Age-Related Macular Degeneration: News and Advancements
The last decade has seen an enormous advancement in the care of Age Related Macular Degeneration (ARMD) and we now see it as somewhat of a chronic disease that requires regular medication. Much like diabetes or hypertension, we cannot cure these diseases, but we can try to control them with medications. This article will discuss some of the future treatments that appear to be on the horizon and also the current state of treatment for ARMD. This month’s article will focus on non-exudative or dry ARMD. Next month’s will be focused on exudative or wet ARMD.
The NIH studied vitamins and their role in eye health in two studies called The Age Related Eye Disease Study (AREDS). The findings were that the high doses of anti-oxidants and other minerals were protective against DRY ARMD progressing to the Wet Form. Smoking was also found to be a major risk factor for developing ARMD. This is still the only known treatment for DRY ARMD. One new tool we have to try to establish a risk profile and try to develop a more tailored plan for a patient with DRY ARMD is genetic testing. We can offer a simple (cheek swab) test to help determine your risk. This can help understand your disease better and try to establish more customized follow up plan.
There are many ideas and treatments in research phase right now. There are eye drops that may help keep DRY ARMD from progressing. You would use these drops chronically to keep the macular degeneration from advancing, much like the AREDS, but possibly more targeted. There are oral drugs in study that try to “protect” the retinal cells by various means, including changing your immune system. There is also a surgical implant that attempts to slowly release a drug that may protect against ARMD advancing. There are gene replacement studies that try to keep the disease from occurring in the first place.
One treatment that is still being researched is cell transplantation. This technique of growing new cells for the body is used widely in many conditions in the body and appears exciting and since it has been so successful in other parts of the body, many of my patients assume it is just a matter of time before we are able to replace damaged retinal cells with “new” ones. This is an area of active research and it may be possible at some point, but at this time there are many technical hurdles to overcome and this is not a treatment you could expect to see soon.
Another treatment that has garnered much attention and headlines in the news is the “Retinal Chip.” Many patients and their family hear about a retinal chip, much like your digital camera sensor, that is surgically implanted under the retinal and then lets you see. There is a prosthetic retinal implant that has been FDA approved and is being implanted. But, this is for certain genetic conditions where the patient has very nearly no functional sight. This is not approved for use in ARMD and does not provide the level of vision that most ARMD patients already have. Patients with a chip implanted are able to distinguish a door on a wall and whether lights are On or Off. This chip does not provide ability to see faces, read, or likely care for yourself fully. Advancements in this area may make this a viable treatment for macular degeneration in the future.