For patients with age-related macular degeneration (AMD), Duke offers state-of-the-art diagnostic, medical, and surgical care, as well as low vision rehabilitation services, orientation and mobility training, and a patient and family support program.
AMD is the leading cause of central vision loss in the Western world in persons over the age of 55.
At Duke, your care team has broad experience and expertise in AMD and includes retina physicians and surgeons, low vision rehabilitation specialists, social workers, and AMD-trained ophthalmic technicians and staff.
Duke Eye Center has been a worldwide leader in dry macular degeneration and wet macular degeneration care and research for the last several decades. Dry macular degeneration -- the more common of the two -- is the deterioration of the macula in the retina. Wet macular degeneration is caused by swelling (edema) from leaky blood vessels in the back of the eye.
Duke physicians have played a major role in the development of current AMD treatments and continue to be leaders in AMD research and clinical trials.
Anti-angiogenesis therapy: Angiogenesis occurs when new blood vessels form. Several medications, including angiogenesis inhibitors or vascular endothelial growth factor (VEGF) inhibitors, limit the growth of new blood vessels or diminish their injury to the retina and may prevent vision loss from wet AMD. Angiogenesis and VEGF inhibitors are typically injected in or around the eye.
The two most common VEGF-inhibitors doctors use to treat wet AMD are bevacizumab (Avastin) and Lucentis. Avastin in the treatment of wet AMD is off-label, meaning it is not FDA-approved for injection in the eye.
There is an ongoing NIH-sponsored clinical trial comparing Lucentis and Avastin. Both Lucentis and Avastin are used widely by retina specialists, and many insurance plans cover these drugs for AMD.
Photodynamic therapy (PDT): Dye is used to make abnormal blood vessels sensitive to light. The dye is injected intravenously and activated by a low-power laser, sometimes called "cold" laser.
Conventional laser therapy: A high-power laser, sometimes called "hot" laser, burns the abnormal blood vessels and overlying retina. This treatment may be used when the abnormal vessels are outside the center of the macula.
Macular translocation surgery: This may be an option if vision continues to worsen despite other treatments such as anti-angiogenesis therapy or photodynamic therapy. Learn more about macular translocation surgery.
In addition to the therapies listed above, other services offered include:
Clinical trials are an important part of AMD patient care and allow for the rigorous scientific testing necessary to develop new and better therapies. Clinical trials research for new AMD therapies is tightly regulated and controlled by the U.S. Food and Drug Administration (FDA).
Because most clinical trials require very specific AMD clinical findings to be present in study patients, many AMD patients are not eligible to participate. Your physician can tell you if you fit the criteria to participate in an AMD clinical trial.
Find out more about clinical trials available at Duke.
To make an appointment for dry or wet macular degeneration treatments or for evaluation for macular translocation surgery in the Raleigh, Durham, or Cary, North Carolina, area, please call 888-ASK-DUKE (888-275-3853).
To refer patients to the Duke Center for Macular Degeneration, call the Duke Consultation and Referral Center at 800-MED-DUKE (800-633-3853).
This single telephone number has been implemented specifically for health care providers to access the Duke University Health System. The referral center hours of operation are Monday through Friday, 7:30 a.m. to 6:00 p.m.
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