Advancing Macular Degeneration, Advancing Treatments
Last updated: October 2019
To all you newly diagnosed AMD folks...Congratulations! Your planning is brilliant and your timing is impeccable!
No...I am serious. I really mean that. You have “chosen” to develop a retina disease at the best time ever in human history. As I have said elsewhere, this is a great time to be going blind!
You may not feel like you are fortunate but you are. The fate of the blind throughout history has not been pretty. There are still parts of the world that the job openings for the blind are either in begging or prostitution. Your choice. And that is a step up from those times and places that the blind were killed.
History of cataract surgery
Even in the developed world, it has been only recently that we have been successfully treating vision loss. According to Geetha Davis, MD, while the first reported surgical cataract removal was in 1747, permanent artificial lenses were not implanted until 1950 by Harold Ridley in Great Britain.1 Before that, past cataract folks had to wear “coke bottle bottom” lenses. Hmmm...do you think Mr. McGoo had had cataract surgery?
History of anti-VEGF injections
And how about a type of vision loss that is nearer and “dearer” to our hearts? According to Kim and D’Amore writing for the American Journal of Pathology in 2012, it was Pegaptanib that was approved as the first anti-VEGF treatment for wet AMD. Wanna guess the date? Try December 17, 2004, for the first FDA approval of a treatment for neovascular AMD.2 Less than 15 years ago. I have jeans older than that!
In those 15 years, the options for treating wet AMD have multiplied. There are now four, main, anti-VEGF drugs and they are researching a variety of other possibilities. They are also researching longer-acting forms of current drugs and delivery systems that are hoped to ease the treatment burden of “eye shots.”
While dry AMD has been the proverbially harder nut to crack, things are moving in that theatre of endeavor as well. Those of us with early and intermediate dry AMD are keeping an eye on LumiThera and other producers of photobiomodulation equipment. The preliminary evidence suggests light therapy can be used to reduce the size of drusen and slow the progression of the disease before there is significant vision loss.
Complement factor inhibitors
Those of us with moderate level losses - like me! - are being recruited for studies with complement factor inhibitors. These break the chain of chemical signals that lead to an autoimmune reaction in our eyes. If we can slow down the rate at which our innate immune system attacks healthy retinal tissue, we can slow down disease progression.
Stem cell research
They are also moving ahead with regenerative medicine. I was recently contacted by someone being recruited for a phase 1 stem cell study. Stem cell research remains in the early days but is progressing. Will we someday be able to grow our own replacement parts? I believe we will and my personal opinion is it will happen within the next decade.
But if you don’t want to grow your own, new parts, how about becoming a cyborg? Bionic eyes are real. Some are mounted on glasses with a direct connection to the vision centers of the brain. Others are actually implanted in the eye itself and interface with the optic nerve.
The pace of research on AMD is staggering. We are on the verge of new discoveries on a number of fronts. Follow the research and you will see. In a few years, new AMD patients will have little if anything to fear.
Welcome to an exciting time in history. Congratulations! Your timing is impeccable.
Do you find that fear interferes with your ability to regularly go to eye specialist appointments?