New technologies and treatments could slow vision loss from macular degeneration

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Airman 1st Class Jessica Borrowman uses a fundus camera to take a photo of a patient’s retina on Naval Air Facility Atsugi, Japan. File photo by Senior Airman Laura Muehl/ Illinois Air National Guard

NEW YORK, March 1 (UPI) — Age-related macular degeneration remains one of the leading causes of vision loss in the United States, but new advances could help manage and, in some cases, prevent its devastating symptoms, experts recently told UPI.

That would be good news for the more than 13 million people nationwide who are affected by the disease, which gradually destroys the macula, or the part of the eye that provides sharp central vision needed to see objects clearly. .

More than 1 in 10 people with age-related macular degeneration, or AMD, will have their symptoms progress such that they lose most or all of their vision, impacting their ability to perform daily activities, including driving and living independently, research indicates.

For nearly 20 years now, people with advanced AMD, which tends to affect older people and get worse with age, have been treated with drugs called anti-VEGF therapies, which are injected into the eye. assigned every one to three months.

Although effective — nine out of 10 people treated with anti-VEGF injections say their vision remains stable, while one in three report improvement — the injections can cause pain and discomfort. Doctors have looked for less invasive options.

“Many drugs are in development and we are excited to have two new drugs recently approved by the Food and Drug Administration,” ophthalmologist Dr. J. Fernando Arevalo told UPI in an email.

As with anti-VEGF therapies, with these new drugs, “early treatment is associated with better vision,” said Arevalo, chairman of the department of ophthalmology at Johns Hopkins Bayview Medical Center in Baltimore.

New drugs

One of the new FDA-approved treatments, called the Port Delivery System, changes the way an older anti-VEGF therapy, ranibizumab, is delivered, possibly allowing people with age-related macular degeneration” to ‘avoid monthly injections,’ Arevalo said.

Cleared for use by the FDA in November, the Port Delivery System is surgically inserted into the affected eye or eyes and delivers, by “slow release”, the anti-VEGF drug ranibizumab, he said.

The implant only needs filling about every six months, according to Arevalo.

The other new option, approved by the FDA last week, is an anti-VEGF drug called faricimab, which is sold under the brand name Vabysmo, and it “has a longer duration of action” than older products. , Arevalo said.

This longer duration of action, which means it works longer than older drugs, could allow patients with age-related macular degeneration to last up to four months without the need for injections of followed, he said.

An ounce of prevention

Still, researchers hope to find ways to avoid surgeries and injections, by not developing age-related macular degeneration in the first place.

To that end, researchers at the University of California-Davis have found that adults who regularly eat a small portion of dried goji berries may be able to prevent or delay the development of macular degeneration linked to Alzheimer’s disease. age.

In a study published by the journal Nutrients in December, 13 healthy participants aged 45 to 65 who consumed 28 grams, or about one ounce, of goji berries five times a week for 90 days increased the density of protective pigments called lutein and zeaxanthin in their eyes , according to the data.

These pigments filter out harmful blue light, provide antioxidant protection and help protect the eyes during aging, study co-author Dr. Glenn C. Yiu told UPI in an email.

“Goji berries have a high concentration of macular pigments [that] can help filter out harmful light radiation,” said Yiu, an associate professor of ophthalmology at UC-Davis.

With these nutrients, the berries could offer “potential for preventing or reducing progression,” he said.

Goji, which is also called wolfberry, boxwood and wedding vine and is native to China, is a woody, thorny deciduous shrub, according to Penn State University Extension.

Eaten fresh, they can taste bitter, although in dried form, the type used in Davis’s study, they resemble cranberries, reports the food blog SimplyHealthyFamily.org.

However, people at risk for age-related macular degeneration, typically white adults aged 50 and older, should wait for more studies before expecting miracles from goji berries, Yiu said.

Still, people who take them in moderation aren’t likely to experience side effects, meaning they could provide a risk-free prevention strategy until more research becomes available, he said. .

Nutrition-based prevention for age-related macular degeneration isn’t new, according to Johns Hopkins’ Arevalo.

The National Eye Institute currently recommends a Bausch & Lomb formulation called AREDS2 for age-related eye disease. It contains vitamins and antioxidants known to improve eye health and slow the progression of macular damage, he said.

Additionally, the acai berry has been touted for its anti-aging properties, although scientific research supporting its benefits is lacking, reports the National Center for Complementary and Integrative Health.

“Because goji berries are not a medicine, but a natural food and an ingredient that has anti-oxidant properties, I think people can consider trying to incorporate it into their diet,” Yiu said. .

There is an application for that

Meanwhile, a company called Balanced Media/Technology has worked with the Retina Foundation of the Southwest and researchers at Southern Methodist University to develop an app that uses automated software and a video game to diagnose AMD and other diseases. eyepieces.

The original video game, called Eye in the Sky: Defender, uses embedded optical coherence tomography retinal images to effectively scan players’ eyes for disease damage, the developers said.

Optical coherence tomography is a noninvasive imaging test that uses light waves to take cross-sectional pictures of the retina, allowing ophthalmologists to see its individual layers and measure their thickness, according to the American Academy of Ophthalmology.

As players predict the path of the alien force in Eye in the Sky: Defender, they unknowingly learn to draw lines similar to those used to perform optical coherence tomography diagnostic measurements, the game’s developers have said. .

When combined with an AI platform developed by Balanced, data collected in-game can be used to train a machine learning algorithm to more accurately analyze optical coherence tomography images, have they stated.

It wouldn’t prevent the onset of AMD, but it could speed up its diagnosis, the developers say, and earlier diagnosis means earlier treatment, which can improve outcomes, Arevalo said.

“The use of gaming software, combined with optical coherence tomography imaging, forms a [disease] detection and monitoring tool,” Matthew Levine, director of grants, partnerships and advocacy for the nonprofit Macular Degeneration Foundation, told UPI in an email.

This is “a very important step forward [that] could lead to earlier and more timely interventions,” said Levine, who was not involved in the development of the app.

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