Sustained Preservation of Vision in Wet Age-Related Macular Degeneration Through Sequential Shodhana and Chakshushya Rasayana

Abstract

Age-related macular degeneration (ARMD) is a retinal disorder and a major cause of irreversible central visual impairment in older adults. Neovascular (wet) ARMD involves choroidal neovascularization and subretinal fluid, causing rapid visual decline. Although anti-VEGF therapy is standard, repeated injections, prolonged monitoring, variable response, and financial burden may encourage complementary approaches. This case report describes Ayurvedic management of a 49-year-old male with bilateral early wet ARMD. Based on fundus and optical coherence tomography (OCT) findings, the condition was interpreted according to Pitta Vidagdha Drishti, with Kapha-Pitta predominance in the fluid-dominant phase and Vata-Pitta involvement during the chronic stage, with Rasa, Rakta, Mamsa, and Meda Dhatu involvement. Subretinal fluid was considered suggestive of a Rasa-Rakta Abhiṣyanda-predominant, Āmavastha-like stage. Treatment comprised Rukṣaṇa and Sodhana, followed by Samana, Drishti Prasādana, Brimhaṇa therapies. Three inpatient treatment courses were administered, with Chakṣuṣya Triphala Rasāyana continued as maintenance therapy. During 2.5 years of follow-up, best corrected visual acuity improved from 6/36 to 6/18 in the right and 6/60 to 6/18 in the left eye. OCT demonstrated reduction of subretinal fluid and restoration of foveal contour. No adverse events were documented. This case highlights the potential applicability of stage-specific Ayurvedic management in early wet ARMD.