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The robbers of vision in the elderly

Untreatable eye diseases which can often blind older adults are called macular degeneration or AMD. It is the leading cause of loss of vision amongst seniors in our population, which gradually erodes crucial central vision responsible for fine detail and colour. Although there are different forms of age-related macular degeneration, unfortunately over five million people worldwide have the advanced type of the dry macular degeneration for which there is no proven effective treatment.
With macular degeneration, patients may first notice blurriness when they look straight ahead, and eventually many develop blank spots in the central vision and can even become legally registrable as blind. They lose the ability to read and watch television and even see the faces of their loved one. There is a lot of development going on with drugs at the moment, including one I read about today called Lampalizumab, which slows the destruction of the light-sensing cells in the retina when there is dry age-related macular degeneration called geographic atrophy. At the moment when those cells die, they do not grow back, and loss of vision is irreversible.
The study I read was an 18-month study of 129 patients who had monthly injections of the drug which modestly slowed worsening of the disease compared to patients giving placebo or dummy shots. It turns out that nearly six of ten of the studies participants carry a gene variation that makes part of their immune system goes awry and it is a genetic flaw known to increase the risk of getting macular degeneration. It is those patients with the gene variation who benefited most from the drug, having 44% less eye damage then the untreated patients. While it was a small study, it shows that if Lampalizumab helps maintain vision, there is a bigger difference than the overall results would suggest. It is an immune related gene effect on ageing eyes.
Although macular degeneration patients are often advised to take certain vitamin combinations that may help stave off advanced disease, they need to know what they are taking. While there is no current treatment for the advanced dry form despite the above experimental early evidence, there is the wet form of age-related macular degeneration which occurs when leaky blood vessels go under the retina, and there are several therapies which can help those patients.
Clinical trials are going on at the moment to help treat wet macular degeneration including supplements and foods, as well as more direct eye injections or laser macular regeneration.
At Clinica London, Mr Jaheed Khan and Professor Michel Michaelides are both Medical Ophthalmologists who do medical retinal disease and would be pleased to assess your macular degeneration and advise on whether treatment is indicated, possible and what the likelihood of improvement to vision or stabilisation of existing vision will be.


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