Treatments for Dry & Wet AMD
Treatment for age-related macular degeneration (AMD) has advanced considerably in recent years.
For people with wet AMD, medications can often preserve vision and sometimes improve it. Newer treatments for advanced dry AMD can slow the progression of retinal damage.
Although there is still no cure for AMD, treatment options are better than they were even a decade ago.
Treating Wet Macular Degeneration
Wet AMD develops when abnormal blood vessels grow beneath the retina and leak fluid or blood, damaging the macula.
The major breakthrough has been medications that block a protein called vascular endothelial growth factor (VEGF), which promotes abnormal blood vessel growth.
These medications are injected directly into the eye.
Common treatments include:
Eylea (aflibercept) — Widely used to control abnormal blood vessel growth and leakage.
Vabysmo (faricimab) — Targets two pathways involved in retinal disease and may allow longer intervals between injections.
Lucentis (ranibizumab) — An established treatment that helps preserve vision.
Avastin (bevacizumab) — A less expensive medication frequently used off-label for wet AMD.
These treatments have transformed the outlook for patients with wet AMD.
Many patients can maintain useful vision for years, and some experience meaningful improvement.
What Are Eye Injections Like?
The idea of an injection into the eye can be frightening, but the procedure is usually quick.
The ophthalmologist first numbs and disinfects the eye. A very small needle is then used to deliver medication into the fluid-filled space inside the eye.
Most patients experience relatively little discomfort.
Initially, injections may be needed every month. Depending on the medication and the patient's response, treatment intervals can sometimes be extended to several months.
Regular monitoring is important because stopping treatment prematurely may allow the disease to become active again.
Treatments for Dry Macular Degeneration
Dry AMD is more common and usually progresses more slowly than wet AMD.
For early dry AMD, there is currently no medication proven to stop the disease. Regular monitoring and attention to lifestyle remain important.
For some patients with intermediate AMD, AREDS2 nutritional supplements can reduce the risk of progression to advanced disease.
Advanced dry AMD can lead to geographic atrophy, in which retinal cells gradually deteriorate and areas of central vision are lost.
Until recently, no approved medications were available specifically to slow geographic atrophy.
New Treatments for Geographic Atrophy
In 2023, the FDA approved two medications for geographic atrophy:
Syfovre (pegcetacoplan)
Izervay (avacincaptad pegol)
Both target parts of the immune system's complement pathway, which is involved in inflammation and damage to retinal cells.
Clinical trials have shown that these treatments can slow the enlargement of areas affected by geographic atrophy, generally by a modest percentage.
However, they have not been shown to restore lost vision or reliably improve reading ability.
They require repeated injections into the eye, typically every month or two.
Potential risks include inflammation, infection, and an increased chance of developing wet AMD. Rare but serious complications have also been reported.
For this reason, retinal specialists weigh the possible benefits against the risks, treatment burden, and stage of the disease.
How Much Can Treatment Help?
The outlook differs considerably between wet and dry AMD.
Wet AMD: Anti-VEGF medications have strong clinical evidence showing that they can prevent further vision loss in many patients and improve vision in some.
Advanced dry AMD: The newer complement inhibitors can slow the expansion of damaged retinal areas, but their effects on everyday visual functioning remain uncertain.
This distinction is important when evaluating claims about new treatments.
A medication that slows disease progression does not necessarily restore vision or improve a patient's ability to read or recognize faces.
When Is Treatment Most Effective?
Early diagnosis and appropriate treatment are particularly important for wet AMD.
Sudden blurring, distorted straight lines, or a new dark spot in central vision should prompt urgent evaluation by an ophthalmologist.
For people with known AMD, regular eye examinations and retinal imaging help identify changes before substantial additional damage occurs.
Preserving existing vision is often easier than recovering vision that has already been lost.
Bottom Line
Treatment advances have substantially improved the outlook for people with macular degeneration.
Anti-VEGF injections have become highly effective at controlling wet AMD in many patients.
Newer medications for geographic atrophy represent progress for advanced dry AMD, although their benefits are more limited.
The most important steps are recognizing changes early, obtaining an accurate diagnosis, and discussing realistic treatment goals with a retinal specialist.
Learn More
National Eye Institute: Explains anti-VEGF injections and other treatments.
Comparison of Anti-VEGF Treatments
American Academy of Ophthalmology: Compares commonly used medications and treatment intervals.
National Eye Institute: Describes the development of medications for geographic atrophy.
New Geographic Atrophy Drugs: The Good, the Bad, and the Unknown
American Academy of Ophthalmology: Discusses the benefits, uncertainties, and risks of the newer treatments.