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new item Research and Treatment for Dry AMD

The March 11 webcast of the International MD Support Group featured Janet Sunness, M.D. (Greater Baltimore Medical Center) in a presentation on the dry form of macular degeneration (geographic atrophy). As one of the leading experts in the field of AMD research, she explained the condition and summarized current research in the field.

To access the free webcast, select "Research and Treatment for Dry AMD" in the MD Support Audio Visual Library. To find descriptions of studies currently underway, see A Guide to Research in Dry AMD in the MD Support Library.

More than 220 groups worldwide have affiliated with the IMDSG and are taking advantage of its free programs and services. For information about affiliating an existing group or starting a new one with the help of MD Support, select this link.


Saffron Shown to Improve Vision

Clinical trials in Italy and Australia have shown that the spice, saffron, can improve vision in people with AMD.

The trial was conducted at Policlinico Gemelli in Italy by Professor Benedetto Falsini. It was double blind and randomly controlled, involving 25 subjects over six months. Half the group was given a saffron pill for the first three months followed by a placebo the second three months. The other half of the group followed the same protocol in reverse. All subjects in the first group experienced up to 2 lines of improvement in their vision while taking saffron pill, but the effect quickly disappeared when the dose was discontinued. Researchers theorize that the improvement is a result of the anti-apoptotic properties of the spice. A 12-month dose-escalation trial is now underway at the Catholic University of Rome and the University of L'Aquila.

According to Richard Trevino, O.D., in a recent message to MDList, "It seems the research focused on improvements in vision function, rather than actual morphologic retinal improvements (eg OCT changes). This is similar to the research on lutein - it may improve the vision function of surviving cells but does not roll-back the damage that is already present.

"I have read," continued Dr. Trevino, "that the healing benefits of saffron are attributed to crocin, a carotenoid. So, rather than look for saffron pills, you may want to look for a crocin supplement, or just get more saffron in your diet."

Source: www.medindia.net


After AREDS

Nutrition science has advanced considerably since the Age Related Eye Disease (ARED) study formulation was designed in the late 1980s. This was good research, but the new AREDS2 and other smaller studies are addressing knowledge gained since that time.

Here is a summary of a list published by Ellen Troyer (MD Support nutrition advisor) of new research during these past twenty years. Links to further information are included. Macula Complete and related products offered by Biosyntrx, Inc. are recommended by MD Support as the best-researched and most all-inclusive line of supplements for macular health.

Hopefully, this information will help bring everyone up to date on current knowledge about nutrition. For those of us with the dry form of AMD, sensible diet and behavior are our only treatments at this time. For information about studies underway, see A Guide to Research in Dry AMD.

Oral Drug For Dry AMD Enters Phase 2 Trials

Following the success of the Phase I clinical trial, Acucela Inc. has begun recruiting participants with dry AMD for a Phase II study of the oral drug ACU-4429 for dry AMD. Known as the ENVISION Clarity Trial, Acucela is planning to enroll at least 56 participants at multiple sites throughout the U.S. Participants will receive either the drug or a placebo.

For more information about the trial, contact Covance Clinical Research Unit in Dallas, Laura Lonsdale at (214) 920-9053, Covance Clinical Research Unit in Austin, David Carter at (512) 302-6519, or visit www.clinicaltrials.gov and search for "Acucela."

For information about all research currently being conducted in the field of dry AMD treatment, see A Guide to Research in Dry AMD.


Study Shows Lucentis and Avastin to be Equal

Investigators at Kaiser Permanente Southern California in Pasadena reported in the February 2010 issue of Ophthalmology that Avastin and Lucentis performed equally in recent testing.

In an indirect comparison of the two drugs, study author Dr. Donald Fong and coauthors reviewed the records of 452 patients treated for wet AMD with Avastin or Lucentis. They found that 22.9 percent of Avastin patients and 25.0 percent of Lucentis patients attained visual acuity better than or equal to 20/40 after a year of treatment. Similar numbers of patients in each group also showed some degree of vision improvement at 12 months.

The Kaiser Permanente study is one of several comparing the two drugs. The largest, and probably most definitive, study is the National Eye Institute's ongoing Comparisons of Age-Related Macular Degeneration Treatments Trials (CATT), involving 44 centers across the U.S. Results from that research are expected in 2011.


PEG-POD - New Gene Delivery Tool

Researchers have developed a new tool for gene therapy that significantly increases gene delivery to cells in the retina compared to other carriers and DNA alone. The study was published in the January 2010 issue of The Journal of Gene Medicine by Tufts University School of Medicine and the Sackler School of Graduate Biomedical Sciences at Tufts (Rajendra Kumar-Singh, PhD, senior author).

A peptide called PEG-POD provides a safe and effective vehicle for transferring DNA into cells without using a virus, currently the most common means of DNA delivery. According to Dr. Kumar-Singh, PEG-POD protects DNA from damage in the bloodstream, allowing for gene therapy treatments that can be administered through an IV and directed to many other parts of the body.

The researchers used an in vivo model to compare the effectiveness of PEG-POD with two other carriers (PEG-TAT and PEG-CK30) and a control (injections of DNA alone). They found that gene expression in specimens injected with PEG-POD was far more effective than the other two carriers at 215 times greater than the control.

Journal Reference:

Read SP, Cashman SM, Kumar-Singh R. A poly(ethylene) glycolylated peptide for ocular delivery compacts DNA into nanoparticles for gene delivery to post-mitotic tissues in vivo. The Journal of Gene Medicine, 2010; 12 (1): 86 DOI: 10.1002/jgm.1415


Spikes in IOP May Result From Particulate Matter in Avastin

In a presentation to Hawaiian Eye 2010, Malik Y. Kahook, MD, said that Avastin (bevacizumab) stored for long periods of time shows evidence of increased large particulate matter. This debris can block the eye's trabecular network and lead to increased intraocular pressure (IOP) in patients being treated with the drug for wet AMD.

According to Dr. Kahook, "Avastin is not formulated for sitting in a plastic syringe for an extended period of time. It is also not formulated for sitting in a plastic syringe that has a rubber stop in it."

This may explain the 56 published reports to date showing IOP spikes up to 40 mm Hg in AMD patients treated with Avastin. This has not been seen with Lucentis (ranibizumab), which is stored in a glass syringe.

Dr. Kahook suggested that ophthalmologists should be careful of the quality of their repackaged bevacizumab, use syringes stored for less than 2 weeks and keep syringes refrigerated. Not shaking or tapping the syringe and possibly buying one's own vial might also be good practice.


Image of the cover of 'The First Year: Age-Related Macular Degeneration' By Dan Roberts

"The First Year: Age-Related Macular Degeneration"
An essential guide for the newly-diagnosed and anyone else affected by diseases leading to central vision loss.

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