What You Need to Know About Dry Age-Related Macular Degeneration

BrightFocus Foundation
“What You Need to Know About Dry AMD”
Transcript of Teleconference with Gayatri S. Reilly, M.D.
March 25, 2015
1:00 – 2:00 p.m. EDT

Please note: BrightFocus Chats may be edited for clarity and brevity.

GUY EAKIN: Hello, everyone, and welcome to our monthly BrightFocus Chat, presented by the BrightFocus Foundation (BFF). My name is Guy Eakin; I’m the Vice President of Scientific Affairs at here at BrightFocus. Today we are delighted to talk to Dr. Gayatri Reilly of The Retina Group of Washington, which is a very large eye care practice, which specializes in macular degeneration, and it’s housed here in the greater Washington dc area.

Every month we feature a different topic for our chats, and today we are going to be focusing on dry AMD. So in every chat, if you have a question that you would like to ask, our caller this time, Dr. Reilly, has agreed that she will be there to answer questions. The way you ask those questions is press *3, and that will take you out of the call to submit your question to an operator. If for some reason you are disconnected from the call, there is a number to call back in, that number is 877-229-8493 and then you will be asked to punch in an ID code 112435.

So, Dr. Reilly, you have quite a background with macular degeneration, you’ve performed research on it, you’ve trained other clinicians, and of course, you’re treating patients yourself. Could you provide us with a description of what dry AMD is?

GAYATRI REILLY: I just wanted to thank you again for inviting me to speak on this very, very pertinent, and very interesting topic that affects so many people over age 60. So what macular degeneration is—that it’s a condition that gradually destroys the center portion of vision. And that area is called the macula. This area is what you need to see objects clearly and perform daily tasks.

Most cases of macular degeneration start off in this dry form, and that’s characterized by a thinning of the macula, which is, again, the central portion of the vision. What we see on examination is that you get tiny little yellow deposits that we call drusen that develop underneath the retina, and that’s the most common early sign of dry macular degeneration. It develops slowly; it’s a very gradual condition, but it does cause decreased vision, gradually as well, and you can also develop severe vision loss with just dry macular degeneration. Unfortunately, what makes it difficult is that there’s frequently no pain, and in some cases you may not even notice it, in terms of having vision while you actually have the condition.

GUY EAKIN: If I could interrupt you, I heard you—for the first time, I heard someone say, there’s frequently no pain. Are there times when dry macular degeneration, or the wet form, could—the disease itself could cause pain or another sensation?

GAYATRI REILLY: It’s generally very uncommon, but very rarely with wet macular degeneration, you can develop a large hemorrhage that can—a big area of bleeding that can cause pain. But typically, you know, over 95% of the time, it will not be associated with pain.

GUY EAKIN: You described for us the dry form, and of course most people are very, very worried about this wet form of the disease, and we—in the U.S., we probably have about 2 million people that have the wet form of the disease, and maybe about 9 million with the dry form of the disease, but how often do people progress from the dry to the wet form? And can you give us a sense of timeline, of when it does occur?

GAYATRI REILLY: Sure, so it’s about 10 to 15% of people who have dry macular degeneration will progress to the wet form, but it’s, you know, over the very first 5 years of the diagnosis of dry macular degeneration.  There’s almost about a 40% chance of the transformation from dry to wet within the first 5 years. It’s very, very important to have early diagnosis and frequent monitoring. We will talk a little bit more about it, both at home and with your physician, to help assess any transformation from dry to wet.

GUY EAKIN: So you say 10 to 15% progress to the wet form, I like to hear 85 to 95—85 to 90 don’t progress to the wet form, but it’s the same message either way. We know that many people out there are fearful that AMD will blind them, it’s described in so many places as a blinding disorder and I understand that has some technical context to it that may, it may not be the complete story just to say that it’s blinding.  So what do you tell patients when they ask you, “Will I go blind?”

GAYATRI REILLY: Well, you know, I think it’s a question I get every single day, and it’s extremely important to address.

That answer has changed over time, as you know. First of all, with even the most severe form of macular degeneration, this affects the central vision only, which—the difference between that—you use your peripheral vision less often, but when you’re not focused on something, you still see other parts in your vision, and that’s your peripheral vision, and that will always remain intact with even the most severe form of macular degeneration.

And the reason why this answer has changed over time, it was only as little—about 15 years ago, we had no treatments at all for wet macular degeneration, and the central part of the vision was something that we would expect for patients to lose, but now, over the past 10 years with research, and the treatments have changed dramatically, and what we can actually tell patients and have the expectations are that we hope to maintain good vision—and good vision including vision that’s capable for driving, for reading, and that’s the expectations that I would hope with early diagnosis.

GUY EAKIN: So, you mentioned that patients are—that you have to monitor their symptoms and identify treatments as necessary. So you have success controlling vision loss, but what are some of the ways that we as the patient population could tell if the disease is progressing? So, what can we do at home?

GAYATRI REILLY: So, there’s a couple of things that you can do at home, and I’m really excited about one of the more new ones. Traditionally we give patients an Amsler Grid, which is a square of horizontal and vertical lines that resemble a checkerboard. And if you use—if you test one eye at a time, close one eye, focus on the central area, and if there’s any new areas that appear blurry, dark or distorted, that’s something that we consider that you need to call your eye doctor immediately for. That could be a sign that something has changed.

More recently, and this is just as recent as the end of last year, there’s a new device that you can use at home that just plugs into the wall, you don’t need to have an Internet connection, but it’s called the Foresee monitoring device, it’s FDA approved. And it’s meant for the earliest detection of wet macular degeneration.  So it’s for patients who already have the diagnosis of dry macular degeneration, and they use this device—takes about 3 minutes per eye—and they use it as often as they can, at least three to four times a week.  If there was ever a change in their testing, there is an alert that gets triggered, and with this device, we’ve been able to see that in a clinical trial that over 94% of eyes were detected with very good vision, meaning 20/40 vision or better, compared with just the usual waiting for a drop in vision that a patient would see.

GUY EAKIN: So I’d like to mention that if you don’t already have an Amsler Grid or if you’d like more information about the Foresee Home Monitor, that’s spelled F-o-r-e-s-e-e, you can stay on the line after the chat and leave a message requesting more information. You can also always call us at 1-800-437-2423 to ask for those materials. I should take a reminder to say if you have a question, do feel free to press *3, and that will take you out of the conversation just for a moment to submit your question to an operator.

So, you mentioned that the Foresee monitor or the Amsler Grid might help in detecting changes and so if you saw a change, if you received one of these alerts from the Foresee monitor or just from a patient and they came into your office, but there was a change, but it wasn’t necessarily a change to the wet form of the disease where we know we have lots of treatments available, what would you be doing with that information in the context of dry AMD?

GAYATRI REILLY: I think it’s an opportunity to review with the patient, you know, what the status of their macular degeneration is. So, you know, we do classify macular degeneration as dry and wet, but within dry, there’s mild, moderate and severe, and those expectations really vary between how severe the macular degeneration is. So, even if we don’t see a change to wet macular degeneration, coming in and getting this exam really serves as an opportunity to review—and I really think that, like you kind of alluded to earlier, a lot of patients have incorrectly assumed that they are going to go blind with this condition. And it’s an opportunity to reassure, and say that things are where they are, and, you know, these are the expectations going forward.

GUY EAKIN: I think I—we, certainly at BrightFocus Foundation, have our eyes on a couple of clinical trials that are happening now, and the hope, of course, is that in the near future we will have approved therapies for dry AMD, and knowing your status, hopefully, would put you in line to be able to take advantage of those opportunities if they come through. So again, you can press *3 to submit questions to an operator and if you’re disconnected to the call, you can dial 877-229-8493and you’ll be asked to punch in the ID code which is 112435.

So, we talked a bit about the lack of current treatments and research, and there’s a couple of things up there, but the pipeline isn’t very deep to treat dry AMD. We spoke about this last month, but there’s so many patients, and I have a question from Terry from Maine who has had dry AMD with geographic atrophy since 1982 and she’s wondering what else she can do to protect her eyes: I take a product called MacuHealth; I take nutritional supplements, herbs, I eat a lot of fruit and vegetables and I get plenty of exercise. I’m otherwise very healthy. Is there anything else I can do?

GAYATRI REILLY Well, I would first say that, you know, it’s great that she was diagnosed so early, especially back in 1982, and it sounds like she’s doing everything that I would recommend for any patient to do. The number one thing is maintaining a healthy diet, just as she is, eating a lot of green leafy vegetables, avoiding smoking—that is essential for the process of dry macular degeneration—as well as taking the AREDS vitamins. The AREDS vitamins are the one thing we do have for dry macular degeneration that decreases the risk for that patient, from progressing to wet macular degeneration and its associated vision loss. And it’s something that’s available over the counter, you don’t need a prescription for. It’s the one thing that has been proven to decrease that risk.

GUY EAKIN: And so as I’m looking at my list of questions, one of the things that comes up occasionally is we’re talking about dry AMD, which kind of puts patients in the pattern of wait and see. And I’m curious how often you recommend that people with dry AMD come back and consult the eye doctor, how often should those visits be occurring in a general sense?

GAYATRI REILLY: A lot of it depends, again, on the level of dry macular degeneration, but the average is somewhere between one and it can be as much as three times in a year to monitor dry macular degeneration, depending on how concerned or how advanced the dry macular degeneration is. I would say the minimum would certainly be one time a year for a good dilated exam.

GUY EAKIN: And do you have an opinion—there are lots of different types of eye care providers, but if you were talking to a family member who might be experiencing some vision problems, where would you send them first?

GAYATRI REILLY: We do have, fortunately, lots of access to eye care with optometrists, general ophthalmologists, and then specialists, like myself, in retina. You know, I think many of my patients see an optometrist once a year. They do a complete and thorough eye examination, and check them for a variety of eye conditions. However, if they were experiencing any particular vision loss or change, I would say your general ophthalmologist would be a good place to start, because they’re really able to assess whether it’s a cataract that’s changing, is there any sign of glaucoma that’s causing things…they are really able to fine tune and help make a diagnosis of what exactly is causing this change in vision.

GUY EAKIN: Ok, thank you. So we are going to turn to some questions that are coming in from the people who are listening to the chat today. As I said earlier, you can ask your own question by pressing *3 and be taken to an operator. We have one from Jeff from California, and he has dry macular degeneration and he says that sometimes the blurriness seems to go from one eye to the other. How or why is this happening and do you have any advice for Jeff?

GAYATRI REILLY: Well, Jeff, with dry macular degeneration, it’s not uncommon to have fluctuations in your vision. There are going to be times, both whether in it’s in a day or it’s in an eye, where you’re going to have changes to the vision, where sometimes it’s better and sometimes it’s not. The best thing I would recommend is that, particularly if you notice that there’s a lot of fluctuations in the day, I would make sure that the eyes are very well lubricated. Sometimes dryness can compound the problems that we have inherently, whether it’s from cataracts or macular degeneration, and I would try to assess whether it fluctuates frequently while reading or on the computer—really pinpoint when you notice that there’s fluctuation in the vision.

GUY EAKIN: Thank you. Jeff, I hope that answers your question. We have a set of similar questions coming in from Carol from Ohio, as well as Caroline from California, who are asking about cataracts in the context of macular degeneration. And they’re asking are there situations in which you would have concerns about giving cataract surgery to an AMD patient.

GAYATRI REILLY: That’s a really good question, definitely a question we get almost every day. Prior to just a couple years ago, we didn’t really have a good answer for it, we sort of anecdotally saw that most patients did okay, but there was a recent large study that was just published last year that looked at this: whether patients had mild, moderate, advanced macular degeneration and what happened after they had cataract surgery.

Fortunately, we saw that this had over 1,000 patients enrolled in this, we saw that vision improvement was seen in all these groups, whether mild or advanced macular degeneration, after a cataract surgery. I no longer—I certainly encourage my patients who need to have cataract surgery, and they have macular degeneration, I try to reassure them that from what we know that they can certainly undergo cataract surgery without any expectation that there would be any change to their macular degeneration. The exception to that would be if there has been a change to wet macular degeneration and it’s a bit uncontrolled—as you know, we have treatments for wet macular degeneration, and ideally, we would like the wet macular degeneration to have at least started treatment, and again, this is all assessed in the office just to make sure that things are relatively controlled prior to having any surgery. The best thing would certainly be discussing this with your eye doctor, and they certainly will be able to tell you on a case-by-case basis.

GUY EAKIN: A few calls ago we had a man named Jim Hindman as a guest on our program, and he had an implant in his eye lens that has relatively recently been approved for macular degeneration, and Ann from Mississippi is asking why the telescopic implant can’t be done after a cataract surgery—she’s asking as well about cataract surgery, but also about this implantable telescopic lens that has been recently approved by the FDA.

GAYATRI REILLY: That’s a very good question. It’s more just the technical component of the telescope itself. It actually has to be done in conjunction with the cataract surgery. You can’t have already had the surgery in order to implant the telescope, the telescope is with the new intraocular lens that would be put into the eye at the time of cataract surgery. In order for the device to even be placed, you need to never have had cataract surgery first.

GUY EAKIN: Charles from Georgia has asked, and I think Charles hit on something that I realize we take a shorthand around here, he asked when I say “macular degeneration,” is that any different than AMD?

GAYATRI REILLY: That’s a good question, because there’s a lot of different terms that people end up using for the condition of AMD, and the most precise is AMD, saying its age-related macular degeneration. This is kind of one condition that has a larger umbrella of macular degenerations, so macular degenerations—most commonly, somebody is speaking about macular degeneration, they are talking about the age-related macular degeneration. But there are other macular dystrophies and other conditions that affect the macula that also have a whole completely different set of expectations and prognosis. The nomenclature is certainly very, very important to differentiate, and I will say that most of the time we are saying macular degeneration, we do mean AMD.

GUY EAKIN: And that A stands for age, so I apologize for the shorthand we use, but we’re almost always, like Dr. Reilly, talking about age-related form of macular degenerations, both the dry and the wet form.

There was a question about whether or not the dry could progress into wet, and that is one of the hallmarks of macular degeneration, that it can start off as a dry form and convert over time into wet macular degeneration. Going on to Carmen from Florida, Carmen says that she was diagnosed with AMD a year ago and has had five injections with Lucentis and Eylea*—these are two drugs for wet macular degeneration—and so that was on the left eye for wet and with no results. She went back to Bascom Palmer and they concluded that she had dry in both eyes. She is wondering if the injections ever make things worse, is it possible that the injections could have made her left eye worse?

GAYATRI REILLY: What more commonly—what probably happened was one of the outcomes for the injections for wet macular degeneration is for the fluid that we see, for that to go away and ultimately make the macula dry again. So what I would suspect happened was that in the left eye, you were treated again with the five injections and that it’s transformed the eye from being initially wet and has dried out the macula after these injections. By the time you were examined at Bascom Palmer, the fluid has resolved, which is actually a goal of the injections. So it’s a bit of a longer answer to the question. Injections don’t tend to make the vision worse, or make anything worse in the eye, but it sounds like you got very good care in that, what was wet macular degeneration has now become dried out and the fluid has regressed.

GUY EAKIN: So, I do want to say that some of the words we are using are a little long, we’re naming some names of drugs. We will have, if you give us just a little bit, give us a week or so, we will have the transcript up on our website. We will also have it available if you would like to dial in and just ask for a copy of the transcript, and you can dial it in 1-800-437-2423, just give us a week to prepare that transcript for you.

So, one woman who wrote in with severe AMD in both eyes asked if she could participate in any clinical trials, could you tell her how you go about recommending people to, how they would find out about clinical trials or what clinical trials might be in their own case appropriate?

GAYATRI REILLY: So, there are a lot of clinical trials for wet macular degeneration that are currently enrolling. There’s also a brand new clinical trial for dry macular degeneration that is enrolling patients in the upcoming month, and this is all brand new.

On our website, which is www.rgw.com, if you go to clinical trials, it has a list of all the clinical trials that are ongoing for both wet macular degeneration, for dry macular degeneration, and for other conditions, aside from macular degenerations. And it summarizes what the condition is and what it’s trying to assess, so usually when patients come in, I’ll have a pretty good idea if any of these patients would be eligible for a clinical trial.

GUY EAKIN: Thank you. So, Mary from Illinois has wet macular degeneration in one eye and she has had three injections so far. The doctor is saying that no more are needed at this time, and she’s asking if it could be possible that she would need more in the future.

GAYATRI REILLY: Typically the answer would be yes. Macular degeneration, and the reason why we have so many frequent visits, is that it tends to go up and down, with time. Having such a good result after three injections and possibly needing any, is a very, very good sign. That shows that the eye is responding very well to the medication and overall has a good prognosis. However, it is common, it’s almost more likely that the wet, the fluid will reoccur and you may need more injections in the future, and that’s where the importance of follow ups is so essential, where you still come in initially every month, to every couple of months, to make sure the fluid has not come back.

GUY EAKIN: Ms. Darcy from Colorado wrote in and asked if there are specific types of light that can either help or irritate people who suffer from AMD.

GAYATRI REILLY: It’s been known that blue wavelengths of light are considered to be harmful for eyes in general, for the macula, and blue wavelengths of light have been sort of wondered, and there’s been many, many research trials looking at whether having exposure to blue light impacts macular degeneration. It’s never been actually determined to be the case, but blue wavelengths of light have certainly been found to be somewhat harmful to the macula and its pigment that lie in the macula. On the other hand, bright light—like the LED lights that we have—are very helpful for patients with macular degeneration, because as many of you know, needing more light is part of having the disease and the bright LED lights seem to help patients the most.

GUY EAKIN: There’s another question in here, asking for clarification between what dry AMD is and retinal detachment; so, to my knowledge, they’re separate things, but could you tell us a little more about retinal detachment and any relationship there might be to dry AMD?

GAYATRI REILLY: Sure. Those are two completely unrelated conditions that can happen to your retina, and having one does not predispose you to developing the other at all, and that is always something that’s important. Retinal detachment is actually where the retina, which is the wallpaper of the eye, has separated from the wall of the eye, and there’s usually a retinal tear that has caused this and usually surgery is necessary to reattach the retina to the wall of the eye. Again, what’s very important is having the retinal detachment does not put you at any higher risk of having macular degeneration or vice versa.

GUY EAKIN: Okay. Dorothy from Maryland is asking about just living with macular degeneration. Her husband has dry and is still using his car, and asking if there’s any device that can be installed to help with backing up.

GAYATRI REILLY: Well, there are things like cameras that can be installed in the car to help improve visibility. There’s a lot of things that are available for patients with dry macular degeneration that low vision therapists are very helpful in identifying what would be most helpful. These are optometrists who specialize in these conditions, like macular degeneration and other things that gradually influence your vision and based on what problems that you have, they really help to optimize things, whether it’s LED lights or other devices to improve your quality of life.

GUY EAKIN: Thank you. So, Sue from Michigan is asking, is there still a 40% chance that dry can change to wet even if she’s taking the AREDS supplements, and maybe if you could make a statement about the home monitoring in addressing her question.

GAYATRI REILLY: Yes, so the AREDS vitamins, while they are great and really essential for dry macular degeneration, they decrease the risk—so it can certainly still occur, it does decrease the risk, from what we mentioned, the 40-something percent to about 30-something percent, and while that doesn’t sound like a gigantic difference, it’s still very, very relevant over such a large population of patients who have dry macular degeneration, and so it doesn’t make the risk 0, unfortunately. There are many patients who are taking the vitamins and take it religiously and still, unfortunately, can develop wet macular degeneration, and that’s where the home monitoring device comes in.

What’s so effective about this home monitoring device, it can detect this transformation from dry to wet, way before whether you would notice it or it would impact your ability to read or even just using the Amsler Grid. It detects it much sooner than you otherwise would. The one thing we know about wet macular degeneration is that the sooner it gets detected with better vision, the better that patient will do.

We have a very good amount of treatments that are designed to maintain vision, and it’s always harder to regain vision, so if you come in and your vision is still 20/30, and you’re still able to read and you’re still able to drive, I can tell that patient that my expectation is, is that I’m hoping that we should be able to maintain that, and I’m not expecting you to lose vision because the medications that we have now are very good at maintaining this vision. That’s why I do think the home monitoring device being able to detect it before you otherwise would is so important.

GUY EAKIN: Jim from Virginia asked kind of a nice follow up to that question, is when you’re dealing with wet macular degeneration, how important is it to get the injections and how soon should you start those injections?

GAYATRI REILLY: That’s very dependent on each eye, but frequently we initially do these injections once a month, and they don’t work very well when we’re off schedule. And initially you might need at least three injections, each done once a month, to get enough medication in the eye to start to stabilize things. They don’t work as well if we do one injection and then for whatever reason you come back 3 or 4 months later and then you need another injection. These drugs only seem to last and be effective for about 4 weeks. It is very, very important to keep these follow ups, and your doctor will usually tell you if you can come back in 4 weeks or 6 weeks or even 8 weeks, in some cases, but the follow up is definitely essential.

GUY EAKIN: We have one question asking about itching and dry eye, and there’s, I think it’s a clarification issue, dry eye is a condition that can occur in eyes and it’s different from dry macular degeneration. Could you elaborate on that for us?

GAYATRI REILLY: Absolutely. Dry eye refers to the very front part of the eye, the cornea is the outer shell of the eye, and if you’re not able to produce enough tears, that’s when you get a sensation that something might feel like something’s in the eye, or sometimes you tear a little extra and your eye is very watery, and that’s where lubricating drops and things help with dry eye. Dry macular degeneration affects the back lining of the eye, the retina, which is in the back part of the eye and is more of a process where that area, the macula, starts to get thin as we get older and older.

GUY EAKIN: There’s a number of questions that are coming in about conditions that are important conditions and asking if there’s any recommendation for them. We are going to keep the conversation to macular degeneration right now, improvements on those conditions are certainly something you should discuss with your eye care provider. Dominic from New Jersey is asking if bright sunlight will hurt his eyes, if he doesn’t wear sunglasses. Sometimes when he’s driving he doesn’t see everything that he expects to see, and he wants to know if that is normal?

GAYATRI REILLY: Exposure to bright lights can affect vision in a couple of ways. If you have a preexisting cataract, being exposed to bright light can make your vision worse. Also, exposure to bright lights in general can also accelerate the cataract development, as well as it is slightly implicated with macular degeneration. We usually recommend if at all possible to wear sunglasses so that you decrease the exposure to sun to your eyes, because it is certainly something that accelerates, specifically, cataract formation.

GUY EAKIN: We talked a little bit about blue wavelength light earlier, which blue wavelengths are components of the light that we have in our environment that comes from the sun. We didn’t talk about protecting the eye—I want to say that we have an article that we distribute through the mail and through our website, called the Insights article that talks about choosing the best sunglasses. But Dr. Reilly, could you tell me something about what types of sunglasses or eye protection you might tell people, or any rules of thumb you might give people as they are going out and looking for something that will work for them and their condition.

GAYATRI REILLY: I like polarized sunglasses because they do prevent the harmful UV light and the blue light from being absorbed to the eye. That’s usually what I recommend, but to be honest, any sunglasses is better than no sunglasses at all, so I would ideally recommend polarized sunglasses, but just sunglasses overall.

GUY EAKIN: Thank you so much. We have a question from Doris from Massachusetts, and she’s taking something called PreserVision for dry AMD and she’s asking if there’s something else she should be taking, and I’m just curious, what are the general supplements and things we can buy that you would recommend in your office?

GAYATRI REILLY: Sure. This gets very confusing, because it is available over the counter—we talked about the AREDS vitamins, and there are multiple companies that produce these vitamins. These companies also make a general eye health vitamin that frequently gets advertised on television, and it gets confusing: “Am I supposed to be taking the general eye health vitamin, am I supposed to be taking something else?”

What I usually recommend the most is that there are companies that make the vitamins—and they are called PreserVision, Ocuvite, Focus MaculaPro—these are all vitamins that are meant for macular degeneration, but the part that patients have to be clear about is that when they are buying the vitamins, it does have to say AREDS formula. Any true vitamin that is meant for macular degeneration will either say AREDS, A-R-E-D-S, or AREDS2 formula on it. That’s going to differentiate it from a general eye vitamin that they should be taking.

The AREDS2 formula is a more recent formulation of the original AREDS formula, and it incorporates a couple of extra things—Lutein and Zeaxanthin—into the vitamins, which allow the vitamins to take out Vitamin A. It was at one point important to differentiate whether you smoked in the past or not. For smokers, we did not want them to take AREDS vitamin that had Vitamin A because there is a risk of lung cancer, so to make things a little bit easier and also through the clinical trial the AREDS2 supplementation took vitamin A out completely for all formulations and added antioxidants, Lutein and Zeaxanthin, in order to still prevent the transformation to wet macular degeneration.

GUY EAKIN: Well thank you so much, that’s all incredibly helpful. We are running out of time, the time has just flown by that we have.

We are committed to providing the information that you need most.  Take a moment to let us know if this Chat answered some of the questions that you have about AMD. If you found it very helpful today, we appreciate it if you press 1 on your phone, if you found the topic somewhat helpful you can tell us that by pressing 2, and if you press 3 you’ll be telling us that you did not find the topic helpful and that we have a little bit more work to do.

Thank you so much for taking the time to speak with us today. Thank you to Dr. Reilly for generously going through all the questions with us, and to everyone who joined the call and asked those questions.

Within about a week, we will be posting the recording and the transcript of the call on our website. You can also listen and download the Chat on iTunes or SoundCloud, or you can call 1-800-437-2423,  and you can request the transcript or any of the materials we have and we will put it in the mail for you.

Our next Chat will be on “Low Vision Therapy.” What you should know for the next Chat: it’s on Wednesday, April 29th, 1:00 p.m. Eastern/10:00 a.m. Pacific, and we do encourage you as always to register and submit questions in advance, and we will be sending you a reminder email if you were registered on this call.

You can register right now and request those free materials from BrightFocus, like our “Macular Degeneration Essential Facts” brochure or our fact sheet about “Foresee Home Monitors.” You can do that by calling us at that number, 1‑800‑437‑2423, or visiting our website at brightfocus.org, that’s dot o-r-g.

Thank you again to everyone for joining us today, thank you to Dr. Reilly for providing us with your expertise, and if you’d like to leave a comment after the call, just stay on the line. Thank you from all of us at BrightFocus Foundation and have a great day.

• BrightFocus Foundation website, www.brightfocus.org, or call us at 1-800-437-2423.
• U.S. government website listing clinical trials, clinicaltrials.gov.
• Retina Group of Washington website, www.rgw.com.
• Tips for living with dry AMD:
  • Eat a lot of green leafy vegetables.
  • Avoid smoking.
  • Take the AREDS or AREDS2 vitamins (more information, from NIH: www.nei.nih.gov/research/clinical-trials/age-related-eye-disease-study-2-areds2/public-what-areds-means-you and www.nei.nih.gov/research/clinical-trials/age-related-eye-disease-study-2-areds2/media-questions-and-answers-about-areds2).
  • Wear sunglasses in bright sunlight.
• Monitoring your AMD at home:
  • Amsler Grid
  • Foresee Home Monitor (http://www.foreseehome.com) for the earliest detection of wet macular degeneration in patients who already have been diagnosed with dry macular degeneration. It is now available  for eligible Medicare patients across the US.

The information provided here is a public service of BrightFocus Foundation and is not intended to constitute medical advice. Please consult your physician for personalized medical, dietary, and/or exercise advice. Any medications or supplements should only be taken under medical supervision. BrightFocus Foundation does not endorse any medical products or therapies.

* UPDATE: In October of 2019, the FDA approved Beovu® (brolucizumab) for the treatment of wet macular degeneration. Learn more about this treatment.