From the Guidelines
Prednisone is not recommended as a treatment for age-related macular degeneration (AMD) due to the lack of strong evidence supporting its use and the potential for significant side effects. The standard treatments for wet AMD include anti-VEGF injections such as ranibizumab (Lucentis), aflibercept (Eylea), or bevacizumab (Avastin), which are administered directly into the eye 1. For dry AMD, recommended approaches include AREDS2 vitamin supplements (containing vitamins C and E, lutein, zeaxanthin, zinc, and copper), lifestyle modifications like smoking cessation, and regular eye examinations 1.
Key Considerations
- The prevalence, incidence, and progression of AMD increase significantly with age, making early detection and treatment crucial 1.
- Cigarette smoking is a significant risk factor for AMD progression, and smoking-cessation counseling can help reduce this risk 1.
- Anti-VEGF treatment has been shown to reduce legal blindness and visual impairment in patients with neovascular AMD, highlighting the importance of early treatment 1.
- Long-term use of systemic corticosteroids like prednisone carries significant side effects, including increased risk of cataracts, glaucoma, diabetes, osteoporosis, and immunosuppression, making them unsuitable for the chronic management of AMD.
Recommendations
- If you have macular degeneration, consult with a retina specialist for appropriate evidence-based treatments rather than using prednisone.
- Follow recommended approaches for dry AMD, including AREDS2 vitamin supplements and lifestyle modifications like smoking cessation.
- Regular eye examinations are essential for early detection and treatment of AMD.
From the Research
Prednisone and Macular Degeneration
- The use of prednisone in treating macular degeneration has been studied, with one study 2 showing that corticosteroid therapy with prednisolone acetate improved peripheral visual field defects in patients with dry age-related macular degeneration.
- This study found that patients treated with corticosteroids had improvements in peripheral visual field from 10 to 25 degrees and central field improvements from 5 to 20%, whereas the control group treated with vitamins showed minimal improvements in central visual field.
- Another study 3 discussed the use of intravitreal triamcinolone acetonide in treating various ocular diseases, including exudative age-related macular degeneration, and found that the improvement in vision was lower in patients with this condition compared to other diseases.
- The relationship between prednisone and macular degeneration is not fully understood, but research suggests that corticosteroids may have a role in improving visual field defects in patients with this condition 2.
- Macular degeneration is a leading cause of central blindness or low vision among the elderly in industrialized countries, and its treatment has limitations 4.
- Vision rehabilitation can help patients with macular degeneration to maximize their remaining vision and adapt to activities of daily living 4.
Treatment Options
- Corticosteroid therapy with prednisolone acetate has been shown to improve visual field defects in patients with dry age-related macular degeneration 2.
- Intravitreal triamcinolone acetonide has been used to treat various ocular diseases, including exudative age-related macular degeneration, but its effectiveness varies depending on the disease 3.
- Vision rehabilitation, including low vision aids and therapy, can help patients with macular degeneration to cope with their condition and improve their quality of life 4.
Risk Factors and Prevention
- Macular degeneration is a chronic, progressive eye disease that is the leading cause of blindness in older Americans 5.
- The disease has a significant genetic component, and genetic testing may allow for specific preventive treatments to be delivered to individuals at risk in the future 6.
- Cigarette smoking has been associated with an increased risk of developing macular degeneration, and quitting smoking may help to reduce this risk 4.