In This Issue...
- President’s Corner
- Macular Degeneration: Signs and Symptoms
- Clinical Trial Aims to Reduce AMD Injections
- Register for BrightFocus Chats!
Free monthly calls about AMD
- Understanding the Role of Sleep Apnea in AMD
- Provide Security for Your Loved Ones
… and help fight AMD!
Update on The Macular Degeneration Drug Pipeline
Current effective treatments for wet age-related macular degeneration (AMD) often require monthly eye injections to preserve vision. There is no treatment at all for advanced dry AMD. Fortunately, research and drug developments are advancing rapidly. A number of clinical trials are under way to make better treatment options available to people affected with either form of AMD. Some examples are:
This new drug blocks vascular endothelial growth factor (VEGF), a protein that leads to abnormal blood vessel growth in the eye. Now in a Phase 3 clinical trial, it can last as long as 12 weeks between eye injections. Approval by the U.S. Food and Drug Administration (FDA) is expected in 2019.
The Port Delivery System (PDS) is a device implanted by a doctor into the wall of the eye in an operating room procedure. This device stores and slowly releases the anti-VEGF drug Lucentis®. This approach may result in fewer office visits and treatments. Scientists have started enrolling patients for a Phase 3 clinical trial. To learn more about this exciting advance, see the clinical trials article on page 4.
VEGF isn’t the only protein that triggers leaky blood vessel growth in the eye, so other drugs targeting different proteins, in combination with antiVEGFs, are being tested. One of these, dorzolamide-timolol (Cosopt®), an eye drop used to treat glaucoma, has been shown to decrease fluid buildup in the retina when used in conjunction with injected antiVEGF drugs. This is now being tested in a Phase 3 clinical trial.
- Lipoic Acid
In a current Phase 2 clinical trial, alpha-lipoic acid is being used to treat advanced dry AMD, also known as geographic atrophy. This dietary supplement is able to remove excess iron, believed by many scientists to contribute to retinal damage, from the body. This trial is funded in part by Macular Degeneration Research and is expected to finish in the spring of 2019.
This drug has been shown to slow the expansion of the area of atrophy in people with advanced dry AMD, protecting their field of vision. APL-2 is injected into the eye either monthly or every other month and neutralizes a protein called C3 that promotes inflammation in the eye. Now in a Phase 3 clinical trial, APL-2 is also being tested for treatment of wet AMD.
I’m confident that we will one day stop AMD.
As our cover story shows, research developments are advancing rapidly. A number of clinical trials—including one funded in part by Macular Degeneration Research—give hope for better treatments to people with both the wet and dry forms of AMD.
That’s not all. As you’ll see in this issue of Macular Degeneration Research News, one of our grantees is investigating the link between AMD and sleep apnea. This could ultimately help prevent vision loss among people who suffer from this common sleep disorder. Plus, you’ll find helpful information about signs and symptoms of AMD.
With your support, we will continue to fund pioneering studies and provide critical information to help people protect their sight. Thank you for your generosity!
Stacy Pagos Haller
Macular Degeneration: Signs and Symptoms
AMD causes no pain and—particularly if only one eye is affected—you may not notice any symptoms in the early stages. However, an eye doctor may be able to detect early signs of it before symptoms appear. That’s why it’s vital to have regular, comprehensive eye exams.
Signs of early dry AMD include slightly blurred central vision, both close up and far away. The center of vision may become fuzzy or shadowed. As the disease progresses, this area grows larger. Blind spots may develop, and you may have more difficulty seeing color and fine detail.
These same symptoms can occur in wet AMD. In addition, straight lines may appear wavy. Central vision loss can occur rapidly, sometimes within weeks or even days.
AMD can cause other symptoms that can affect daily life, including:
- Visual field defect
The wide angle of vision that a healthy eye can see is called the “visual field.” As AMD progresses, the center of your visual field may become smudged, distorted, or lost. This can cause problems with reading, driving, watching TV, and recognizing faces.
- Decreased contrast sensitivity
This makes it harder to distinguish between colors when two similar hues are placed side by side. It can also get harder to see textures and subtle changes. Being unable to see slight contrasts in pavements and stairs, for instance, can increase the risk for falls.
- Poor tolerance for changing light levels
It can become hard for your eyes to adjust when driving or walking at sunset, or when going from a well-lit room to a darker one. Glare can worsen the problem. For example, a bright shaft of sunlight streaming in through a window may cause everything outside the glare to “black out.”
- Need for higher light levels
You may find that you need brighter lights for reading, cooking, and other daily tasks.
- Impaired depth perception
An inability to properly judge distances can also make walking harder, which could lead to falls.
New Clinical Trial Aims To Reduce Frequency of AMD Injections
Appearing on a recent BrightFocus Chat, a top scientist from Genentech shared details on a new clinical trial the pharmaceutical company is launching to reduce the frequency of eye injections that wet AMD patients require.
The clinical trial, known as Archway, will test an experimental Port Delivery System—a small device implanted in the eye that is about the size of a grain of rice. According to Dr. Chris Brittain, the company’s Interim Global Head of Ophthalmology and Clinical Development, it will contain a small reservoir of ranibizumab, a medicine commonly known as Lucentis®.
In an earlier phase of the clinical trial involving 220 participants, 80 percent of volunteers were able to go six months before requiring a refill of the product, which is done through a minimally invasive officebased procedure. This result is significant because it shows promise of reducing the burden of injections which patients receive as frequently as every four weeks.
Archway will take place in sites across the country and will expand upon these encouraging results by enrolling 360 participants. This Phase 3 trial will further test the device’s safety and effectiveness compared with monthly ranibizumab injections in participants with wet AMD.
To learn more about this trial or find study sites, please call the Genentech Clinical Trials Information Line at 1-888-662-6728. We encourage you to share this information with your eye doctor.
Understanding the Role of Sleep Apnea in AMD
Why do people with sleep apnea suffer more often from AMD?
That’s the question that Macular Degeneration Research grantee Florian Sennlaub, MD, PhD, of the Fondation Voir et Entendre in France, is trying to find out.
Dr. Sennlaub’s previous research showed how a variant of complement factor H (CFH)—a strong genetic risk factor—impedes waste removal in the retina and encourages inflammation. Now, his preliminary data on sleep apnea suggests that the frequent bouts of oxygen deprivation which characterize this common disorder activate immune cells and lead to increased expression of CFH. This in turn promotes longer and stronger inflammation in the eye in AMD.
“The key to understanding the disease process and to developing efficient therapies is to understand more about the environmental and genetic risk factors that trigger the disease in the first place,” says Dr. Sennlaub.
His Macular Degeneration Research grant will help him discover how sleep apnea further fuels the chronic inflammation that leads to retinal degeneration. “Increased awareness of this mechanism will help us to diagnose and treat sleep apnea in affected AMD patients, inhibiting inflammation, degeneration, and vision loss in the future,” he says.
Provide Security For Your Loved Ones and Help Fight AMD!
One way you can benefit your loved ones and also help Macular Degeneration Research is to create a charitable remainder trust. This method of giving provides income to loved ones for the rest of their lives or for a term of years. After that, the remainder goes to us to help fight AMD.
How It Works
- You decide which assets to donate. Popular options include cash, stock, or real estate.
- You choose who you would like to benefit from the trust.
- Those beneficiaries receive income for the rest of their lives or a specified number of years.
- After their lifetimes or a term of years, the remaining assets are given to us to support our mission.
How You Benefit
- A potential income tax charitable deduction for a portion of the full fair market value (not the cost basis) of the assets placed in the trust, when you itemize.
- Elimination of any up-front capital gains tax when you fund the trust with long-term appreciated property.
- Fulfillment in knowing you help fight AMD.
To learn more about a charitable remainder trust and the benefits you could receive, please contact Lauren Fields, Manager, Planned Giving, at 855-345-6637 or Lfields@brightfocus.org.
The information provided in this section is a public service of BrightFocus Foundation, and should not in any way substitute for the advice of a qualified healthcare professional, and is not intended to constitute medical advice. Although we take efforts to keep the medical information on our website updated, we cannot guarantee that the information on our website reflects the most up-to-date research. Please consult your physician for personalized medical advice; all medications and supplements should only be taken under medical supervision. BrightFocus Foundation does not endorse any medical product or therapy.
Some of the content in this section is adapted from other sources, which are clearly identified within each individual item of information.