A study recently presented at the Association for Research in Vision and Ophthalmology 2010 annual meeting showed and association between aspirin use and macular degeneration.  According to Dr. Paulus de Jong there had been several studies that had found an association as well as several studies that had found no association and this study was meant to “disentangle the conflicting evidence” between aspirin use and macular degeneration.

The study examined 4691 patients 65 years of age or older.  Study participants were asked about their use of aspirin as well as other possible risk factors known to contribute to macular degeneration.

The study concluded that frequent aspirin use appeared harmful for the aging macula and contributed to the onset of the eye disease macular degeneration.

Dr. de Jong indicated patients should not stop taking aspirin for cardiovascular disease but should look at other medications if it is used as a pain killer.  Others have expressed concerns over the study saying that while there is an association between aspirin use and macular degeneration there may be other factors not explored, including the reasons for taking the aspirin.

More research into aspirin use and macular degeneration is required before any definite link to the eye disease is known.

According to Dr. Benjamin Reubinoff, the study’s lead author “Although there are a variety of therapeutic approaches under development to delay the degenerative process, the grim reality is that many patients eventually lose their sight. (Stem) Cell therapy to replenish the degenerating retinal cells may potentially halt disease progression.”

Stem cell treatments are not the only macular degeneration and eye disease treatment being explored.  In 2001 a study released by the National Eye Institute suggested that high doses of antioxidants, beta-carotene and the mineral zinc reduce the risk of vision loss associated with advanced macular degeneration.  Other nutritional supplements containing omega-3 and omega-6 fatty acids have been shown to have benefit at reducing the risk of diseases such as macular degeneration and restore conditions associated with other eye diseases.

However, many are placing hope in the ability of stem cell therapy to provide an eventual cure for degenerative eye diseases such as macular degeneration.  The potential of stem cell treatments have been clearly demonstrated in studies similar to those conducted by the Jerusalem researchers.

Reporting their findings in the November 9 edition of the Archives of Ophthalmology, researchers are hoping that the discovery of this new inherited eye disease can provide a deeper understanding of other common retinal diseases.

Dr. Vinit Mahajan, the lead author said “It is rare to find a new inherited eye disease that affects the macula.  We thought we had seen them all.”

The newly found retinal eye disease causes abnormal blood vessels to form in the macula.  These abnormal blood vessels are prone to bleeding and this will cause both swelling and scars that affect vision.  These are symptoms that are generally associated with wet macular degeneration.

The researchers discovered their findings when one person in a family sought care for eye problems.  “If a doctor saw just one family member, they would probably call this macular degeneration. We knew there was something different, and we had to examine the rest of the family,” Mahajan said.

After examining 20 extended family members with visual problems of different severities.  Some family members had lost central vision and some had strabismus, a disorder in which the eyes are not aligned.

It is hoped that the discovery of this new macula eye disease will lead to a greater understanding of other eye diseases.

Macular Degeneration is thought to result from the breakdown in the relationship between retinal pigment epithelium (RPE) and the vascular layer that nourishes the retina.  It is thought that as the RPE degenerates it will not produce VEGF and that this results in damage to the vascular layer.  As a result, dry macular degeneration will occur.

Conversely, if the vascular layer degenerations there is an over-production of of VEGF as the eye attempts to grow new blood vessels.  This may result in the onset of wet macular degeneration.

VEGF molecules produces by the RPE must travel across the Bruch’s membrane to the vascular layer in the retina.  In the research, the mice were only able to produce a type of VEGF that could not travel across this membrane, thus depriving the vascular layer of VEGF.  In the genetically engineered mice however, the progressive degeneration resulted in a decline in visual acuity.

The researchers were quick to caution that continued blocking of VEGF through use of anti-VEGF drugs such as Lucentis may contribute to the development of late state dry macular degeneration.

Previous studies had shown a relationship between cataract surgery and the exposure of the retina to blue light.  This was said to be a contributing factor for the development of macular degeneration.

It was thought that the retina may be protected from macular degeneration by macular pigment.  This may prevent the onset of macular degeneration as well as the progression of macular degeneration according to the study authors.

In a prospective and randomized study of 42 patients, 21 of which were implanted with an AcrySof Natural IOL with blue light-filtering capability and the other 21 implanted an an AcrySof three-piece acrylic IOL, those patients implanted with the blue light-filtering IOL were shown to have increased macular pigment at 3-months after the surgery.

With Lutein and Zeaxanthin serum concentrations also assessed, researchers found that the results showed that implantation of blue light-filtering IOL increased macular pigment in the absense of raised lutein or zeaxanthin serum levels.

The study authors commented that “Further study is required in the form of controlled long-term trials to investigate whether implantation of a blue light-filtering IOL is effective in preventing or delaying development or progression of macular degeneration.”

Source: Invest Ophthalmol Vis Sci. 2009;50(10):4777-4785.

While patients with dry macular degeneration often have superior vision than patients with wet macular degeneration, Dr. Mogk indicated that suffering from the eye disease made it difficult to perform specific tasks such as reading, money management, self care, meal preparation and housekeeping.  These tasks generally directly impact the quality of life of people suffering from the degenerative eye disease.

According to the study presented at the American Academy of Ophthalmology meeting, 100 percent of patients suffering from wet macular degeneration had difficult reading compared to 90 percent of patients suffering from dry macular degeneration.  When asked about money management, 88.3 percent of those suffering from wet macular degeneration had difficult compared to 83.2 percent suffering from dry macular degeneration.  For self care, 71.8 percent of people suffering from the eye disease wet macular degeneration indicated they experienced difficulty versus 61.1 percent of those with wet AMD.  Similar percentages were also noted for both meal preparation and housekeeping.

Patients with both forms of the eye disease also showed similar scores on the Geriatric Depression Scale, with 30 percent of patients suffering from wet macular degeneration showing probable depression version 24 percent of patients with dry macular degeneration.

According to the study’s senior author, Dr. Robert J. Nicolosi, “Two eggs per day is probably all that is needed to maximize blood levels of lutein and zeaxanthin as well as macular pigment optic density (MPOD) status.”  Both lutein and zeaxanthin have been shown in other studies to help lower the risk associated with macular degeneration.

Study subjects were all older adults taking statins.  Their low-density-lipoprotein cholesterol levels were unaffected even when they ate as many as four yolks per day.  Out of the 52 participants in the study, serum lutein increased by an average for 16 percent after the 2-yolk phase and 24 percent after the 4-yolk phase of the study when compared to the baseline.  Serum zeaxanthin increased by 36 percent and 82 percent respectively.  Macular pigment optic density increased significantly after both phases, but only among individuals with low baseline density values.

While these results may indicate a lower risk of dry macular degeneration, there is a current study underway to evaluate the consumption of 12 eggs per week on the progression of dry macular degeneration.  The senior author points out “Although this was only a 5-week study and the 1-year data are not ready for comment, it would seem to me that physicians could consider that those patients on statins, who have early stage macular degeneration, could be prescribed 2 egg yolks per day.”

Dr. Nicolosi also added that “increases in blood levels of lutein and zeaxanthin and MPOD correlate well with the risk for age-related macular degeneration.”

The impact of such nutrients supports other studies that have indicated that the risk of macular degeneration for individuals can be lessened.

The dry macular degeneration eye drop MC-1101 delivered through Mystic’s VersiDoser delivery system successfully reached the back of the eye and modulated blood flow in the choroid.  The delivery system allowed patients suffering from dry macular degeneration to self-administer the eye drop to the front of the eye.

VersiDoser regulates the dosage level and frequency of the eye drop in those patients suffering from dry macular degeneration.  The regulation of MC-1101 dosing allows for the delivery of a preservative-free formulation of the drug.  This precise delivery of the eye drop facilitated the absorption of the drug to the back of the eye affected with dry macular degeneration.

According to MacuClear president and CEO Philip G. Ralston Jr., “We are very pleased with the groundbreaking results of this study.  We have confirmed the safety of MC-1101 in humans, a primary endpoint for the study.”  Mystic president Timothy Sullivan said that “An overwhelming majority of trial participants expressed a strong positive preference for using the VeriDoser delivery system over traditional eye drop delivery.”

Further studies in the dry macular degeneration eye drops are expected to continue later in the year.rop

Researchers used a large prospective study and examined people with the eye disease macular degeneration and found there was a 50 percent greater risk of heart disease than those with it.  In examining the available data, it was shown that there was no increased risk associated with macular degeneration and stroke.

“This provides further support that age-related macular degeneration is associated with underlying systemic vascular disease,” researchers said.  They noted that evidence suggesting that the eye disease and heart disease share common mechanisms is increasing.

During the study, researchers examined 1,786 patients without heart disease and 2,228 patietns with stroke as a baseline.  All patients were between the ages of 69 and 97, and had been enrolled in the Cardiovascular Heart Study.  Macular degeneration was evaluated using photographs taken at the time of examination.

Of those patients free of heart disease, 303 developed the disease, while 198 of those free of stroke developed the disease.  Early macular degeneration was hown to occur more in those patients with heart disease than those without.  The association of heart disease with macular degeneration was shown even when things such as age, gender, race, blood pressure and smoking were accounted for in the study.

However, late macular degeneration was not associated with heart disease.  Both early macular degeneration and late macular degeneration were not associated with stroke.

Researchers also discovered the associated between macular degeneration and heart disease was stronger in younger patients.  Those people between 69 and 78 years of age had and 80 percent higher risk for heart disease than those without the eye disease.  The risk was only 45 percent for those patients from 79 to 97.

The researhers indicated that their findings were consistent with other literature indicating the association between heart disease and macular degeneration.  “Our findings,” they concluded, “may have broader implications of cardiovascular safety for the many patients with age-related macular degeneration who are treated with long-term antivascular endothelial growth factor therapy.”

With the risk of heart disease increasing when a person suffers from macular degeneration, proper eye health is important.

Primary source: Ophthalmology
Source reference:
Sun C, et al “Age-related macular degeneration and risk of coronary heart disease and stroke: The Cardiovascular Health Study” Ophthalmol 2009; DOI: 10.1016/j.ophtha.2009.03.046.

Macular degeneration is an eye disease that involves the degeneration of light-sensitive retinal cells in the eye.  Treatments are currently available for only wet macular degeneration, leaving people suffering from dry macular degeneration with little or no treatment options.

Growing retinal cells from skin cells could lead to a new treatment for macular degeneration.

As part of their research, human skin cells were manipulated to act like embryonic stem cells.  Stem cells can then be used to grow into any tissue in the body, including retinal cells.  This research suggests that doctors may be able to repair retinal cells damaged by macular degeneration by growing new cells generated from a patients own skin.

People with macular degeneration and retinitis pigmentosa, eye diseaseas that eventually lead to blindness, may benefit from this possible new treatment.

According to David Gamm, a professor of ophthalmology and visual sciences at the University of Wisconsin, the laboratory process of creating human retinal cells helps researchers understand how eyes develop, so disease (such as macular degeneration) that lead to vision loss may someday be treated or even cured with retinal stem cells.

This research comes after several other researchers have announced successes using stem cells to treat macular degeneration.