Treatment of nonexudative (dry) age-related macular degeneration.
OBJECTIVE
The purpose of this report is to review the recent literature and summarize currently available and potential new treatment options for nonexudative age-related macular degeneration.


RESULTS
High-dose vitamin supplementation may have some associated systemic toxicity. It is important to check that the patient is taking beta-carotene and not vitamin A as retinal acetate or palmitate, which have been associated with osteoporosis and hepatotoxicity. High-dose vitamins E and C may be associated with cardiovascular disease. Decreasing inflammation by lowering systemic cardiac C-reactive protein, fibrinogen and cholesterol may be important, especially in light of recent epidemiologic and genetic data. The results of randomized trials of laser treatment for drusen and rheopheresis should be available during 2006. Treatment with these modalities before the results of the trials are evaluated should be avoided.


CONCLUSIONS
The holy grail of therapy for age-related macular degeneration is to avoid the development of choroidal neovascularization. High-dose vitamin supplementation should be used only in those in whom it is indicated and inflammatory parameters including highly sensitive C-reactive protein, fibrinogen and cholesterol should be stabilized because there are data associating these parameters with age-related macular degeneration and also with cardiovascular disease.
Donaldson
Mark J
MJ
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Pulido
Jose S
JS
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D005122:Exudates and Transudates; D006801:Humans; D053685:Laser Therapy; D014975:Lutein / Q000627:therapeutic use; D008268:Macular Degeneration / Q000628:therapy*; D010956:Plasmapheresis; D011244:Pregnadienediols / Q000627:therapeutic use; D015593:Retinal Drusen / Q000628:therapy*; D024341:Xanthophylls / Q000627:therapeutic use; D065146:Zeaxanthins
D020533:Angiogenesis Inhibitors; D011244:Pregnadienediols; D024341:Xanthophylls; D065146:Zeaxanthins; D014975:Lutein; C418047:anecortave acetate