Table of ContentsView AllTable of ContentsIn Wet AMDWho Develops It?Treatments When AdvancedSupport and Assistance
Table of ContentsView All
View All
Table of Contents
In Wet AMD
Who Develops It?
Treatments When Advanced
Support and Assistance
Neovascular AMD ranks as the most common cause of blindness among older adults. While this type of AMD occurs in about 10% to 15% of all people with AMD, it leads to 80% of severe vision loss linked to AMD.
There is no cure for this type of AMD. Early detection and treatment can help slow its progress and reduce the amount of vision loss. The most common treatment involves the injection of special drugs into the affected eye(s). Laser therapy is sometimes combined with these drugs.
This article describes neovascular AMD and how it affects your eyes and vision. It also explains risk factors, treatments, and resources to help you manage vision loss.
Israel Sebastian / Getty Images
Neovascularization in Wet AMD
“Neovascularization” means “new blood vessels.” In wet AMD, new blood vessels form and sprout in thechoroid, a layer that contains blood vessels under your retina. New blood vessels develop when your retina produces too much of a substance called vascular endothelial growth factor (VEGF). This protein supports the growth of new blood vessels.
What Happens to Eyes
Vision Effects
Fluid from abnormal blood vessels can cause a rapid and dramatic decline in vision. Vision effects can include the following:
Macular Degeneration: Timeline of Vision Loss Progression
Who Gets Neovascular AMD?
The reason that AMD occurs and progresses to neovascular AMD in some people is not clearly understood.While no specific cause exists for neovascular AMD, research indicates that certainrisk factorscan contribute to your chances of having it. Since neovascular AMD occurs as late-stage AMD, risk factors that contribute to disease progression can also increase your risk of neovascular AMD.
The following non-modifiable risk factors (risk factors that can’t be changed) are among those linked to neovascular AMD:
Several modifiable risk factors can also contribute to your risk of developing neovascular AMD. These factors include the following:
Non-neovascular AMD vs. Neovascular AMDThere are twotypes of age-related macular degeneration (AMD). They differ in the type of damage they cause and how they occur.Non-neovascular AMD, ordry AMD, results when macular cells begin to thin and deteriorate. As these cells decompose, small pieces of cellular debris calleddrusenaccumulate and cause gradual loss of central vision.Neovascular AMD begins as non-neovascular AMD and occurs as a late-stage version of the disease. It is called wet AMD because vision loss occurs due to abnormal blood vessels that leak fluid into your retina. Vision loss from wet AMD can happen suddenly within days or weeks.
Non-neovascular AMD vs. Neovascular AMD
There are twotypes of age-related macular degeneration (AMD). They differ in the type of damage they cause and how they occur.Non-neovascular AMD, ordry AMD, results when macular cells begin to thin and deteriorate. As these cells decompose, small pieces of cellular debris calleddrusenaccumulate and cause gradual loss of central vision.Neovascular AMD begins as non-neovascular AMD and occurs as a late-stage version of the disease. It is called wet AMD because vision loss occurs due to abnormal blood vessels that leak fluid into your retina. Vision loss from wet AMD can happen suddenly within days or weeks.
There are twotypes of age-related macular degeneration (AMD). They differ in the type of damage they cause and how they occur.
Non-neovascular AMD, ordry AMD, results when macular cells begin to thin and deteriorate. As these cells decompose, small pieces of cellular debris calleddrusenaccumulate and cause gradual loss of central vision.
Neovascular AMD begins as non-neovascular AMD and occurs as a late-stage version of the disease. It is called wet AMD because vision loss occurs due to abnormal blood vessels that leak fluid into your retina. Vision loss from wet AMD can happen suddenly within days or weeks.
Treatments for Advanced Neovascular Wet AMD
Without prompt treatment, neovascular wet AMD can cause central vision loss. Vision loss can become permanent if wet AMD treatment does not begin within a few days to weeks from the start of symptoms.
The following treatments can’t cure advanced neovascular wet AMD, though they may slow the rate of vision loss or stop further damage:
Anti-VEGF (Anti–Vascular Endothelial Growth Factor) Injections
Anti-VEGF injections are the first-line treatment for neovascular wet AMD. These injections deliver drugs that inhibit VEGF. This prevents the growth of abnormal blood vessels that can damage your macula.
Anti-VEGF injections help most people with neovascular AMD. About 33% of people treated with anti-VEGF therapy achieve improved vision, while 90% of those treated get at least stabilized vision.
Anti-VEGF treatments are given asintravitrealinjections. This involves injecting the drug into your vitreous cavity (the space directly behind your eyes). Numbing eye drops reduce pain and discomfort. The procedure takes a few seconds.
Anti-VEGF injections are repeated initially about every four to six weeks, based on factors related to your condition and the drugs used. The span between treatments may be extended depending on how your eye responds.
While anti-VEGF treatments are effective, the need for frequent, ongoing injections can be a barrier to continued care and getting the best results. Though rare, side effects and eye damage can occur.
Anti-VEGF medications differ in how long they last in your eye. Your ophthalmologist will determine which medication is most appropriate for your condition. The medications used in anti-VEGF injections include:
Photodynamic Therapy
While anti-VEGF injections alone are effective for most people, a few cases of neovascular AMD achieve better results when the injections are used in combination with photodynamic therapy. Unlike anti-VEGF injections, photodynamic therapy alone does not improve vision.
This treatment involves the injection in the arm ofverteporfin, a photosensitizing drug (a substance sensitive to the influence of radiant energy, namely light). The drug travels through your bloodstream to your eye. Your ophthalmologist shines a laser beam into your retina to activate the drug. When activated, verteporfin works to attack the abnormal blood vessels causing vision loss.
Based on your reaction to this treatment, photodynamic treatment may be necessary at three-month intervals.
Laser Photocoagulation
Laser photocoagulationis a type of minimally invasive laser surgery. It was the first treatment used for neovascular AMD. However, it is only appropriate for certain rare types of this disease in which abnormal blood vessels are not located beneath the center of your macula. It uses thermal laser treatments to seal or destroy leaking blood vessels.
Since laser photocoagulation also damages vision cells, it is only used when faulty blood vessels are located far from the center of your macula. A major problem with laser photocoagulation is recurrent choroidal neovascularization. This can occur in up to 60% of neovascular AMD treatments.
Emerging Therapies
Emerging therapies for neovascular AMD involve treatments that may provide options to those who require indefinite injections. Researchers are seeking to create therapies that are both effective and convenient so more people will comply with their treatment plans. These emerging therapies include the following:
Wet AMD Support and Vision Assistance
Living with wet AMD can be challenging. The vision impairment that AMD causes can occur dramatically and suddenly, leaving you little time to become accustomed to the change. Research indicates that people with wet AMD and their caregivers have a high risk of anxiety and depression.
Support groups can be a valuable source of information, encouragement, and social interaction as you navigate the changes that occur with wet AMD. Ask your eye specialist or general healthcare provider for referrals to local support groups that might include people with wet AMD.
You can also find many macular degeneration resources online. Look for national organizations that support people with vision problems and eye diseases. They often provide newsletters, news on the latest treatments, and tips for living with vision loss from wet AMD. Organizations relevant to wet AMD and related eye diseases include:
Many national organizations sponsor local, online, or telephone-based support groups for people with vision loss. These support groups include:
Coping With Macular Degeneration
Summary
Neovascular AMD is an eye disease that damages your central vision. It is an advanced form of AMD that can cause fast and severe vision loss without prompt and proper treatment.
Getting early treatment can help stabilize vision loss. It may also restore lost vision in some cases. Most people achieve results with anti-VEGF treatments if they follow the advised schedule of injections.
The physical changes that can occur with wet AMD can include emotional challenges. Resources like support groups can provide encouragement and education to help you meet the changes this disease can cause.
26 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chaudhuri M, Hassan Y, Bakka Vemana PPS, Bellary Pattanashetty MS, Abdin ZU, Siddiqui HF.Age-related macular degeneration: an exponentially emerging imminent threat of visual impairment and irreversible blindness.Cureus. 15(5):e39624. doi:10.7759/cureus.39624American Academy of Ophthalmology.What is macular degeneration?Bright Focus Foundation.What is choroidal neovascularization?Macular Society.Wet age-related macular degeneration (AMD).Pugazhendhi A, Hubbell M, Jairam P, Ambati B.Neovascular macular degeneration: a review of etiology, risk factors, and recent advances in research and therapy.Int J Mol Sci. 2021;22(3):1170. doi:10.3390/ijms22031170Sergejeva O, Botov R, Liutkevičienė R, Kriaučiūnienė L.Genetic factors associated with the development of age-related macular degeneration. Medicina (Kaunas). 2016;52(2):79-88. doi:10.1016/j.medici.2016.02.004Chapman NA, Jacobs RJ, Braakhuis AJ.Role of diet and food intake in age-related macular degeneration: a systematic review.Clin Exp Ophthalmol. 2019;47(1):106-127. doi:10.1111/ceo.13343Zhang Q.Y., Tie L.J., Wu S.S., Lv P.L., Huang H.W., Wang W.Q., Wang H., Ma L.Overweight, obesity, and risk of age-related macular degeneration.Investig. Ophthalmol. Vis. Sci.2016;57:1276–1283. doi:10.1167/iovs.15-1863National Eye Institute.Age-related macular degeneration (AMD).American Macular Degeneration Foundation (AMDF).Wet macular degeneration.BrightFocus Foundation.Anti-VEGF treatments for wet age-related macular degeneration.Fleckenstein M, Schmitz-Valckenberg S, Chakravarthy U.Age-related macular degeneration: a review.JAMA. 2024;331(2):147-157. doi:10.1001/jama.2023.26074American Academy of Ophthalmology.Anti-VEGF treatments.American Society of Retina Specialists.Retinal health series: intravitreal injections.American Society of Retina Specialists.Retinal health series: intravitreal injections.BrightFocus Foundation.Injections for wet macular degeneration: what you need to know.American Academy of Ophthalmology.What is Avastin?University of Michigan.Choosing one drug over another to treat blindness could save Medicare billions.WillsEye Hospital.Wet AMD.National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).American Academy Ophthalmology.New treatments for age-related macular degeneration.American Academy of Ophthalmology.Gene therapy for AMD.Arepalli S, Kaiser PK.Pipeline therapies for neovascular age related macular degeneration.International Journal of Retina and Vitreous. 2021;7(1):55. doi:10.1186/s40942-021-00325-5Ranade SV, Wieland MR, Tam T, et al.The Port Delivery System with ranibizumab: a new paradigm for long-acting retinal drug delivery.Drug Deliv. 2022;29(1):1326-1334. doi:10.1080/10717544.2022.2069301Nair AA, Finn AP, Sternberg Jr P.Spotlight on faricimab in the treatment of wet age-related macular degeneration: design, development and place in therapy.Drug Des Devel Ther. 2022;16:3395-3400. doi:10.2147/DDDT.S368963Senra H, Balaskas K, Mahmoodi N, Aslam T.Experience of anti-VEGF treatment and clinical levels of depression and anxiety in patients with wet age-related macular degeneration.Am J Ophthalmol. 2017;177:213-224. doi:10.1016/j.ajo.2017.03.005
26 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chaudhuri M, Hassan Y, Bakka Vemana PPS, Bellary Pattanashetty MS, Abdin ZU, Siddiqui HF.Age-related macular degeneration: an exponentially emerging imminent threat of visual impairment and irreversible blindness.Cureus. 15(5):e39624. doi:10.7759/cureus.39624American Academy of Ophthalmology.What is macular degeneration?Bright Focus Foundation.What is choroidal neovascularization?Macular Society.Wet age-related macular degeneration (AMD).Pugazhendhi A, Hubbell M, Jairam P, Ambati B.Neovascular macular degeneration: a review of etiology, risk factors, and recent advances in research and therapy.Int J Mol Sci. 2021;22(3):1170. doi:10.3390/ijms22031170Sergejeva O, Botov R, Liutkevičienė R, Kriaučiūnienė L.Genetic factors associated with the development of age-related macular degeneration. Medicina (Kaunas). 2016;52(2):79-88. doi:10.1016/j.medici.2016.02.004Chapman NA, Jacobs RJ, Braakhuis AJ.Role of diet and food intake in age-related macular degeneration: a systematic review.Clin Exp Ophthalmol. 2019;47(1):106-127. doi:10.1111/ceo.13343Zhang Q.Y., Tie L.J., Wu S.S., Lv P.L., Huang H.W., Wang W.Q., Wang H., Ma L.Overweight, obesity, and risk of age-related macular degeneration.Investig. Ophthalmol. Vis. Sci.2016;57:1276–1283. doi:10.1167/iovs.15-1863National Eye Institute.Age-related macular degeneration (AMD).American Macular Degeneration Foundation (AMDF).Wet macular degeneration.BrightFocus Foundation.Anti-VEGF treatments for wet age-related macular degeneration.Fleckenstein M, Schmitz-Valckenberg S, Chakravarthy U.Age-related macular degeneration: a review.JAMA. 2024;331(2):147-157. doi:10.1001/jama.2023.26074American Academy of Ophthalmology.Anti-VEGF treatments.American Society of Retina Specialists.Retinal health series: intravitreal injections.American Society of Retina Specialists.Retinal health series: intravitreal injections.BrightFocus Foundation.Injections for wet macular degeneration: what you need to know.American Academy of Ophthalmology.What is Avastin?University of Michigan.Choosing one drug over another to treat blindness could save Medicare billions.WillsEye Hospital.Wet AMD.National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).American Academy Ophthalmology.New treatments for age-related macular degeneration.American Academy of Ophthalmology.Gene therapy for AMD.Arepalli S, Kaiser PK.Pipeline therapies for neovascular age related macular degeneration.International Journal of Retina and Vitreous. 2021;7(1):55. doi:10.1186/s40942-021-00325-5Ranade SV, Wieland MR, Tam T, et al.The Port Delivery System with ranibizumab: a new paradigm for long-acting retinal drug delivery.Drug Deliv. 2022;29(1):1326-1334. doi:10.1080/10717544.2022.2069301Nair AA, Finn AP, Sternberg Jr P.Spotlight on faricimab in the treatment of wet age-related macular degeneration: design, development and place in therapy.Drug Des Devel Ther. 2022;16:3395-3400. doi:10.2147/DDDT.S368963Senra H, Balaskas K, Mahmoodi N, Aslam T.Experience of anti-VEGF treatment and clinical levels of depression and anxiety in patients with wet age-related macular degeneration.Am J Ophthalmol. 2017;177:213-224. doi:10.1016/j.ajo.2017.03.005
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Chaudhuri M, Hassan Y, Bakka Vemana PPS, Bellary Pattanashetty MS, Abdin ZU, Siddiqui HF.Age-related macular degeneration: an exponentially emerging imminent threat of visual impairment and irreversible blindness.Cureus. 15(5):e39624. doi:10.7759/cureus.39624American Academy of Ophthalmology.What is macular degeneration?Bright Focus Foundation.What is choroidal neovascularization?Macular Society.Wet age-related macular degeneration (AMD).Pugazhendhi A, Hubbell M, Jairam P, Ambati B.Neovascular macular degeneration: a review of etiology, risk factors, and recent advances in research and therapy.Int J Mol Sci. 2021;22(3):1170. doi:10.3390/ijms22031170Sergejeva O, Botov R, Liutkevičienė R, Kriaučiūnienė L.Genetic factors associated with the development of age-related macular degeneration. Medicina (Kaunas). 2016;52(2):79-88. doi:10.1016/j.medici.2016.02.004Chapman NA, Jacobs RJ, Braakhuis AJ.Role of diet and food intake in age-related macular degeneration: a systematic review.Clin Exp Ophthalmol. 2019;47(1):106-127. doi:10.1111/ceo.13343Zhang Q.Y., Tie L.J., Wu S.S., Lv P.L., Huang H.W., Wang W.Q., Wang H., Ma L.Overweight, obesity, and risk of age-related macular degeneration.Investig. Ophthalmol. Vis. Sci.2016;57:1276–1283. doi:10.1167/iovs.15-1863National Eye Institute.Age-related macular degeneration (AMD).American Macular Degeneration Foundation (AMDF).Wet macular degeneration.BrightFocus Foundation.Anti-VEGF treatments for wet age-related macular degeneration.Fleckenstein M, Schmitz-Valckenberg S, Chakravarthy U.Age-related macular degeneration: a review.JAMA. 2024;331(2):147-157. doi:10.1001/jama.2023.26074American Academy of Ophthalmology.Anti-VEGF treatments.American Society of Retina Specialists.Retinal health series: intravitreal injections.American Society of Retina Specialists.Retinal health series: intravitreal injections.BrightFocus Foundation.Injections for wet macular degeneration: what you need to know.American Academy of Ophthalmology.What is Avastin?University of Michigan.Choosing one drug over another to treat blindness could save Medicare billions.WillsEye Hospital.Wet AMD.National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).American Academy Ophthalmology.New treatments for age-related macular degeneration.American Academy of Ophthalmology.Gene therapy for AMD.Arepalli S, Kaiser PK.Pipeline therapies for neovascular age related macular degeneration.International Journal of Retina and Vitreous. 2021;7(1):55. doi:10.1186/s40942-021-00325-5Ranade SV, Wieland MR, Tam T, et al.The Port Delivery System with ranibizumab: a new paradigm for long-acting retinal drug delivery.Drug Deliv. 2022;29(1):1326-1334. doi:10.1080/10717544.2022.2069301Nair AA, Finn AP, Sternberg Jr P.Spotlight on faricimab in the treatment of wet age-related macular degeneration: design, development and place in therapy.Drug Des Devel Ther. 2022;16:3395-3400. doi:10.2147/DDDT.S368963Senra H, Balaskas K, Mahmoodi N, Aslam T.Experience of anti-VEGF treatment and clinical levels of depression and anxiety in patients with wet age-related macular degeneration.Am J Ophthalmol. 2017;177:213-224. doi:10.1016/j.ajo.2017.03.005
Chaudhuri M, Hassan Y, Bakka Vemana PPS, Bellary Pattanashetty MS, Abdin ZU, Siddiqui HF.Age-related macular degeneration: an exponentially emerging imminent threat of visual impairment and irreversible blindness.Cureus. 15(5):e39624. doi:10.7759/cureus.39624
American Academy of Ophthalmology.What is macular degeneration?
Bright Focus Foundation.What is choroidal neovascularization?
Macular Society.Wet age-related macular degeneration (AMD).
Pugazhendhi A, Hubbell M, Jairam P, Ambati B.Neovascular macular degeneration: a review of etiology, risk factors, and recent advances in research and therapy.Int J Mol Sci. 2021;22(3):1170. doi:10.3390/ijms22031170
Sergejeva O, Botov R, Liutkevičienė R, Kriaučiūnienė L.Genetic factors associated with the development of age-related macular degeneration. Medicina (Kaunas). 2016;52(2):79-88. doi:10.1016/j.medici.2016.02.004
Chapman NA, Jacobs RJ, Braakhuis AJ.Role of diet and food intake in age-related macular degeneration: a systematic review.Clin Exp Ophthalmol. 2019;47(1):106-127. doi:10.1111/ceo.13343
Zhang Q.Y., Tie L.J., Wu S.S., Lv P.L., Huang H.W., Wang W.Q., Wang H., Ma L.Overweight, obesity, and risk of age-related macular degeneration.Investig. Ophthalmol. Vis. Sci.2016;57:1276–1283. doi:10.1167/iovs.15-1863
National Eye Institute.Age-related macular degeneration (AMD).
American Macular Degeneration Foundation (AMDF).Wet macular degeneration.
BrightFocus Foundation.Anti-VEGF treatments for wet age-related macular degeneration.
Fleckenstein M, Schmitz-Valckenberg S, Chakravarthy U.Age-related macular degeneration: a review.JAMA. 2024;331(2):147-157. doi:10.1001/jama.2023.26074
American Academy of Ophthalmology.Anti-VEGF treatments.
American Society of Retina Specialists.Retinal health series: intravitreal injections.
BrightFocus Foundation.Injections for wet macular degeneration: what you need to know.
American Academy of Ophthalmology.What is Avastin?
University of Michigan.Choosing one drug over another to treat blindness could save Medicare billions.
WillsEye Hospital.Wet AMD.
National Eye Institute.Treatments for wet AMD (advanced neovascular AMD).
American Academy Ophthalmology.New treatments for age-related macular degeneration.
American Academy of Ophthalmology.Gene therapy for AMD.
Arepalli S, Kaiser PK.Pipeline therapies for neovascular age related macular degeneration.International Journal of Retina and Vitreous. 2021;7(1):55. doi:10.1186/s40942-021-00325-5
Ranade SV, Wieland MR, Tam T, et al.The Port Delivery System with ranibizumab: a new paradigm for long-acting retinal drug delivery.Drug Deliv. 2022;29(1):1326-1334. doi:10.1080/10717544.2022.2069301
Nair AA, Finn AP, Sternberg Jr P.Spotlight on faricimab in the treatment of wet age-related macular degeneration: design, development and place in therapy.Drug Des Devel Ther. 2022;16:3395-3400. doi:10.2147/DDDT.S368963
Senra H, Balaskas K, Mahmoodi N, Aslam T.Experience of anti-VEGF treatment and clinical levels of depression and anxiety in patients with wet age-related macular degeneration.Am J Ophthalmol. 2017;177:213-224. doi:10.1016/j.ajo.2017.03.005
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