A new way to treat the leading cause of vision loss?
Macular degeneration affects more than 10 million Americans, according to the American Macular Degeneration Fund, and it’s the leading cause of vision loss. The disease is a result of the deterioration of the central portion, or the macula, of the retina.
There are two main types of macular degeneration:
Dry Macular Degeneration (non-neovascular)
This is seen as an early stage of the disease, and it is diagnosed when yellowish spots, known as drusen, accumulate in the macula. Gradual central vision loss is a potential consequence of dry macular degeneration, but the symptoms are not as severe as with wet macular degeneration.
Wet Macular Degeneration (neovascular)
Dry macular degeneration can sometimes progress to wet macular degeneration as abnormal new blood vessels grow beneath the retina and leak blood and fluid. The leakage causes permanent damage to retinal cells, creating blind spots. In severe, untreated cases, blindness from a loss of central vision is a possibility.
As the disease is age-related, it is most often seen in individuals above the age of 80. Those of European descent and those with affected family members are at a higher chance of developing macular degeneration. “If all of us were to live long enough, we would each most likely develop some stage of the disease,” explains Dr. Zac Ravage, an ophthalmologist who specializes in retinal diseases and surgery at Advocate Condell Medical Center in Libertyville, Ill.
While macular degeneration is currently considered an incurable eye disease, there are treatment options which exist to manage the disease and limit blindness. “In most cases of dry macular degeneration, we give eye vitamins which contain vitamin C, vitamin E, zinc, lutein and zeaxanthin to help combat the disease. If the condition has progressed to wet macular degeneration, we treat the patient with eye injections. These contain a medication that blocks a key factor responsible for development of the disease,” says Dr. Ravage.
“In clinical trials, approximately 90 percent of patients who receive treatment typically maintain the same level of vision as they came in with, and about 40 percent of patients can regain up to three lines on the eye chart,” he says.
As of now, we are fortunate to have treatments for wet macular degeneration. The next level of research is to find a way to treat dry macular degeneration. In recent years, scientists have learned that the complement cascade, which is a pathway that is a part of the immune system, is involved in macular degeneration. As a result, one of the most promising avenues of study is a drug which inhibits one of the proteins involved in the complement cascade called complement factor 3 (C3). Using the drug would theoretically limit the progression of dry macular degeneration.
While there isn’t a possibility for completely curing macular degeneration in the near future, there lies hope in treating it much earlier, limiting some of the consequences that currently arise.
Dr. Ravage recommends anyone in the at-risk category for macular degeneration should take proper preventive measures, which include having a diet that is abundant in leafy green vegetables and restraining from smoking. “Generally speaking, heart-healthy measures are eye-healthy,” says Dr. Ravage.
About the Author
Shvetali Thatte, a junior at the Illinois Mathematics and Science Academy, is a remote Public Affairs and Marketing intern for Advocate Condell Medical Center in Libertyville, Ill. She spends her time by engaging in clubs and sports at school as well as volunteering at the hospital and nearby tutoring programs. She enjoys spending time with her friends, traveling, and reading. In the future, she hopes to pursue a career in medicine with a focus on public health.