What are the AMD treatment risks?
So what are the risks of AMD treatment? Well, treatment for wet age-related macular degeneration involves tiny injections to the eye under a local anaesthetic. There are significant benefits of the treatment including stabilisation of vision and indeed an improvement of vision in a proportion of patients.
However, there are small risks. The main small but serious risk is one of sight-threatening infection but the risk of that is often quoted is approximately one in 1,000. But looking at the treatments that I’ve performed, including working in my team in the NHS and in privately the risk is, in reality, something like one in 3,000 or one in 5,000. So this risk is exceedingly low.
There are other small risks such as bleeding into the eye or problems with the lens or indeed conditions such as retinal detachment. But again, thankfully, those risks are exceedingly low too. The bigger risk is actually not to have treatment and to run the significant risk of severe visual loss as a result of the disease process itself.
We know that the earlier we start treatment, the better our chances of preventing irreversible vision loss due to wet age-related macular degeneration.
For every ten people who receive injection treatment for wet age-related macular degeneration, nine people experience a stabilisation in their vision with 3 or 4 people seeing a significant improvement in vision. This means that the risk of not responding well to treatment is approximately 1 in 10 and there can be a range of reasons for this including the development of scarring (macular fibrosis) which is associated with loss of health light-detecting photoreceptor cells in the retina or thinning of the retina (atrophy).
Occasionally there can be tears or splits in one of the layers of cells supporting the retina (the retinal pigment epithelium or RPE), and this can be associated with bleeding below the retina. These RPE tears need to be treated for longer to help prevent further vision loss and can also happen as part of the disease process of wet AMD and not just after injection treatment.
The era of effective AMD treatments
We know about that risk because unfortunately, we haven’t had effective treatments for wet age-related macular degeneration until the last eight or ten years. So, before that, I used to see patients who used to lose vision, and there was nothing I could do about it, but now thankfully we’re in the era of effective treatments for wet age-related macular degeneration. And the significant benefits outweigh the small risks.