Dry Macular Degeneration - what’s new in 2025?
Dry macular degeneration is a leading cause of visual impairment in the UK, affecting thousands, particularly the elderly. Despite its prevalence, there remain no effective treatments to halt progression, leaving many patients with gradual vision deterioration. Current management focuses on supportive care, but the lack of viable medical interventions remains a significant challenge.
Over the past five decades, various treatments for dry macular degeneration have been explored, including subthreshold diode laser, radiotherapy, and light modulation therapies. Subthreshold diode laser aimed to slow retinal damage but lacked consistent efficacy. Radiotherapy showed promise in targeting degenerative processes but failed due to side effects limited effectiveness.
Light modulation therapies, such as photobiomodulation, have demonstrated potential in early trials, but long-term benefits remain uncertain because the trials have faced methodological flaws, including poor study design, small sample sizes, and lack of statistical significance. Many studies fail to use randomised controlled trials or adequate blinding, leading to potential investigator bias. Additionally, the low number of participants limits the ability to draw meaningful conclusions, reducing the reliability of findings. Without large-scale, well-structured trials, results remain inconclusive, preventing widespread clinical adoption other than in isolated private clinics.
Several active clinical trials are investigating intravitreal agents for the treatment of dry macular degeneration, particularly geographic atrophy (GA). Studies are evaluating BI 771716 and BI 1584862, both aiming to slow disease progression. GAL-101 eyedrops are being tested for their ability to prevent GA from reaching the fovea. Additionally, JNJ-81201887 is undergoing long-term safety assessments following intravitreal injection. These trials focus on reducing retinal damage, but definitive treatments remain elusive.
Supportive treatment for dry macular degeneration includes evidence-based dietary supplements, particularly AREDS2 formula, which contains vitamins C and E, lutein, zeaxanthin, zinc, and copper. These supplements are recommended for patients at high risk of progression to advanced disease.
Low vision support services in the UK provide practical assistance, including magnifiers, adaptive technology, and rehabilitation programs. Organisations such as the RNIB and Macular Society offer guidance, emotional support, and accessibility tools to help individuals maintain independence.
