Science & Research

Macular degeneration is the name for a broad category of diseases. Of this broad category, age-related macular degeneration is the most common subtype. The prognosis, treatment, and potential clinical trials depend on the specific type of macular degeneration you have. Please ask your retina specialist to determine the exact type of macular degeneration you have and then you can research your specific disease. Several clinical trial websites are listed on this page of our site:

• www.brightfocus.org/macular/treatment/clinicaltrials.html

In addition, Health Canada is building a similar registry. These websites will be helpful after speaking to your retina specialist.

In several large clinical trials, Lucentis stopped vision loss in 90 percent of patients, and improved vision in about 30 – 40 percent. You mother may not be in the 30 – 40 percent of patients that demonstrates an improvement in vision after taking Lucentis, especially if she has had prior laser treatment for age related macular degeneration. Laser treatment for wet age-related macular degeneration (ARMD) was minimally effective in stopping vision loss from ARMD, and sometimes resulted in scarring of the retina and worse vision. This unfavorable risk to reward profile is why laser treatment is not commonly used today to treat wet ARMD.

There is no evidence that use of computers, tablets, or eReaders is harmful to people with dry or wet age-related macular degeneration (ARMD). In fact, patients with ARMD often benefit from the abilities of these electronic devices to provide increased contrast or enlargement of text. Low vision specialists often recommend such assistive devices when reading for patient with various eye diseases.

Numerous studies have been performed to determine if cataract surgery is associated with increased progression of dry age-related macular degeneration (ARMD), or conversion of dry ARMD to wet ARMD. Though some studies found a link between cataract surgery and exacerbation of dry ARMD, many other studies did not find a link. Currently, the consensus is that cataract surgery is not a definite risk factor for progression of dry ARMD.

Though research is ongoing, no one knows the definitive effects of switching patients with wet age-related macular degeneration (ARMD) from one therapy, such as Lucentis, to another therapy, such as Eylea. The trials performed with Eylea were performed on patients who had never been treated with any medicine for wet ARMD. Though these large clinical trials have demonstrated that overall, both Eylea and Lucentis perform similarly for large groups of untreated patients with wet ARMD, it may be that particular individuals respond better to one medication than the other. However, many patients have been switched between drugs without adverse events in practices across the country. Please ask your retina specialist about the possible reasons for the visual decline, as well as if switching back to Lucentis may be beneficial.

No clinical studies have been published linking wet or dry age-related macular degeneration (ARMD) to myelodysplastic syndrome (MDS). The exact cause of ARMD is not known, but it is thought to be related to environmental toxins, such as cigarette smoke, and genetic predispositions. One such predisposition is a certain mutation in part of the immune system called the complement cascade. Some patients with MDS also have abnormalities in the complement subpart of the immune system, but this is not thought to be a common cause of both diseases.

AREDS supplementation has been shown to slow disease progression in eyes that meet certain criteria based on clinical exam findings. Many people with wet-age related macular degeneration (ARMD) in one eye meet these criteria. If a patient has one eye with wet ARMD and another with dry ARMD, the AREDS supplement is not thought to worsen the eye with wet ARMD, while slowing disease progression in the dry AMD eye. The high levels of vitamins found in the AREDS formulation can have side effects, but in the AREDS clinical trial, the side effects were minimal. The most common side effects were a mild yellowing of the skin and a slight increase in urinary tract infections. If your mother is also taking other vitamin supplements, she should discuss this with both her primary doctor and her retina specialist to avoid any vitamin-related toxicity.

People with high myopia have a higher risk of developing choroidal neovascularization (CNV). In people who have developed CNV in one eye, the risk of developing this condition in the other eye is around 35 percent. Scleral buckling is a treatment for certain types of retinal detachment and would not typically be helpful in the treatment of CNV or myopic degeneration. People with high myopia are also at higher risk for retinal detachment, so it is important to discuss the warning signs with your retina specialist so that you know what symptoms to watch for.