Treatment of dry AMD vs. wet AMD
Differences in Treatment for Dry and Wet Macular Degeneration
Have you heard of age-related macular degeneration (AMD)? This is one of the most concerning eye diseases today, precisely because the population is living longer, and as a result, conditions related to aging are becoming increasingly common. The macula is the central region of the retina responsible for detailed vision, reading, and facial recognition. When it is compromised, the patient's quality of life can profoundly change.
But what are the differences between the dry and wet forms of AMD? And, most importantly, how is treatment provided in each case?
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Dry Macular Degeneration: Slow Progression and Chronic Treatment
The dry form accounts for 85 to 90% of cases. It tends to progress more slowly, with progressive loss of central vision over the years. Often, the patient notices distortions in images (metamorphopsia) or a gradually enlarging spot in the center of vision.
Diagnosis is primarily made through optical coherence tomography (OCT), which reveals changes such as drusen (yellowish deposits) and, in more advanced stages, areas of retinal atrophy.
Treatment of the dry form is not curative. It aims to slow the progression of the disease. Among the most commonly used strategies are:
Supplementation with specific vitamins (AREDS 2), combined with lutein and zeaxanthin, which help slow the progression.
Lifestyle changes, such as quitting smoking and protecting the eyes from excessive sun exposure. * Photobiomodulation, with devices like the Valeda, which use light at a specific wavelength to stimulate the mitochondria of retinal cells, helping to preserve cellular function and, in some cases, improve vision.
In the United States, intravitreal injections for the dry form are also available, especially indicated in cases of geographic atrophy, an advanced stage of the disease. These medications do not restore vision, but they can reduce the progression of vision loss. This type of treatment is expected to arrive in Brazil in the coming years.
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Wet Macular Degeneration: Risk of Sudden Vision Loss
The wet (or exudative) form is less common but much more aggressive. It occurs when abnormal vessels grow under the retina and begin to leak fluid and blood, causing swelling, bleeding, and rapid impairment of central vision.
Unlike the dry form, in which vision worsens slowly, in wet AMD, loss can occur overnight. Therefore, early diagnosis is essential. An OCT scan allows the doctor to observe areas of edema and the presence of fluid in or under the retina.
The most effective treatment is intravitreal injections of antiangiogenic drugs, medications that block the formation of these abnormal vessels and reduce fluid leakage. Several options are already available in Brazil, including Eylea, Eylea HD, Lucentis, and Vabysmo.
The most commonly used protocol is called "treat and extend": the patient receives one injection per month for the first three months, and depending on the response, the intervals between injections are gradually extended to 2, 3, 4, or even 5 months. In some cases, treatment can even be discontinued, provided that the patient is closely monitored, as the disease can recur.
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Conclusion
*Dry macular degeneration* is more common, progresses slowly, and requires treatments that slow its progression, such as vitamins, photobiomodulation, and, eventually, specific injections. *Wet degeneration* is rarer but extremely aggressive, requiring immediate treatment with intravitreal injections that can stabilize and even improve vision.
If you or someone close to you experiences symptoms such as blurred vision, distorted lines, or dark spots in the center of vision, **see an ophthalmologist specializing in retina**. Proper diagnosis and follow-up make all the difference in preserving your quality of life.
This video, as well as its comments, is not a substitute for a medical consultation and is for educational purposes only. It should not be used for decision-making, as an in-person consultation with a specialist is required. Author:
Dr. Mário César Bulla
Cremers 28120
Ophthalmologist - Retinologist
www.clinicabulla.com.br
www.especialistaemretina.com.br
Instagram: @retina.bulla
Video URL: • Tratamento da DMRI seca X DMRI úmida
@Retina and Vitreous
#retina
#oftalmologia
0:00 Difference in the treatment of dry and wet AMD
0:59 Dry and wet AMD
3:00 AMD Treatment
4:00 Dry AMD treatment with photobiomodulation using the Valeda device.