeneration?
Dry AMD progresses over several years. In early-stage dry AMD, you may not experience any changes in your vision. If you have intermediate dry AMD, you will start to have blurred vision. It’s important to note that complete blindness is not a common result of dry macular degeneration.
Macular degeneration causes central vision loss. People with late-stage AMD may notice that straight lines look wavy or crooked and there is a blurry area near the center of your vision.
What should you eat to assist with dry macular degeneration?
Foods to include are dark, leafy green vegetables and yellow fruits and vegetables. They contain antioxidants that can keep the macula healthy. Eating plenty of fish, which is high in omega-3 fatty acids, is also considered helpful for eye health.