Macular Degeneration News
Implant in Development to Restore Vision
CAMBRIDGE, Mass., CLEVELAND, Ohio, & IRVINE, Calif., March 2010 — Researchers have teamed up to create an implant that may help restore vision for people with macular degeneration and other diseases that damage the eye.
The implant contains enzymes that clear disease-related scar tissue. Then, progenitor cells are delivered to grow into new photoreceptors, which replace the light-sensitive cells in the retina damaged by the disease.
The research team from Harvard University, University of California, Irvine, and Case Western Reserve University have found promising results thus far. The implanted progenitor cells took the form of mature photoreceptors in a mouse model after 14 days.
"No one knows what the magic number of cells needed to regain sight is," stated Budd Tucker, PhD, one of the Harvard University researchers. However, he said previous work leads him to suspect that it's a reasonable number.
Now the team is developing a smaller implant that is more biocompatible and will cause less irritation to the eye. Team members said they will soon test the new implant on a diseased eye.
The study was reported in the January issue of Biomaterials.
FDA Approves ForeseeHome Age-Related Macular Degeneration Monitor
ST. LOUIS, February 2010 — The ForeseeHome monitor is a tool for people with age-related macular degeneration (AMD) to detect visual distortions they may be experiencing and to monitor their progress with the disease. (See October 2009 item below for more information.)
The device was in development for a time, and now the FDA has approved it for sale in the United States, for monitoring the wet form of AMD. The device, distributed by Notal Vision, can also transfer data to the patient's eye doctor, as well as the Notal Vision Data Monitoring Center.
Smoking Increases Macular Degeneration Risk More as You Age, So It's Never Too Late To Benefit From Quitting
LOS ANGELES, February 2010 — It is becoming common knowledge that smoking increases your risk for age-related macular degeneration (AMD), possibly by reducing serum antioxidant levels and changing blood flow to the eyes. But some older people may be reluctant to stop smoking, believing that it's too late to benefit from the effects of quitting.
A UCLA study of 1,958 older women found that even after age 80, smoking continues to increase the risk for AMD. The women who smoked had 11 percent higher rates of AMD than other women their same age. But of the women who were over 80, the smokers were 5.5 times more likely to develop AMD than the non-smokers their same age.
The researchers concluded that quitting smoking even late in life may reduce your risk of developing AMD.
The study report appeared in the January issue of the American Journal of Ophthalmology.
CATT Comparison of Avastin and Lucentis Begins
KOLOA, Hawaii, February 2010 — A major clinical trial to compare Avastin and Lucentis has completed patient enrollment, and the first results are expected in January 2011.
The study will compare the effectiveness of the two similar substances in treating age-related macular degeneration (AMD).
Many ophthalmologists have been using Avastin off label to treat their AMD patients because it is less expensive than Lucentis. However, only Lucentis is FDA-approved specifically for such eye applications, while Avastin is approved for treatment of colon and other cancers.
The study, called "Comparisons of Age-Related Macular Degeneration Treatments Trials" or CATT, will also compare fixed vs. variable dosing, to determine the best treatment strategies for certain patients at certain times.
Low-Dose Aspirin = Low AMD Protection?
SAN FRANCISCO, January 2010 — Studies examined whether aspirin and statins, both treatments for cardiovascular disease (CVD), may impact the risk and progression of macular degeneration (AMD). The fact that CVD and AMD share similar risk factors may mean they can share similar treatments.
Researchers evaluated the results from the Women's Health Study, involving one group that took a low-dose aspirin (100 mg) on alternate days, and another group that took a placebo. After 10 years, the aspirin-taking group had 18 percent fewer women who developed AMD than the placebo group.
Although the researchers concluded that the study found no significant benefit from taking low-dose aspirin, they support further research to determine whether aspirin is mildly protective against AMD.
Another study called the Complications of Age-Related Macular Degeneration Prevention Trial examined the effects of statins, a class of lipid-lowering drugs, on advanced AMD patients. The study found no evidence that statins decreased the risk for advanced AMD. However, the researchers noted that factors may be concealing protective effects of statins because patients taking the drugs for CVD have a high risk for AMD also.
The studies were reported in the December issue of the journal Ophthalmology.
Artist Portrays What Vision Is Like for People With Macular Degeneration
LONDON, December 2009 — For those of us who don't suffer from age-related macular degeneration (AMD), it's difficult to imagine what the world would look like with the associated vision loss.
Portrait painter Adam Hahn of London, England, decided to find out. He painted portraits of people with AMD, and before he started each one, he talked to the subjects about their vision.
The paintings are an attempt to show how each person sees him- or herself with the partial sight they have.
Hahn started the project in memory of his grandmother, who also had AMD. The portraits are wholly or partially blurred, and most are in a palette of black, white and grays, perhaps to indicate the deterioration of color vision that many people with AMD also experience.
Cataract Surgery Benefits Macular Degeneration Patients
SAN FRANCISCO, November 2009 — Both mild-stage and advanced-stage macular degeneration patients benefit from cataract surgery, according to an evaluation of 1,244 patients from the Age-Related Eye Disease Study (AREDS) that was funded by the National Eye Institute.
This is contrary to previous findings that cataract surgery might make macular degeneration worse.
On average, the study participants gained visual acuity after cataract surgery. It didn't matter whether their macular degeneration was the wet form or the dry form.
Emily Chew, MD, led the study, and the report appeared in the November issue of the journal Ophthalmology.
Blue Light-Filtering IOLs May Help Protect Against
Age-Related Macular Degeneration
WATERFORD CITY, Ireland, November 2009 — Although it is not clear why, implanting a blue light-filtering intraocular lens (IOL) during cataract surgery increases the amount of macular pigment in the eye, which may protect against the development and progression of age-related macular degeneration.
This is according to a new study published in the October issue of Investigative Ophthalmology & Visual Science.
Macular pigment consists of lutein, zeaxanthin and meso-Z and has antioxidant properties. It enters the body through diet.
The eye's natural lens blocks blue light from reaching the retina, and when it is removed during cataract surgery, that blue light may increase the incidence of macular degeneration. Replacing it with a blue light-filtering IOL may slow or reduce the incidence.
The 42 study patients were randomized to implantation with a blue light-filtering IOL or a standard acrylic IOL. Researchers measured the optical density of the macular pigment in their eyes as well as the serum concentrations of the macular carotenoids. Both measurements were done before the surgery and several times afterward during a one-year follow-up period.
Coming in 2010: A Device That Monitors Your Vision at Home
BLOOMINGTON, Minn., October 2009 — After a diagnosis of the dry form of age-related macular degeneration, it's important to monitor your vision to see if it's progressing to the more severe stage (wet AMD). Why? Because treatment is most effective at this point.
Getting treatment before you experience visual symptoms is the best way to slow or minimize vision loss.
One way to monitor your vision is to use the ForeseeHome AMD Monitor, a device for home use. Basically, you sit in front of a screen, and with one eye covered, you respond to distortions you see on the screen.
It takes about five minutes for each eye.
The technology used by the ForeseeHome monitor is the same as in the FDA-approved Foresee PHP, which eye doctors use in their offices to monitor patients.
The main advantage of the home version is that you can test your vision more often, even several times a week, to really stay on top of your eye condition.
Sightpath Medical plans to make the ForeseeHome monitor available early next year.
Please click here for a closeup photo.
Taken Orally, Fenretinide Shows Promise as AMD Treatment
FORT LAUDERDALE, Fla., September 2009 — For the 90 percent of age-related macular degeneration (AMD) patients who have the dry form of the disease, oral fenretinide may slow or halt the progression of the geographic atrophy (GA) that occurs with it. GA forms a circular lesion in the very center of the macula; it is considered the end-stage of dry AMD and causes major central vision loss.
Oral fenretinide is undergoing a two-year evaluation involving 246 people with GA due to AMD. Preliminary results show that starting the treatment in the early stages of the disease before serious damage occurs seems to slow or halt the GA.
One advantage of this medication is that it's taken orally once a day, unlike other treatments that are injected into the eye periodically. Several side effects have appeared, including night blindness or delay in dark adaptation, dry eye, anemia and elevated liver enzyme levels. But patients were willing to continue treatment because of the potential benefits.
The preliminary results were reported at the Association for Research in Vision and Ophthalmology annual meeting. The study will end in spring of 2010, when it will be decided whether oral fenretinide should be evaluated further as an AMD treatment.
Systemic Avastin Tested as Alternative to Lucentis
Injections in the Eye
VIENNA, August 2009 — One treatment for age-related macular degeneration is periodic injections of the drug Lucentis into the eye. But researchers in Austria have been investigating whether this type of drug could work if it were injected elsewhere in the body.
In a study of 16 eyes, participants received infusions of either Avastin or sodium chloride every two weeks. Avastin is a cancer drug very similar to Lucentis that is sometimes used off-label for macular degeneration treatment.
After six months, lesion size and macular thickness decreased in the Avastin group, though visual acuity had the same stability level in both groups. The Avastin group also had a treatable rise in blood pressure.
The scientists, based at Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, concluded that systemic Avastin could be an option for people with AMD in both eyes and/or those who refuse eye injections, if they have normal blood pressure and no history of thrombosis. They published their findings in the British Journal of Ophthalmology (April).
Predicting Macular Degeneration Involves Both
"Nature" and "Nurture" Factors
BOSTON, July 2009 — Early screening for macular degeneration (AMD) may be possible with a predictive model resulting from a new study by researchers at Tufts University School of Medicine.
The researchers analyzed data collected from more than 1,400 people in the Age-Related Eye Disease Study (AREDS), with an average follow-up time of 6.3 years. They also genotyped genetic specimens to evaluate the role of genetics in AMD risk calculations.
One of the study conclusions was that even though AMD risk is strongly genetic, living in a healthy way (not smoking, controlling weight) can reduce that risk. In one example, people with a certain genetic makeup (the "homozygous C3 risk genotype") had a three-fold risk for progressing to the advanced form of AMD if they didn't smoke. But the smokers in that group had a 10-fold risk.
A report on the study appeared in the journal Investigative Ophthalmology & Visual Science in May.
Ozurdex Steroid Implant for Macular Edema Now Available
IRVINE, Calif., July 2009 — Ozurdex, a biodegradable, injectable steroid implant, has received FDA approval for treatment of macular edema following branch retinal vein occlusion or central retinal vein occlusion.
Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy, according to Ozurdex's manufacturer, Allergan. RVO can cause significant vision loss.
Ozurdex contains dexamethasone, a corticosteroid, and is delivered into the back of the eye via a sustained-release injectable implant.
"In the clinical studies, 20 to 30 percent of patients suffering from this severe retinal condition experienced a three-line improvement in best-corrected visual acuity with an onset of effect within the first two months following therapy," said Scott Whitcup, MD, Allergan's executive vice president, research and development and chief scientific officer.
A "line of improvement" means that vision has improved to the point that a line of previously unreadable smaller text on an eye chart can now be seen.
Ozurdex is not recommended for people with certain eye infections, advanced glaucoma or hypersensitivity to corticosteroids.
Trans Fats May Increase Macular Degeneration Risk
MELBOURNE, Australia, June 2009 — Eating higher amounts of trans-unsaturated fats is associated with increased incidence of the vision-destroying disease age-related macular degeneration (AMD), says a recent study.
From 2003 to 2006, researchers checked macula photographs of 6,734 participants' eyes for signs of early and late AMD. Then they compared the evaluations with nutrient intake information supplied by the participants.
Late AMD risk was higher in people who ate a lot of trans-unsaturated fats. But eating fatty acids and olive oil seemed to reduce the risk of AMD. Fish, total fat, butter and margarine did not show significant associations with AMD.
Trans-unsaturated fats are a known cause of heart disease. They are hardened fats that raise levels of bad cholesterol (LDL) and lower levels of good cholesterol (HDL). Doctors recommend that people avoid their consumption altogether, and they are gradually disappearing from processed foods.
The study report appeared recently in Archives of Ophthalmology.
Study Supports Injections of Anti-VEGF in Both Eyes on Same Day
FORT LAUDERDALE, Fla., May 2009 — With advanced macular degeneration in both eyes, people who need injections often have the extra burden of undergoing an injection in one eye only to be told they need to return to the clinic on another day for an injection in the second eye.
This is a problem particularly for those who live far from the clinic or who must rely on others for transportation.
So why is it done this way? Most eye doctors are reluctant to perform an invasive procedure on both eyes during the same visit. If anything goes wrong, then the patient risks having a problem in both eyes instead of just one.
But a study that examined results from 102 people who had received injections in both eyes (bilateral) and 102 who had received unilateral injections of anti-VEGF (either bevacizumab or ranibizumab) for macular degeneration found no difference in risk between the two methods.
The bilateral injections were done during the same visit, but separate trays of sterile instruments were used along with drugs from different manufacturer lots. So even if one eye developed infection or suffered an allergic reaction from the instruments or drugs, chances were that the other eye would not.
The study results were presented at the 2009 annual meeting of the Association for Research in Vision and Ophthalmology.
Macular Degeneration Cases Expected to Double by 2050
RESEARCH TRIANGLE PARK, N.C., April 2009 — Researchers predict that the number of people with age-related macular degeneration (AMD) in the United States will double by 2050 to more than 17.8 million. This is largely influenced by the baby boomer generation reaching retirement age, as the incidence rate increases from 1 percent for people 60 and younger to more than 5 percent for those 80 and older.
Without treatment, approximately 1.6 million AMD cases in 2050 would result in visual impairment and blindness; but existing treatments could reduce the number by 35 percent. Current treatments include vitamin prophylactic therapy (meaning, preventive vitamin use, which costs only about $100 per patient annually) and anti-vascular endothelial growth factor (anti-VEGF) injections.
The study found that vitamin prophylactic therapy, which slows the progression of AMD, alone could reduce visual impairment and blindness by 23 percent if used universally among early AMD patients. The sole use of anti-VEGF injections, which prevents the growth of blood vessels in the eye, could reduce the number by 17 percent for those in an advanced stage of the disease.
The study's lead author, David Rein, PhD, from RTI International, acknowledged that medical technologies are changing rapidly, as no treatments for AMD existed 10 years ago. Future advancements may lead to an even greater reduction in visual impairment and blindness from AMD, according to Dr. Rein.
The study was published in the April issue of Archives of Ophthalmology.
Implantable Eye Telescope Recommended for FDA Approval
SARATOGA, Calif., April 2009 — The Implantable Miniature Telescope (IMT), developed by VisionCare Ophthalmic Technologies, Inc., has received a unanimous recommendation for approval by the FDA Ophthalmic Devices Advisory Panel.
The panel recommended use of the IMT for end-stage age-related macular degeneration (AMD), with conditions including post-approval surveillance and labeling suggestions.
Photo: VisionCare Ophthalmic Technologies
The tiny IMT is implanted in one eye and is designed to send central vision images, magnified up to three times, over a wide area of the retina. It is the central part of the retina that macular degeneration damages most. By focusing images on other, healthier areas of the retina, the IMT can reduce the central "blind spot" that impairs vision in an AMD patient.
The eye without the IMT provides peripheral vision, which AMD doesn't affect as much. This provides the patient with mobility and navigation.
Usually FDA approval follows on the heels of recommendations by the advisory panel.
Chronic Kidney Disease Linked to Macular Degeneration
MADISON, Wis., March 2009 — Chronic kidney disease and the presence of serum cystatin C (a marker for kidney disease) have been associated with the incidence of age-related macular degeneration (AMD) in participants of the Beaver Dam Eye Study.
Serum cystatin C is found in retinal pigment epithelium cells. In this new analysis, its presence was associated with the incidence of early AMD and exudative AMD (in which abnormal blood vessels grow within the eye). Results were similar in both genders and increased with age.
Mild chronic kidney disease itself was associated with early AMD.
The researchers, from the University of Wisconsin School of Medicine and Public Health, said the underlying biological processes for these links are still unknown. The study was reported in the February issue of Archives of Ophthalmology.
The well-known Beaver Dam Eye Study began with 4,926 residents of Beaver Dam, Wis., in 1988, with follow-up examinations of participants every few years. Macular degeneration is but one of the many eye conditions that the study has measured.
Vitamin B Supplements May Help Prevent Macular Degeneration
BOSTON, March 2009 — Significant findings from a large study show that taking certain vitamin B supplements could reduce chances of developing age-related macular degeneration, which can be blinding in advanced forms.
Vitamin supplements including B-6, folic acid and B-12 reduced homocysteine levels in the blood, according to study results reported by Brigham and Women's Hospital researchers.
Some theories indicate that these higher homocysteine levels can cause heart disease, although previous studies have not confirmed this.
But in the recent study, researchers postulate that reducing homocysteine levels in the blood may help prevent diseases related to impaired function of small blood vessels — including macular degeneration and certain types of stroke.
The study was designed to follow more than 5,000 women who were 40 or older when the investigation began. These women also were considered at risk of developing cardiovascular disease.
After about seven years, researchers found that women who took vitamin B supplements had a 35 percent to 40 percent decreased risk of developing macular degeneration.
The study could not assess the value of vitamin B supplementation for preventing advanced forms of macular degeneration, because too few participants developed a progressive form of the eye disease.
Study results were reported in the February issue of Archives of Internal Medicine. 
Please click here for more macular degeneration news from 2008.
[Page updated March 16, 2010]
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