The best treatment for macular degeneration depends on which type you have. Wet AMD is treated with regular eye injections that block abnormal blood vessel growth, and these drugs can stabilize or even improve vision in many patients. Dry AMD, the more common form, had no FDA-approved treatment until 2023, when two new drugs became available to slow its most advanced stage. Both types benefit from specific nutritional supplements that can reduce the risk of progression.
Wet AMD vs. Dry AMD: Why It Matters
Age-related macular degeneration comes in two forms, and they require completely different approaches. Dry AMD accounts for about 80 to 90 percent of cases and progresses slowly as light-sensitive cells in the macula break down over time. Wet AMD is less common but more urgent: abnormal blood vessels grow beneath the retina and leak blood or fluid, which can blur or destroy central vision rapidly if untreated.
Dry AMD can also convert to wet AMD at any point, which is why ongoing monitoring matters even if your current diagnosis is the dry form.
Anti-VEGF Injections for Wet AMD
The standard treatment for wet AMD is a class of drugs that block a signal protein called vascular endothelial growth factor (VEGF). VEGF fuels the growth of those leaky, abnormal blood vessels under the retina. By neutralizing it, these drugs reduce the leakage and can stabilize or improve your vision.
Four medications are widely used:
- Eylea (aflibercept) and its higher-strength version, Eylea HD, designed specifically for AMD
- Lucentis (ranibizumab), also designed specifically for AMD
- Vabysmo (faricimab), which targets both VEGF and a second protein called angiopoietin-2, potentially offering a longer-lasting effect
- Avastin (bevacizumab), originally a cancer drug used off-label for AMD at a fraction of the cost
All four are delivered by injection directly into the eye. That sounds alarming, but the eye is numbed with anesthetic drops beforehand, and most patients describe the procedure as brief and tolerable. The most serious risk, a severe internal eye infection called endophthalmitis, occurs in fewer than 1 in 1,000 injections.
How Often You’ll Need Injections
Most patients start with monthly injections until the fluid and swelling resolve, which your doctor tracks with retinal imaging scans. Once things stabilize, many doctors use a “treat-and-extend” approach: the interval between injections is stretched by two weeks at a time, as long as the disease stays quiet. If fluid returns, the interval shortens back to four weeks. The maximum gap typically reaches 12 weeks.
This means some patients eventually come in only every two to three months, while others need injections closer to monthly for years. The schedule is individualized based on how your eyes respond, so there’s no single answer for how long treatment lasts. For most people, it’s an ongoing commitment.
New Treatments for Advanced Dry AMD
The most advanced stage of dry AMD is called geographic atrophy, where patches of retinal cells die off permanently. Until recently, there was nothing to slow this process. That changed in 2023 with two FDA-approved complement inhibitors, drugs that target part of the immune system’s inflammatory cascade that drives cell death in the retina.
Pegcetacoplan, approved in February 2023, was the first. Avacincaptad pegol followed shortly after. Both are given as eye injections, similar to wet AMD treatments. In clinical trials, both slowed the growth of atrophic lesions by roughly 14 to 20 percent over 12 months compared to no treatment. That may sound modest, but for a disease that previously had zero options, it represents a meaningful shift. In a network comparison of trial data, avacincaptad pegol at its standard dose showed the largest reduction in lesion growth at one year.
These drugs slow progression rather than restore lost vision, so starting earlier in the geographic atrophy stage is likely to preserve more sight over time. Pegcetacoplan can be given monthly or every other month, while avacincaptad pegol is given monthly.
AREDS2 Supplements for Dry AMD
If you have intermediate dry AMD or advanced disease in one eye, a specific vitamin formula called AREDS2 has been shown to reduce the risk of progressing to advanced AMD by about 25 percent. This isn’t a generic multivitamin. The formula contains precise amounts of nutrients studied in large clinical trials:
- Vitamin C: 500 mg
- Vitamin E: 180 mg
- Zinc: 80 mg
- Copper: 2 mg (to offset zinc-related deficiency)
- Lutein: 10 mg
- Zeaxanthin: 2 mg
These are the total daily amounts, typically split across two softgels. Many brands sell AREDS2-labeled products, so check the label to confirm the dosages match. These supplements are not helpful for people without AMD or with only very early signs of it.
Monitoring for Conversion to Wet AMD
If you have dry AMD, one of the most important things you can do is catch any conversion to wet AMD early, because treatment works best before significant damage occurs. The simplest tool is an Amsler grid, a printed square of evenly spaced lines you look at daily. New waviness or blank spots in the grid suggest fluid may be forming under the retina.
A more sophisticated option is the ForeseeHome device, an at-home monitor that tests your central vision electronically. In a long-term study, the device detected about 52 percent of conversions before patients noticed symptoms or were caught at routine visits. Patients who used it checked in about five times per week on average. It’s not foolproof, but it adds a layer of detection beyond what you’d get from office visits alone.
Surgical Options for Severe Vision Loss
For people who have already lost substantial central vision from end-stage AMD, an implantable miniature telescope can magnify images onto a larger area of the retina, helping with tasks like reading and recognizing faces. This tiny device is placed inside the eye during surgery, replacing the natural lens in one eye.
Eligibility is narrow. Candidates must be at least 75, have best-corrected vision between 20/160 and 20/800, still have an intact natural lens (no prior cataract surgery) in the eye being treated, and be willing to work with a low vision therapist before and after the procedure. It’s a last-resort option, not a substitute for earlier treatments, but it can meaningfully improve quality of life for those who qualify.
Gene Therapy on the Horizon
One of the most promising developments is gene therapy designed to make the eye produce its own anti-VEGF protein continuously, potentially replacing the need for repeated injections. A candidate called RGX-314 is currently in a pivotal phase 3 trial. It works by delivering a gene to retinal cells using a viral vector, programming them to manufacture a protein that neutralizes VEGF on an ongoing basis. The trial is comparing this one-time surgical treatment against monthly injections, with results measuring vision changes through about 9 months and safety through nearly 2 years.
If successful, gene therapy could transform wet AMD from a condition requiring injections every few weeks into one treated with a single procedure. That’s still unproven at this stage, but the approach is further along in development than many people realize.