Doctor My Eyes! What’s New in Preventing Blindness from Macular Degeneration

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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As we live longer, vision loss becomes a huge quality of life issue in our older folks. Age-related Macular Degeneration (AMD) is the number one cause of vision loss in Americans 60 and older and there is a ton going on here. New stuff. Good stuff.

Dry macular degeneration can progress to wet macular degeneration, and that’s when treatment begins. Wet AMD can’t be cured but treatments now can slow the progression of vision loss significantly.


If you are a smoker, quit smoking. An aspirin a day helps prevent the progression to wet AMD, and if you have a moderate degree of dry AMD your doctor may have you take an AREDS supplement which is bought over the counter. This is a mixture of Vitamin C, Vitamin E, Beta-Carotene, Vitamin A, Zinc, and Copper. Not everyone should take this (Vitamin E and beta-carotene can increase risk of some cancers) but those with dry AMD do benefit from this supplement.


This is when the new, yet expensive, therapies help quite a bit. These are called anti-VEGF agents and your optho doc will talk to you about the choices here: Lucentis (ranibizumab), Eylea (aflibercept) and Avastin (bevacizumab). Some really good long term studies have shown that all 3 work essentially equally, though the side effect profile of Lucentis is better than Avastin. All work to preserve and improve visual acuity. Another tidbit is that though Avastin (bevacizumab) is cheaper than the other two, it is prepared by a compounding pharmacy and that has some people worried given recent problems with compounding pharmacies. Eylea and Lucentis are brand name drugs and are quite expensive. The eyes though, worth it? I think so.

Dr O.

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