Age-Related Macular Degeneration
Age-related macular degeneration, or AMD, is the leading cause of blindness in people 55 and older in developed countries. The condition can lead to significant loss of central vision.
About the Disease
Age-related macular degeneration, commonly referred to as AMD, is a retinal degenerative disease that causes a progressive loss of central vision. AMD is the most common cause of blindness in individuals over the age of 55 in developed countries. More than 10 million people in the United States have AMD.
The retina is packed with photoreceptors, the cells that enable us to see. Photoreceptors convert light into electrical impulses, which are transferred to the brain via the optic nerve and converted into the images we see. The macula is a small region in the center of the retina that’s rich in cones, the photoreceptors that enable a person to perceive fine details (e.g., read, recognize faces), colors, and objects in daylight or lighted conditions. Central vision loss from AMD occurs when cone photoreceptors in the macula degenerate.
The greatest risk factors for AMD are aging and smoking. An unhealthy diet and unprotected sunlight exposure can also increase AMD risk. Genetics is also a risk factor.
People with AMD may first notice a blurring of central vision, especially during tasks such as reading or sewing. Also, straight lines may appear distorted or warped. As the disease progresses, blind spots may form within the central field of vision. In most cases, if one eye has AMD, the other eye has the condition or is at risk of developing it. The extent of central vision loss varies and can depend on the type of AMD — dry or wet.
Most people with AMD start off with the dry form. In many cases, people will not experience vision loss from the condition. In some cases, dry AMD can progress and cause varying degrees of central vision loss. Advanced dry AMD is sometimes referred to as geographic atrophy.
The hallmark of dry AMD is the accumulation of tiny protein and fat deposits known as drusen underneath the retina. Many people have drusen, which do not affect vision. However, certain types of drusen may interfere with the health of the macula, causing progressive degeneration of the photoreceptor cells and vision loss.
About 10-15 percent of people with dry AMD will develop the wet form in one or both eyes. With wet AMD, abnormal blood vessels grow beneath the macula. These vessels leak blood and fluid into the macula and damage photoreceptor cells. Wet AMD often progresses rapidly and causes substantial loss of central vision, if left untreated.
Researchers have discovered that genetics can play a role in AMD risk. In 2005, three groups of researchers, including a team funded by the Foundation, discovered that a gene called Complement Factor H (CFH) is linked to at least 50 percent of all cases of AMD. Since that breakthrough, researchers have found several other genes linked to AMD. CFH and many of the other AMD genes are involved in the innate immune system, which fights off infection. Scientists believe that over activity of the innate immune system increases AMD risk.
While genetics can play a role in AMD risk, people with low risk genetics can still get the condition. Likewise, people with high risk genetics may not get AMD.
The Age-Related Eye Disease Study (AREDS) — a landmark investigation conducted by the National Eye Institute (NEI) — determined that a specific antioxidant supplementation can slow the progression of AMD. The AREDS2 formulation is an over-the-counter antioxidant supplement recommended for people who are at risk of developing more advanced forms of dry or wet AMD.
The AREDS2 formulation contains the following nutrients:
500 milligrams (mg) of vitamin C
400 international units of vitamin E
80 mg zinc as zinc oxide
2 mg copper as cupric oxide
10 mg lutein and 2 mg zeaxanthin
Several therapies are now available for the wet form of AMD. Most involve regular ocular injections to halt the growth of leaky, vision-robbing blood vessels.
EYLEA™ (alflibercept) — Regeneron’s wet AMD treatment, Eylea, blocks the development of unhealthy blood vessels underneath the retina. Regeneron reports that in clinical trials, Eylea treated wet AMD as effectively as Lucentis, but with fewer intraocular injections. Typically, patients are treated monthly with Eylea for three months and every other month thereafter. Eylea was FDA approved in 2011.
Lucentis™ (ranibizumab) — Developed by Genentech, Lucentis is effective in reducing the risk of losing vision from the abnormal blood vessel growth under the retina associated with wet AMD. The treatment was approved by the FDA and made available in 2006. A two-year study showed that 95 percent of people with wet AMD who received monthly injections of Lucentis experienced no significant loss in visual acuity from baseline. Genentech also reported moderate visual improvement in 24.8 percent of participants treated with a 0.3 mg dose of Lucentis and 33.8 percent of participants treated with a 0.5 mg dose.
A colorectal-cancer drug called Avastin® — a drug similar to Lucentis — has been used “off-label” by some ophthalmologists to treat wet AMD. The NEI completed a large-scale, two-year clinical study comparing Avastin and Lucentis. Results of the study showed that the drugs were similar in safety and efficacy.
Research and Clinical Trials
The Foundation is supporting several promising avenues of research, including gene, stem-cell, and drug therapies.
To learn about clinical trials underway for AMD, visit www.ClinicalTrials.gov.
Mar 7, 2019 Foundation News
Age-related macular degeneration (AMD) is the leading cause of blindness for people over 50 years of age in developed countries.
Jul 19, 2018 Press Releases
Bill Introduced in U.S. House Would Speed Up Cures for Blindness
Mar 23, 2019 Eye On the Cure Research News
Gyroscope Therapeutics, a gene-therapy development company in the UK, has launched the first gene therapy clinical trial for the dry form of age-related macular degeneration (AMD).
Feb 1, 2019 Retinal Disease Research Advances
Recent developments in research on age-related macular degeneration.
Jan 29, 2019 Eye On the Cure Research News
Sofia Sees Hope, a nonprofit dedicated to finding treatments and cures for people with Leber congenital amaurosis (LCA) and other inherited retinal diseases (IRDs), has made a $100,000 donation to the Foundation Fighting Blindness to support therapy development and genetic testing.
Jan 17, 2019 Eye On the Cure Research News
The French bioelectronics company Pixium Vision has reported that its PRIMA bionic vision system has restored some central vision in patients with advanced dry age-related macular degeneration (AMD) participating in a clinical feasibility trial.
Nov 21, 2018 Eye On the Cure Research News
The Seattle biotech Acucela is now enrolling participants in its Phase 3 clinical trial for emixustat hydrochloride, an emerging oral drug for slowing vision loss in people with Stargardt disease, an inherited form of a macular degeneration.
Nov 2, 2018 Eye On the Cure Research News
Since 1989 genetic researchers, many funded by the Foundation, have identified approximately 270 genes linked to IRDs. In most cases, defects in a single gene can cause a retinal disease and vision loss.
Sep 18, 2018 Eye On the Cure Research News
Trial participants will receive intravitreal injections of APL-2, or a sham procedure (placebo), monthly or every other month. The injections are made into the vitreous, the soft gel in the middle of the eye.
Sep 11, 2018 Eye On the Cure Research News
On September 4, 2018, seven researchers, including six previously funded by the Foundation, were recognized with the prestigious 2018 Antonio Champalimaud Vision Award for their contributions to the advancement of blindness-reversing RPE65 gene therapies.
Aug 22, 2018 Eye On the Cure Research News
The company is taking on a multi-track strategy that includes retinal gene-therapy development, including delivery of over-sized genes and design of a two-step process of gene knockdown and replacement for autosomal dominant conditions.
Aug 15, 2018 Eye On the Cure Research News
Each recipient will receive a total of $375,000 over five years to help build an independent research program in addition to their clinical practices.
Aug 6, 2018 Eye On the Cure Research News
Seventy scientists submitted requests for funding.
Jul 20, 2018 Eye On the Cure Research News
Call to Action: Ask Congress to Support $1 Billion in Eye Research
Jul 5, 2018 Eye On the Cure Research News
Many research groups from around the world are investigating ways to create new photoreceptors from stem cells for transplantation into the retina for vision restoration.
Jun 22, 2018 Eye On the Cure Research News
Watch recorded session from VISIONS2018.
May 4, 2018 Eye On the Cure Research News
Dr. Christopher Brittain, Genentech medical director, discusses his company’s port delivery system, a tiny capsule implanted into the eye, for delivery of Lucentis® over a period of a few months.
May 3, 2018 Eye On the Cure Research News
ARVO 2018: Dr. Stephen Daiger Reports on the State of Genetic Testing for Inherited Retinal Diseases
May 2, 2018 Eye On the Cure Research News
FFB’s own Dr. Steve Rose, chief scientific officer, reviews our commitment to funding and exploring CRISPR/Cas9 gene editing for inherited retinal disease.
May 1, 2018 Eye On the Cure Research News
Several research studies have suggested that the Mediterranean diet (MeDi) - which is rich in fruits, vegetables, legumes, cereals, and fish - may be good for your health, including lowering your risk of an early visit from the grim reaper.
Apr 25, 2018 Eye On the Cure Research News
More than 11,000 eye researchers from around the world — including five intrepid members from FFB’s science team — will gather to participate in what is essentially a massive “show and tell” of the latest scientific advancements.
Apr 16, 2018 Eye On the Cure Research News
Regenerative Patch Technologies, a company developing stem-cell-derived treatments for people with retinal diseases, has reported encouraging results for the first five patients with advanced, dry age-related macular degeneration (AMD) participating in a Phase I/IIa clinical trial for its therapy – a patch comprised of a layer of retinal pigment epithelial (RPE) cells on a synthetic scaffold.
Mar 27, 2018 Eye On the Cure Research News
Two patients with advanced wet age-related macular degeneration (AMD) in a Phase I clinical trial demonstrated improved visual acuity sustained for one year after a sheet of retinal pigment epithelial (RPE) cells derived from embryonic stem cells was transplanted under their retinas. Each patient had one eye treated. Vision improvement for one patient was 29 letters or about 6 lines on an eye chart. The other had a gain of 21 letters or about 4 lines.
Jan 17, 2018 Eye On the Cure Research News
The French biotech GenSight Biologics has received regulatory authorization in the UK to launch the PIONEER Phase 1 \ 2 clinical trial for its GS030 system — a light-sensing gene therapy (optogenetics) coupled with eyewear, which enhances visual stimulation.
Jan 9, 2018 Eye On the Cure Research News
An exciting year in fighting blindness.
Dec 20, 2017 Eye On the Cure Research News
Known as LUXTURNA™ (voretigene neparvovec), the gene therapy restored vision in a clinical trial for people between the ages of 4 and 44 with Leber congenital amaurosis (LCA) caused by mutations in the gene RPE65.
Nov 21, 2017 Eye On the Cure Research News
If a clinic is charging for a stem-cell treatment or procedure for an IRD, it is probably not legit. The expense to the patient is a major red flag.
Oct 13, 2017 Eye On the Cure Research News
FDA Committee Unanimously Recommends Approval for Spark's RPE65 Gene Therapy - Final Decision Due in January 2018
An advisory committee comprised of FDA-selected experts voted unanimously – 16 to 0 – to recommend approval.
Sep 27, 2017 Eye On the Cure Research News
In addition to funding promising biotech start-ups, FFB has played a critical role in developing research talent.
Jul 26, 2017 Eye On the Cure Research News
The high-tech, vision-restoring system interfaces with the visual cortex, the back of the brain where visual input is processed to create the images we see.
Jul 25, 2017 Eye On the Cure Research News
Foundation Fighting Blindness and 4D Molecular Therapeutics Partner to Boost Retinal Gene Therapy Development
The partnership will help companies and researchers quickly obtain and implement high-quality vectors for their retinal gene-therapy development efforts.
Jul 24, 2017 Eye On the Cure Research News
The Foundation Fighting Blindness has taken the translational challenge head on by investing more than $75 million in therapy-development projects with strong clinical-trial potential through its Translational Research Acceleration Program (TRAP), which includes Gund-Harrington Scholar Awards.
May 23, 2017 Eye On the Cure Research News
In its fourth year, the meeting is becoming the world’s most comprehensive overview of the promising research underway for emerging IRD treatments.
May 8, 2017 Eye On the Cure Research News
How the Foundation Fighting Blindness (FFB) provided timely funding of $155,000 to help a lab at the University of California, San Diego (UCSD), leverage a $2 million retinal-gene discovery project.
Mar 22, 2017 Eye On the Cure Research News
Dr. Berson dedicated himself to clinical care and vision-saving research for people with inherited retinal diseases for five decades.
Mar 16, 2017 Eye On the Cure Research News
“…participation in a study for an emerging therapy that is not regulated by the FDA or another well-recognized regulatory agency like the European Medicines Agency in Europe, is fraught with dangers and can lead to unexpected serious consequences.”
Feb 17, 2017 Eye On the Cure Research News
Dec 21, 2016 Eye On the Cure Research News
Improved outcome measures will make clinical trials for degenerative retinal diseases — including age-related macular degeneration (AMD), the world’s leading cause of blindness in seniors, and inherited retinal conditions such as RP and Stargardt disease — less expensive to conduct and able to deliver more precise results.
Oct 18, 2016 Eye On the Cure Research News
Understanding the pathways of the retinal neural network — and how they are rewired with aging and disease — is helpful in trying to save and restore vision.
Oct 11, 2016 Eye On the Cure Research News
Dr. Shinya Yamanka discussed his early clinical trial for iPSC-derived retinal pigment epithelial (RPE) cells for a 78-year-old woman with advanced wet age-related macular degeneration (AMD).
Oct 6, 2016 Eye On the Cure Research News
The complex and elusive nature of these conditions can also extend to the way they are passed down in families, making diagnosis and prognosis quite challenging.
Aug 18, 2016 Eye On the Cure Research News
RetroSense’s optogenetic therapy is designed to restore vision to people who are completely blind from retinal degenerative diseases such as retinitis pigmentosa by bestowing light sensitivity to retinal ganglion cells, which survive after photoreceptors, the cells that make vision possible, are lost.
Feb 18, 2013 Eye On the Cure Research News
More good news about treatments and technological advances for restoring vision for people with retinal diseases.
Jan 15, 2013 Science Education
Diseases such as age-related macular degeneration, cone-rod dystrophy and Stargardt disease cause scotomas, or blind spots, which often have devastating effects on central vision. They cause gaps in a person’s visual field, making it difficult to see words in a book, images on a computer monitor or TV and the features of someone’s face.
Jul 27, 2012 Science Education
Great progress is being made in identifying targets for therapies, including using the body’s own protective systems to keep the photoreceptors alive.
Jul 17, 2012 Eye On the Cure Research News
Known as the implantable miniature telescope (IMT), the device is surgically placed in the eye, where it focuses images onto the area of the patient’s retina that is still functional.
Jun 19, 2012 Eye On the Cure Research News
How do you know if a treatment is legit? There should be preclinical and clinical trial data published in a peer-reviewed journal on research for the treatment.