Dry AMD requires regular follow-up because occasionally the transition from dry AMD to wet AMD is not noticed by the patient. Additionally, those patients who have a high risk for wet AMD need to be placed on the nutritional supplements of AREDS2 and instructed on monitoring their vision using either the Amsler grid or the Foreseehome devise. In this way the onset of wet AMD might be detected early resulting earlier treatment and potentially better visual results. Use of the AREDS2 supplement will decrease the risk of progression of dry AMD to wet AMD by approximately 25%.

Wet AMD is currently treated with the intraocular injections to an anti-VEGF drug. This drug blocks the formation of new but abnormal vessels. There are currently 4 drugs being used, Avastin (bevacizizumab), Lucentis (ranibizumab), Eylea (aflibercept) and Beovu (brolucizumab). In administering these drugs the eye is initially prepped with a Betadine solution and topical anesthetic. This followed by a subconjunctival injection of Xylocaine or a Xylocaine ointment and a drop of betadine solution on the eye. After several minutes the anti-VEGF drug is injected into the eye. Initial treatment involves at least 3 consecutive injections approximately 4-5 weeks apart. After these injections the interval between subsequent injections would depend of the response of the wet AMD. Ideally when 2 consecutive follow-up exams show on further leakage the interval between exams is extended to 2 months. During each exam the eye is examined and a diagnostic OCT, to determine the progression/regression of the wet-AMD. Occasionally after repeated injections the eye stabilizes and no further injections are made. In other cases the eye may not dry completely but there is no progressive leakage. In such cases they are just followed and possibly receive maintenance injections as needed as determined by the eye exam. The use of Beovu has a somewhat different treatment protocol in that 3 injections are made but any subsequent injection with Beovu has to be 3 months later. Complications can occur with each injection. These could include infection, retinal detachment, adverse reaction to the medication, increased intra-ocular pressure and intra-ocular hemorrhage. Minor complications include a subconjunctival hemorrhage, corneal abrasion and accumulation of small silicone bubbles, which come from lubricant within the injection syringe. All complications can be handled successfully if treated promptly.