Second Trial Showing Efficacy for Stem Cell Treatment of Dry AMD

A second trial begun in 2018 is showing positive results with replacing defective cells leading to vision loss from dry (geographic) macular degeneration. Implanted cells derived from stem cells have been implanted into five patients by researchers from University of Southern California (USC) and the University of California, Santa Barbara. Results at one year have shown that one patient’s acuity improved by 17 letters and two patients demonstrated improved ability to fixate on a target. Significantly, no patients have demonstrated progressive vision loss during the trial.
This stem cell implantation is similar to the ongoing Moorfields Eye Hospital study in London, the difference being in the composition of the basement membrane that contains the stem cells. Both procedures have the potential to delay the atrophy of the sight cells, and to even restore vision to those affected by dry macular degeneration.
More detailed results from the California trial may be read in the March 4 issue of Science Translational Medicine.
Read about all research being conducted for dry AMD

Gout Associated With Increased Risk of AMD

A recent study by researchers at the University of Alabama at Birmingham School of Medicine, has looked into the association between age-related macular degeneration (AMD) and gout. Gout is a form of arthritis resulting from inflammation in the joints caused by the build-up of uric acid crystals and is associated with oxidative stress.
The main questions the researchers behind this study were looking to answer were if gout does, in fact, relate to an increased risk of AMD and whether gender or race play a factor. The researchers used data collected between 2006 and 2012 through Medicare in the United States.
Of all the data, the data of 1,684,314 participants were eligible to be included in the study. On average, the participants were aged 65 or older. By the end of the data collection period, 116,097 people had developed incident AMD.
The results showed that gout was an independent risk factor for the development of AMD, increasing the risk of developing AMD by 40 percent. The researchers believe that one possible explanation for the relationship between gout and AMD is that gout is associated with hyperuricemia. Hyperuricemia is an abnormally high level of uric acid in the blood which is related to oxidative stress, an important pathway for AMD.
Further research will be required to fully understand the mechanisms behind the association of gout with an increased risk of AMD, as this study only shows a correlational relationship.
The study, “Gout and the risk of age-related macular degeneration in the elderly,” was published online in PLOSone in July 2018.

Novel Gene Therapy In Trials for Wet AMD

(Updated 10/12/19)

Adverum Biotechnologies, Inc. has announced progress with yet another therapy designed to extend the time between anti-VEGF injections for treatment of wet age-related macular degeneration (wAMD). The company’s Investigational New Drug (IND) application has been approved for a multi-center study of ADVM-022, a novel gene therapy candidate for the treatment of wAMD.

“We are excited to have this IND active for ADVM-022, currently the only intravitreal gene therapy candidate entering the clinic for patients with wet AMD,” said Leone Patterson, interim president and chief executive officer of Adverum Biotechnologies.

Results of the phase 1 OPTIC trial, reported at the meeting of the American Academy of Ophthalmology in October 2019, revealed that ADVM-022 showed the ability to maintain vision with a one-time injection and was well-tolerated, with no serious adverse events (SAEs), no dose limiting toxicities (DLTs), and no Grade 3 adverse events.

Six leading retinal centers across the United States are participating in the Phase 1 trial, with each patient being followed for a total of 2 years.

Adverum press release

Related News:
12 Weeks Between Injections: Good News for Wet AMD patients
New Port Delivery System Unveiled for Wet AMD Treatment
Abicipar for Wet AMD May Extend Time Between Treatments

What Are The Highest Priorities in AMD Research?

Four eye health stakeholder groups have come together to help define the focus of research in age-related macular degeneration (AMD). Their purpose was to prioritize clinical questions important for researchers to answer when developing clinical practice guidelines and identifying treatment outcomes important to patients. Participants in the initiative were:

Between January 2015 and January 2017, the participating health care professionals decided upon and assessed 17 highly important clinical questions and rated 12 of 17 questions (71%) as high priority for research to answer. MD Support members assessed those questions and rated all as high priority. Additionally, those patients identified 6 research outcomes as most important to them:
1. development of choroidal neovascularization
2. development of advanced dry AMD (geographic atrophy)
3. retinal hemorrhage
4. gain of vision
5. slowing vision loss
6. serious ocular events (eg. endophthalmitis or retinal detachment)
This investigation may help to best allocate limited resources for research associated with the treatment of age-related macular degeneration (AMD). Consideration of these patient-important outcomes may help to guide clinical care and future areas of research.
The project was conducted under the auspices of the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
The abstract is published on the JAMA Ophthalmology website.

Mifepristone Still Showing Positive Results for Treatment of Central Serous Chorioretinopathy

For the past 18 years, reports have been published here on the slow progress of research for treatment of central serous chorioretinopathy (CSC). Sometimes misdiagnosed as early-onset age-related macular degeneration, CSC is a disease of the central retina (the macula) affecting mostly middle-aged males, and it is thought to be caused by over-production of stress hormones. In spite of the large number of people affected, such studies have been far and few between. It is, therefore, worthy of mention when new findings are reported.
New work has now been done by Roger Goldberg, MD, MBA (Ophthalmic Consultants of Boston), who has offered further evidence that oral mifepristone (RU-486), an abortion drug, may reduce or improve subretinal fluid and improve visual acuity in individuals with CSC. His 29-patient STOMP-CSC study showed a significant reduction in retinal fluid in patients by about 43 μg (micrograms) compared with the placebo group at a reduction of 15 μg. Secondary findings showed an increase in visual acuity of treated patients by 3.6 letters on the eye chart compared to an increase of 0.7 letters by the placebo group. These results show further promise for CSC treatment, but Dr. Goldberg recommends that larger studies be performed in order to verify these results.