By Wendy Haaf
For the past two years, I’ve been receiving an injection to slow down macular degeneration. The condition of my eye is stable. If I stop the treatment and lose the sight in that eye, what will happen to my other eye, which is in perfect condition?
The injections you’re describing are used to treat “wet” age-related macular degeneration (AMD), which typically starts out as the “dry” form of the disease. In the dry form, a protective layer of tissue between the retina and the blood vessels behind it can no longer get rid of normal waste products, leading to the death of the cells that make up the protective lining. In about 10 to 15 per cent of people with dry AMD, the disease eventually evolves into the wet form, according to Dr. Tom Sheidow, an ophthalmologist with the Ivey Eye Institute at St. Joseph’s Health Care London (Ont.).
In wet AMD, tiny, abnormally leaky blood vessels begin growing through areas in the lining that have been weakened by dry AMD. The fluid leakage causes the retina to distort and ultimately creates scarring of the retina, which leads to rapid vision loss.
The injections curb the growth of these leaky vessels, slowing the progress of wet AMD. “In some cases, we can actually improve vision if we catch the disease before scarring occurs,” says Dr. Phil Hooper, a retina-trained ophthalmologist, associate professor at Western University’s Schulich School of Medicine & Dentistry in London, Ont., and president of the Canadian Ophthalmological Society. However, even when there is some reversal of vision loss and the disease is stabilized, a person’s “vision will still continue to decline,” Hooper says.
If you stop getting injections in your affected but stabilized eye, within roughly two to three months, “protection from advancement of the wet macular degeneration is generally lost,” Hooper says. “If the disease progresses and more bleeding and scarring develop, any loss of vision that has occurred is unlikely to be recovered even if treatment is restarted.”
Whether you decide to continue treatment or not will have no bearing on what happens to the sight in your other eye. However, “in those patients who have wet AMD in one eye, 50 per cent over several years will get it in the other eye,” Sheidow says.
There are two steps you can take to reduce that risk. “If you’re a smoker, the most important thing you can do is stop smoking—that reduces your risk significantly, more than any other measure that you can take,” Hooper stresses. And the results of two large-scale studies—known as AREDS (Age-Related Eye Disease Study) and AREDS2—have shown that supplements combining specific doses of certain nutrients can help, too. “The use of these so-called AREDS supplements reduces your risk of having progression to advanced disease in the second eye by 25 per cent,” Hooper says.
Be sure to read labels carefully—not all products proclaiming vision-protective properties contain all of the ingredients at the doses that have been proven to work.