Why can some types of macular degeneration be treated with injections, and others can not?

It is important to have regular screenings for macular degeneration so detection can be caught early. Stock photo

Answers by Dr. Mitchell Gossman, an ophthalmologist at Eye Associates of Central Minnesota, located in St. Cloud

What are the types of macular degeneration, why are some treated with injections,

and why are some not?

There are many distinct types of macular degeneration, much like there are dozens of breeds of cats. However, there are two main categories.

The first category is “wet macular degeneration.” This is a condition where blood vessels grow under the retina and leak fluid or blood causing distortion of your vision or even patchy loss of vision which unchecked can ultimately result in legal blindness. It’s called “wet” because of the blood and fluid. This used to be treated with laser to destroy these vessels (and even today sometimes is), but this leaves behind damage of its own. This all changed dramatically in 2004 with the injectable drugs known as “anti-VEGF” (such as Avastin and Eyelea) which are antibodies destroy these vessels. The main downside is that they usually need to be delivered by injection into the eye, repeatedly, in treatment intervals measured in weeks to months, for life, and there are risks with its use. This has resulted in this formerly more dreaded form of macular degeneration, which could often result in legal blindness, becoming the “treatable” form. Most patients with wet macular degeneration have pre-existing dry macular degeneration, which is the next type:

“Dry macular degeneration” is the more common type and is called “dry” because there is no fluid or blood leaking from blood vessels. It tends to be slower progressing but can cause just as much damage with central vision and ability to see details such as reading.

There are currently two treatments for dry macular degeneration:

1.AREDS vitamins. The most common brand is from Bausch & Lomb under the brand name “Preservision.” For patients with moderate to severe macular degeneration it has been shown to slow progression of the disease. It has been shown to not be effective in preventing it in healthy eyes. I recommend my patients take the “Preservision AREDS 2” preparation twice a day. Shop around, there’s a wide variation in per-capsule prices amongst drug stores, wholesale clubs, online retailers, etc.

2. One specific form of macular degeneration called “Geographic Macular Degeneration” can be treated with an injectable medication placed into the eye that also slows progression. It is not a cure, doesn’t reverse the disease, doesn’t prevent progression, but it does slow progression. The medications are Syfovre and Vabysmo. You may have seen the television ads featuring Henry Winkler.

It’s important to undergo screening examinations to detect these conditions when they are early in order to provide the best chance to retain functional vision for your lifetime. Treatments options should be discussed with your ophthalmologist, optometrist, or retina specialist.

Find out more

Dr. Mitchell Gossman is a comprehensive ophthalmologist, along with Dr. Melanie Thares, an optometrist, at Eye Associates of Central Minnesota. The office is located at 628 Roosevelt Road, Suite 101, in St. Cloud. To make an appointment or to learn more, call 320-774-3789 or email info@eaofcm.com.