Age Related Macular Degeneration (AMD) results in the degeneration of the central portion of your retina that controls your straight ahead vision, leading to gradual loss of central vision while leaving side (peripheral) and color vision unaffected.

Visudyne is one such drug treatment designed to slow the wet form of AMD by using painless lasers to destroy abnormal new blood vessels that form and leak under the retina, including Visudyne which uses laser technology for this purpose.

Visudyne® Implant

Visudyne(r) implant is a port delivery system for anti-VEGF drug ranibizumab that has been designed to target specific regions of the eye via diffusion or osmosis, such as sclera, cornea or anterior segment implant placement. Currently it’s being used to treat neovascular age-related macular degeneration – an eye condition which causes central retinal vision loss – through its targeted delivery system.

The retina is a light-sensitive tissue located at the back of each eye that works much like the film of a camera – gathering light that hits it and sending nerve impulses to various visual centers in our brains to enable reading or driving. Macular degeneration may manifest both dry and wet forms; wet forms typically result in more serious visual loss.

AMD occurs when abnormal blood vessels develop within the retina and leak fluid or blood into the eye, damaging macula–which provides central vision–leading to loss. AMD is one of the primary causes of vision loss among older adults and may eventually lead to blindness; though, in most cases, this disease cannot be stopped from progressing further. There may be steps you can take to slow its progress – see “5 Steps You Can Take to Prevent AMD”.

Dr. Miller is a board-certified ophthalmologist specializing in retinal diseases and conditions. As part of her faculty duties at Massachusetts Eye and Ear and Harvard Medical School, her research is focused on age-related macular degeneration as well as new therapies for sight-threatening retinal disorders.

She was an innovator in developing verteporfin photodynamic therapy, the first pharmacologic treatment for macular degeneration. Additionally, her group identified the role of vascular endothelial growth factor (VEGF) in neovascular AMD which ultimately lead to anti-VEGF therapies used by millions worldwide.

Ocular inserts can be placed into each eye and, when activated by a laser beam, produce a chemical reaction that destroys abnormal blood vessels at the back of your eye and reduces fluid leakage while slowing vision loss. This procedure can be completed painlessly in any doctor’s office.

Clinical Research

Clinical research in macular degeneration has yielded new treatments to slow vision loss; however, no cure exists. Therefore, the best course of action for treating the disease is following your eye doctor’s advice regarding diet, exercise and smoking cessation; you should also be regularly screened for macular degeneration through regular eye exams to detect it early and get a dilated eye exam to detect abnormal blood vessels in your retina.

Recent advancements in medical technology have revolutionized the quality of life for people living with AMD and related conditions like cataracts, dry eye syndrome and glaucoma. These innovations include better diagnostic tests and therapies; new IOLs with improved visual acuity; devices designed to assist with daily activities like reading, driving and recognising faces.

Researchers are studying methods to regenerate the central portion of retina and reduce blind spots caused by age-related macular degeneration. One approach involves applying light directly to the macula using laser photocoagulation; this may be used alongside other therapies or alone for dry macular degeneration; it may even produce scars which distort vision centrally and increase risk factors, including macular detachment or cystoid macular edema. However, scarring caused by such procedures increases significantly the likelihood of future issues, including macular detachment or cystoid macular edema.

Another approach involves injecting therapeutic proteins directly into the eye to treat neovascular macular degeneration. These drugs target vascular endothelial growth factor (VEGF), a protein which promotes abnormal blood vessel growth in the eye. The FDA has approved inhibitors of VEGF such as Macugen and Lucentis that slow progression and may even improve vision.

Pseudophakic cataract surgery is an emerging method that utilizes an artificial iris to correct refractive error. Although suitable for both spherical and aspheric cataracts, pseudophakic surgery poses potential downsides for those suffering macular degeneration; one such issue being an increased likelihood of choroidal thickness differences between pseudophakic eyes and those without macular degeneration. Researchers are investigating ways to prevent these differences with non-invasive procedures like Alimera Sciences Inc’s RETISERT implant device from Alimera Sciences Inc.

Safety

Age-Related Macular Degeneration (AMD) is a progressive eye condition marked by loss of central vision. This condition is due to a breakdown in retinal pigment epithelium and photoreceptors. Although no cure exists for macular degeneration, treatments can slow its progress by targeting vascular endothelial growth factor (VEGF), which promotes new blood vessel formation for oxygen delivery to retina; however these new blood vessels may burst or leak fluid which leads to Neovascular AMD.

Eyes are like brains in that there are multiple barriers preventing drug penetration into them. However, several drugs have been developed to get past this resistance, including AREDS2 (an analogue of vitamin E) and bevacizumab, both used for the treatment of wet AMD.

AREDS2 and bevacizumab have demonstrated positive results in improving visual acuity for patients suffering from wet macular degeneration, but must be taken regularly in order to be effective; furthermore, both medications can be costly and require frequent trips to an ophthalmologist’s office for injections.

Clinical development efforts are currently being done with an iPSC-derived retinal pigment epithelium (RPE). This therapy replaces RPE cells that die due to dry macular degeneration or geographic atrophy; RPE cells provide vital support for photoreceptors found within macula, and are essential to its functionality. IPSC-derived RPE can be grown as one cell thick sheets to replicate natural anatomy of retina, then placed between RPE and photoreceptors by surgeon.

An iPSC-derived RPE was proven safe and effective in a Phase I/II clinical trial for wet AMD that included over 200 patients with neovascular AMD. One-year data demonstrated that using this RPE reduced vision loss rates.