A new treatment called photodynamic therapy is now available at Yale for the most debilitating form of macular degeneration, called the "wet" form. It is this form that accounts for the most severe and debilitating loss of vision.

The wet form is caused by the growth of abnormal blood vessels beneath the central part of the retina. These abnormal vessels leak fluid and blood under the retina, causing a serous or hemorrhagic elevation to form. This leads to scar tissue and a large blind spot. The macula is responsible for what is often called ‘straight ahead’ vision and is what allows you to do everyday tasks like reading, recognizing faces, perform computer work and driving.

The FDA approved early in 2000 the use of photodynamic therapy using Visudyne, an injectable-photosensitizing agent, for wet age-related macular degeneration. The use of Visudyne represents a breakthrough since without treatment, many of these patients would progress to irreversible blindness. Yale was one of the 30 centers that participated in the clinical trials of this treatment. There is the possibility of maintaining one’s independence and quality of life for significantly more years.

The therapy is provided in the physician’s office and begins with the intravenous injection of Visudyne (verteporin) that travels to the abnormal vessels in the macula. The medication is activated by light from a non-thermal, low-energy laser. The laser is strong enough to activate the medication yet selectively treat the abnormal blood vessels but not damage the retina. Once activated, the drug begins to "seal" leaking vessels and restrict the growth of vessels to slow or stop the decline of vision. Patients can return home and to normal activates immediately after treatment. Given that the drug is light activated, patients are instructed to avoid direct or bright light exposure for five days following treatment.

Detecting Macular Degeneration:

• Declining vision identified during comprehensive eye exam
• Straight lines appear distorted
• The center of vision appears more distorted than the rest of the visual "scene"
• Reduced or changes in color perception
• Dark or blurry area or "white-out" spot in the center of vision

For more information, contact a member of the Retina and Macular Degeneration Team.