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Ask Well: A Cure for Macular Degeneration?, NY Times

The short answer is: not yet, but treatments are getting better.

Getting older is the leading risk factor for age-related macular degeneration, the leading cause of vision loss in the United States.

Macular degeneration comes in two forms: dry and wet. The dry form is milder and usually has no symptoms, but it can degenerate into the wet form, which is characterized by the growth of abnormal blood vessels in the back of the eye, potentially causing blurriness or vision loss in the center of the field of vision.

The best treatment for wet macular degeneration is prevention, said Dr. Rahul N. Khurana, a clinical spokesman for the American Academy of Ophthalmology and a retina specialist practicing in Mountain View, Calif. Not smoking, along with eating dark green vegetables and at least two servings of fish a week, may help reduce the risk of macular degeneration, he said.

An annual eye exam can catch macular degeneration while it is still in the dry form, Dr. Khurana said, and vitamins can help prevent it from progressing into the wet form, the main cause of vision loss.

Dr. Joan W. Miller, chief of ophthalmology at Massachusetts Eye and Ear, said anyone with a family history of the disease should get a retina check at age 50. People should also get an eye exam if they notice problems like trouble adjusting to the dark or needing more light to read.

The federally funded Age-Related Eye Disease Study, published in 2001 and updated in 2013, found that people at high risk for advanced age-related macular degeneration could cut that risk by about 25 percent by taking a supplement that included 500 milligrams of vitamin C, 400 I.U.s of vitamin E, 10 milligrams of lutein, 2 milligrams of zeaxanthin, 80 milligrams of zinc, and 2 milligrams of copper.

Even more remarkable, Dr. Khurana said, are medications that slow the growth of blood vessels at the back of the eye, called anti-vascular endothelial growth factor, or anti-VEGF, drugs.

“Macular degeneration was really a one-way ticket to blindness,” he said. Now, such anti-VEGF medications can often prevent further vision loss, and some patients even see vision improvements. “These treatments are one of the biggest advances in all of ophthalmology and, I would argue, in medicine,” he said.

The downside is that these drugs, Lucentis, Avastin and Eylea, require a monthly injection in the eye, and some can cost more than $1,000 per shot.

More treatments, some which may offer the potential for a cure, are under development. Dr. Miller said she was optimistic that more options would be available within the next two to five years.

(Click here to read the full article, written by Karen Weintraub, NY Times)