International Age-Related Macular Degeneration (AMD) Week Congressional Briefing: NEI Researchers Discuss Therapies for this Leading Cause of Blindness
Featured speakers from the National Eye Institute (NEI) Emily Chew, M.D., (Deputy Clinical Director) and Wai Wong, M.D., Ph.D. (Chief, Laboratory on Neuron-Glia Interactions in retinal Disease)
On September 18, in recognition of both Healthy Aging Month and International Age-related Macular Degeneration (AMD) Awareness Week, AEVRs Decade of Vision 2010-2020 Initiative and co-sponsors (see box below) held a Congressional Briefing focusing on the latest therapies to treat AMD, the leading cause of blindness and low vision in the United States, especially in the age 60-plus population. AMD will become increasingly prevalent due to the aging population, with greatest growth in the age 90-plus segment. A June 2014 Prevent Blindness report entitled The Future of Vision: Forecasting the Prevalence and Costs of Vision Problems has projected that the current estimated $145 billion annual cost of vision disorders in 2014 will grow to $717 billion in inflation-adjusted dollars by year 2050—driven significantly by the aging of the population. This presents significant challenges to vision researchers.
Within the National Institutes of Health (NIH), the National Eye Institute (NEI) is leading the nations vision research efforts and has committed significant resources to find the cause of AMD, as well as discover treatments, while educating at-risk populations through its National Eye Health Education Program (NEHEP). To address these efforts, the briefing featured Emily Chew, M.D., NEI Deputy Clinical Director, a medical retina specialist with clinical and research interest in AMD and diabetic eye disease who has extensive experience in designing and implementing clinical trials at the NIH Clinical Center, and Wai Wong, M.D., Ph.D., Chief of NEIs Laboratory on Neuron-Glia Interactions in Retinal Disease, a clinician-scientist who researches the neuro-inflammatory mechanisms underlying diseases such as AMD and diabetic retinopathy.
Dr. Chew described numerous risk factors associated with AMD, including: aging; genetics, obesity, smoking, and nutritional factors. NEI-funded research has identified more than 30 genes already associated with AMD, and genetics may account for 60 percent of the cause of the disease. Smoking is a consistent risk factor, with greater risk in those with increasing number of cigarettes smoked. The NEI-funded Age Related Eye Disease Study (AREDS) demonstrated that daily high doses of vitamins C and E, beta-carotene, and minerals zinc and copper reduced the risk of progression to advanced AMD by 25 percent in five years. Data from a follow-up study, AREDS2, suggest that replacing beta-carotene with lutein and zeaxanthin may produce a safer, more effective formula. Dr. Chew was engaged in both of these trials, serving as the Principal Investigator for AREDS2.
Dr. Chew stressed that, since AMD affects central vision—specifically the macula, which is the central part of the light-sensitive retina in the back of the eye—it impacts an individuals ability to read and drive, significantly affecting quality of life. She shared results from AEVRs 2014 study entitled The Publics Attitudes about the Health and Economic Impact of Vision Loss and Eye Disease—commissioned by Research!America from Zogby Analytics and funded by Research to Prevent Blindness—which reported that Americans across all racial and ethnic lines rate losing their eyesight as having the greatest impact on their daily life and having a significant impact on their independence, productivity, and quality of life.
Dr. Wong addressed NEIs efforts to investigate and find treatments for both wet or neovascular AMD, where new blood vessels disrupt the retina, as well as for dry or atrophic AMD, where the photoreceptors—the light-sensitive cells in the retina—gradually die away. He acknowledged the dramatic improvements in wet AMD treatment from anti-VEGF therapy. These therapies, which are ophthalmic agents developed, in part, through NIH-funded research, inhibit abnormal blood vessel growth due to Vascular Endothelial Growth Factor (VEGF), stabilizing vision loss and, in some cases, improving lost vision. He did caution, however, that there are limitations to these therapies, including that they currently are administered through an injection to the eye. Regarding dry AMD, currently no treatments exist, and investigators are keen to understand and find ways to halt its progress.
Dr. Wong concluded by summarizing where more AMD research is needed: understanding what gives rise to early AMD, how it progresses, and identifying/testing molecules that stop progression; developing new and better clinical trials to confirm effective treatments in patients; comparing and potentially personalizing patient treatment options; and potentially restoring vision to blind patients. In that regard, NEIs Audacious Goals Initiative—a concerted research effort to restore neurons and neural connections in the eye and visual system-aims to restore vision in the next 10-15 years.
AEVRs briefing featured an Eye Healthy luncheon, in which food items were identified for their nutritional content of zinc, copper, antioxidants, omega-3 fatty acids, beta carotene, and lutein/zeaxanthin, per NEIs AREDS and AREDS2 studies.
AEVR wishes to thank its co-sponsors for this event:
Research to Prevent Blindness
AMD Alliance International
Alliance for Aging Research
Association for Research in Vision and Ophthalmology
European Vision Institute
The speakers were approached by several attendees with questions after the briefing. In the foreground, Dr. Chew speaks with Cong. Donald Norcross (D-NJ)
ARVO Deputy Executive Director Joanne Olson with Dr. Chew, who also serves as President-Elect of ARVO, the largest eye and vision research organization in the world
Vision community members attending the event included Ruth Burns of Regeneron, which provided a grant to support the Eye Healthy luncheon, Dawn Mancuso, the new Executive Director of the Association of Schools and Colleges of Optometry, and Michael Duenas. O.D., Chief Public Health Officer at the American Optometric Association