In This Issue...
- A New Imaging Method May Predict Wet Macular Degeneration
- President’s Corner
- Potential New Treatment Could Reduce Frequency of Eye Injections
- Iron and Macular Degeneration
- A New Treatment Target Could Lead to Powerful Therapies
- Register for BrightFocus Chats!
Free monthly calls about macular degeneration
- Eye Doctor Addresses Importance of Clinical Trials
- How a Will Can Keep Giving Long Into the Future
A New Imaging Method May Predict Wet Macular Degeneration
Macular degeneration takes a long time to develop and progress to vision loss. Yet currently, there are no tools to predict when damage will occur or when to start treatment to prevent deterioration of vision.
Now, that may be changing. Macular Degeneration Research grantee Ji Yi, PhD, at Boston Medical Center, is working to develop a new technique to detect the disease’s progression by measuring the permeability of the retinal pigment epithelium (RPE).
The RPE is a layer of cells at the back of the retina. One of its functions is to maintain a barrier from the choroid, which contains blood vessels that nourish the retina.
“The choroidal vessels are actually fairly leaky,” notes Dr. Yi. “This makes the integrity of the RPE barrier important, because the compromise of the barrier function can lead to fluid buildup in the retina.” This happens in wet macular degeneration, where abnormal blood vessels grow and leak fluid into the retina.
Dr. Yi is working on developing three-dimensional imaging techniques to measure leakage through the RPE, which could gauge the disease’s progression. “We will use an animal model of macular degeneration to… see if RPE permeability can be quantified simply by shining a light into the eye,” he adds.
I look forward to the day when we can stop macular degeneration—when no one has to face the threat of irreversible blindness from this disease.
Scientists we fund are working tirelessly to make that day a reality, as you’ll see in this issue of Macular Degeneration Research News.
Our cover story shows how one researcher is developing a new imaging technique that could improve the diagnosis of wet macular degeneration to help prevent vision loss. Another is investigating what causes dysfunction of the RPE in the first place, which could lead to powerful new therapies.
We’ve also included an update about a promising new treatment for wet macular degeneration that could become available this year.
Thank you for enabling us to support vital research and provide sight-saving information to the public. Together, we will find a cure for macular degeneration!
Potential New Treatment Could Reduce Frequency of Eye Injections
[ UPDATE: In October of 2019, the FDA approved Beovu® (brolucizumab). Learn more about this treatment. ]
Currently, wet macular degeneration is treated with eye injections every 4 to 8 weeks, using drugs such as Lucentis®, Avastin®, and Eylea®.
But soon, a longer-lasting treatment may become available.
In a Phase 3 clinical trial, a new drug called brolucizumab (pronounced broh-luh-siz-yoomab), given every 8 to 12 weeks as needed, compared favorably to Eylea, given every 8 weeks.
Specifically, brolucizumab showed superior resolution of fluid that had leaked from abnormal blood vessels into the retina during weeks 36 to 48 of the study. In addition, visual acuity for those treated with brolucizumab was at least as good as for those treated with Eylea.
Brolucizumab works by inhibiting vascular endothelial growth factor (VEGF), a protein that promotes growth and leakage of abnormal blood vessels. Avastin, Lucentis, and Eylea also inhibit VEGF, but brolucizumab’s different structure may influence its ability to penetrate the retina and target VEGF. Moreover, its higher dose may enable it to last longer, so patients require fewer eye injections.
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Iron and Macular Degeneration
If you have macular degeneration, certain steps may help reduce your risk of vision loss: Don’t smoke. Eat a diet rich in vegetables, fruits, and fish. And avoid excess iron in your diet.
Iron can produce free radicals and cause oxidative damage that leads to this disease, says Joshua Dunaief, MD, PhD, at the University of Pennsylvania. “Research over the past 15 years in my laboratory and others around the world has suggested that excess iron may increase the risk of macular degeneration.”
A large clinical trial in Australia found that people who ate more red meat had a higher risk for macular degeneration. One possible reason: high iron levels.
“When we eat red meat, 50 percent of the iron gets absorbed because of the form that it’s in. That can overload our bodies,” says Dr. Dunaief. He recommends limiting red meat consumption to once a week or less. Although other foods contain a lot of iron—like spinach—it’s in a form not readily absorbed by the body.
Iron supplements can also lead to excess buildup. However, whether iron supplementation may increase the risk of macular degeneration is still largely unknown.
Dr. Dunaief has found that people with macular degeneration who donate their eyes after death have more iron in their retinas compared to those from healthy donors of similar ages. In addition, when he tested mouse models that accumulate a lot of iron in their retinas, he found that the buildup caused damage similar to macular degeneration.
“Iron levels need to be just right,” says Dr. Dunaief. He recommends people ask their doctor for a ferritin level test. A normal level is in the 40-80 range. Over 100 means a person probably has more iron than necessary.
A New Treatment Target Could Lead to Powerful Therapies
[ UPDATE: *In October of 2019, the FDA approved BEOVU® (brolucizumab). Learn more about this treatment. ]
The RPE nourishes the retina and removes waste products. Its health and protective functions depend on a highly regulated metabolic process that controls energy production and the detoxification of the resulting by-products. When this process is impaired, it can lead to macular degeneration.
But what causes such impairment in the first place?
That’s the question that Magali Saint-Geniez, PhD, at Harvard Medical School, is answering. Her team recently identified a novel protein linking RPE metabolism to the abnormal blood vessel growth seen in wet macular degeneration. Now, as part of her Macular Degeneration Research-funded study, Dr. Saint-Geniez is investigating how dysregulation of this protein alters RPE energy production and promotes disease.
Dr. Saint-Geniez is committed to finding a cure. “Spending my summers with my dearly loved aunt on a farm in the south of France, I watched her going blind from macular degeneration,” she explains. “I am more determined than ever to use my research to restore sight, hopefully allowing my aunt to one day see my little boy’s face.”
She deeply appreciates the grant she received and the supporters who made it possible. As a result of her study, Dr. Saint- Geniez notes, “My laboratory will be better able to understand how macular degeneration progresses to the most severe and blinding state of the disease, with the hope of discovering new and potentially very powerful therapies.”
Register for BrightFocus Chats
Recently diagnosed with macular degeneration? Know someone who has it? Receive helpful information from our FREE monthly phone call with doctors, researchers, or experts in the field on timely topics. You can submit questions before or during the event. Transcripts and audio recordings are available afterward on our website.
To register, call 800-437-2423 or go to brightfocus.org/eyechats.
Eye Doctor Addresses Importance of Clinical Trials
At a recent BrightFocus Chat, Gayatri Reilly, MD, with the Retina Group of Washington, spoke of the importance of clinical trials in vision research. These are excerpts from that interview:
What do you suggest people do if they want to learn more about clinical trials?
Dr. Reilly: It really helps to have family involved in the initial discussion so everybody hears the same thing. Be prepared with a list of questions: What is the treatment? What are my expectations? How often will I be evaluated? What are the possible risks? Side effects? How do I know if the medication is working? What is being done for my safety?
What prompted you to want to help lead a site for a clinical trial?
Dr. Reilly: It was being able to offer something that we can’t offer right now. I think it’s so exciting to be able to investigate something that has the potential to be better, such as a better drug, or one that might last longer or be a completely different way to treat the eye than we’ve already been doing. We spend a lot of time going through numerous clinical trials that are brought to us to make sure anything that we offer is going to be safe and good for the patients.
To receive a free copy of Clinical Trials: Your Questions Answered and learn how you can participate in clinical research, visit brightfocus.org/clinicaltrials or call 855-345-6637.
This is the last in a series of articles promoting awareness of clinical trials that are supported in part by an educational sponsorship from Biogen. BrightFocus is solely responsible for the content of the article.
How a Will Can Keep Giving Long Into The Future
A will or living trust helps you protect your loved ones long after your lifetime and also support the causes you care about.
Here are a few basics about using your will or trust to make a lasting difference to Macular Degeneration Research’s sight-saving work:
How to Make Your Gift
Including us in your will or trust is easy. Start by contacting us to request official wording for your gift. Then, ask your estate planning attorney to use this language when you create your will or trust. If you already have a will or trust, simply ask your attorney to update the existing document.
- It’s worry-free. You won’t give anything away until after your passing, so you can keep using your possessions and finances.
- You have choices. You can give us a specific item, an amount of money, a gift contingent upon certain events, or a percentage of your estate.
We’re Here to Help
To learn more about making a will, please visit us at brightfocus.org/plannedgiving or contact Charlie Thomas, Manager, Planned Giving, at 301-556-9397 or firstname.lastname@example.org. The impact you can have is priceless.
A variety of resources are available for people living with macular degeneration. To receive a copy of our Resource List, which has information about government programs, transportation assistance, and other special services, please call Macular Degeneration Research at 855-345-6637 or visit our website at brightfocus.org/MDRresources.
This information is not intended as legal or tax advice. For such advice, please consult an attorney or tax advisor. Figures cited in examples are for hypothetical purposes only and are subject to change. References to estate and income taxes include federal taxes only. State income/estate taxes or state law may impact your results
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.