Treatement of Macular Degeneration

Macular degeneration is usually diagnosed on the basis on the investigation of eyes with slit-lamp and OCT investigation (optical coherence tomography). OCT investigation gives a cross-sectional image of the retina layer by layer, and it is also used for monitoring the progression of the disease. Making a picture with an OCT apparatus takes about 5 minutes and it does not preclude any preparation from the side of the patient. Sometimes also fluorescin angiography may be necessary for making the diagnosis.

There is no treatment for the dry form of macular degeneration today. It is recommended to take special eye vitamins as a prophylaxis in case of advanced stages of the disease.

The growth of new abnormal blood vessels that are characteristic of the wet form of the disease can be inhibited with the injection of anti-VEGF drugs (i.e. drugs that act against vascular endothelium growth factor) into the vitreous body.
Anti-VEGF drugs decrease the content of a substance in the eye that promotes the development of new blood vessels. Treatment helps to delay the progression of decrease in visual acuity. The drug has an effect for 6-8 weeks, which means that the injection procedure has to be repeated from time to time to prevent the occurrence and development of new abnormal blood vessels. However, this treatment method is not effective in case of advanced disease when scarring and calcification has occurred in the eyes. If this has happened, the patient has to use a magnifying glass for reading and use other aids that can be obtained from a rehabilitation centre.

Intraocular injection of anti-VEGF will be performed in sterile conditions in an operating room in an outpatient setting. Before the procedure it is necessary to widen the pupil with eye drops. Eyelids are cleaned and the eye is rinsed with iodine solution. Intraocluar injection procedure is painless as local anaesthetic eye drops are used to anaesthetise the eye. The necessary amount of the medicine is introduced into the eye via a superfine needle. It is necessary to lie with closed eyes for some time after the injection.

Your visual acuity may be impaired for up to 12 hours after the procedure. After the injection antibacterial eye drops are instilled into the eye. With the preparation time intraocular injection procedure takes about one hour. Vision may be a bit blurry after the injection. It is recommended to invite someone to take you home or call a taxi. It is not allowed to drive a car for 12 hours. Strenuous exercise and sauna should be avoided for 2 to 3 days. For one week eye drops prescribed by the ophthalmologist have to be used.

Anti-VEGF (vascular endothelial growth factor) therapy (i.e. treatment that inhibits the growth of internal wall of the blood vessels) has been effective in all performed studies. Several anti-VEGF drugs are available for intraocular injection.
On rare occasions (about 3 cases per 10,000 injections) intraocular inflammation can occur. Other possible complications of the intraocular injection:

  • retinal tear and detachment;
  • haematoma of the eye lens;
  • mechanical injury of the lens;
  • increase in intraocular pressure.