Latest news with #maculardegeneration
Medscape
26-05-2025
- Health
- Medscape
Can You Eat Away the Risk for Blindness?
Many clinicians wonder if their advice about smoking cessation, diet, and exercise has much effect on patients. But people with family histories of age-related macular degeneration (AMD) may be more receptive than others. Given the dearth of effective treatments once patients have reached the late stage of the disease, they may be motivated by hearing to lifestyle changes early in the course of the condition may help preserve their vision. Paul Bernstein, MD, PhD 'When I first started in this field 30 years ago, there was really not much we could do for the patients,' said Paul Bernstein, MD, PhD, a professor of ophthalmology and ocular science at the Moran Eye Center at the University of Utah in Salt Lake City. Intravitreal injection therapy with anti-vascular endothelial growth factor (VEGF) agents has made a dramatic difference in the care of the wet form of advanced AMD, or choroidal neovascularization (CNV). CNV results from abnormal growth of blood vessels in the back of the eye and accounts for most cases of blindness from AMD. But 80% of patients with AMD suffer from the dry form of the condition, or geographical atrophy, which is characterized by enlarging areas of photoreceptor and retinal pigment epithelium atrophy. Two recently-approved drugs for dry AMDinhibit steps in the complement pathway and slower the growth of atrophic lesions but do not prevent loss of vision. AMD is to blame for nearly half of the cases of blindness in people older than 40 years. In 2019, an estimated 20 million people older than 40 years in the United States, or about 12.4% of the population, had AMD, of whom 1.5 million had late stages of the condition, when vision loss typically occurs. The Role of Nutrition Age is the biggest nonmodifiable risk factor for AMD, while genetics accounts for 71% of the risk of developing the disorder. Even so, experts say patients need to know that certain behaviors can increase — or reduce — their odds both of developing AMD and slowing its progression. Smoking has long been recognized as an important contributor to the risk for AMD, with a two- to three-fold risk for advanced AMD in current smokers compared with nonsmokers. But 20 years after quitting smoking, the risk returns to that of a nonsmoker. Exercise can help, too. A 2017 meta-analysis of studies examining the relationship between exercise and AMD suggested that regular physical activity could reduce the development of late disease by 40%. Some of the strongest data support the role of nutrition in preventing AMD. 'In terms of things that people can do to lower their risk beyond smoking, nutrition is really kind of the biggest thing that people can do,' Bernstein said. The macula lutea derives its name from the Latin for 'yellow spot.' To Bernstein, that's a clue: 'Lutein and zeaxanthin that we get from our diet come from green leafy vegetables, and orange and yellow fruits and vegetables. Both these compounds are very actively concentrated in the macula of the eye,' he said. 'When the eye goes out of its way to accumulate a nutrient in the retina, that nutrient is likely to be important for the functioning' of the organ. Bernstein's theory has been buttressed by two randomized trials of vitamin supplementation. The Age-Related Eye Disease Study (AREDS1), which ran from 1992-2001, demonstrated patients with intermediate AMD treated with vitamins C, E, and beta-carotene, along with zinc, showed a 25% decrease in the risk of progressing to late AMD after 6 years of follow-up. But given concerns about an increase in lung cancer in patients with a history of smoking who received high doses of beta-carotenoids, the AREDS2 trial replaced the beta-carotene component with lutein and zeaxanthin. That substitution removed the risk for lung cancer while still protecting against progression from intermediate to advanced AMD, and the AREDS2 vitamins have become the standard of care for patients with intermediate forms of the disease. But can preventive efforts be helpful before AMD progresses to its intermediate stage? Tiarnán Keenan, MD, PhD Tiarnán Keenan, MD, PhD, of the National Eye Institute, has used data from AREDS1 and 2 to explore the role of diet in patients already taking supplements. 'The Mediterranean diet, the anti-inflammatory diet pattern, or low glycemic diets are all really strongly associated with reduced risk of disease,' Keenan said. His research has found adherence to a Mediterranean diet in particular can reduce the risk for progression from early to intermediate AMD by 21%, while also lowering the risk for the dry form of late AMD by nearly 30%. The main protective drivers were consuming fish at least twice per week; fruits twice per day; and at least 200 g per day of vegetables. The consumption of six to seven servings of red meat a week for women and nine or more servings a week for men was found to be harmful. Keenan and his colleagues from the AREDS/AREDS2 Research Groups were able to control the use of dietary supplements and a history of smoking, meaning the decreases in risk associated with eating fish and vegetables occurred in addition to the lower risks seen with taking vitamins. 'The answer comes up very clearly that you get additional benefits,' he said. Keenan has encountered patients who don't think they need to change their diets because they already are taking ALREDS2 vitamins, or who have made dietary changes and do not want to take supplements. 'But that's not true. Dietary changes and supplements are complementary,' he said. Keenan told them supplements are mostly helpful in decreasing the risk of developing wet AMD, whereas eating fish, fruits, and vegetables can prevent progression to advanced disease from geographical atrophy. For patients who have a family history of AMD, diet can largely overcome their genetic risk. Participants in the Coimbra Eye Study underwent ophthalmological exams, completed dietary histories, and received genetic testing for variants associated with AMD. Adherence to a Mediterranean diet was associated with a lower risk for the condition overall, but the most significant findings — a 60% reduction in risk — was observed in those with the greatest genetic predisposition. Screening Gaps The American Academy of Ophthalmology (AAO) recommends a formal eye exam, which includes a dilated slit lamp exam, starting at age 40 years even in people without any loss of visual acuity. Because the risk for cataracts, glaucoma, and AMD rises with age, patients should visit an ophthalmologist or optometrist more frequently as they age (Table). But the National Health Interview Survey showed that in 2017 only 40% of patients at high risk for vision loss — people with self-reported diabetes, a self-reported history of vision and eye problems, or who are age 65 years or older — had the appropriate exam in the last year. Steven Bailey, MD Steven Bailey, MD, a professor of ophthalmology at the Casey Eye Institute at Oregon Health and Science University in Portland, Oregon, helped write the AAO's most recent practice guidelines for AMD. 'In general, evaluations for age-related macular degeneration are recommended starting at 50,' he said, as it is uncommon to see AMD before age 50 years even in individuals with a family history. Bailey also said patients with a family history of AMD presenting before age 50 years should be referred earlier as their family member's eye disease may not have been AMD, but something else, such as a macular dystrophy. Primary care clinicians also can educate patients with a family history about the early warning signs of AMD, such as difficulty performing tasks under low light conditions, visual distortion, or symptoms of blurred vison or difficulty focusing, which are red flags indicating need for a referral to an eye specialist. Although the guidelines do not recommend AREDS2 vitamins for patients with a family history of AMD or those with early disease — largely because of lack of efficacy at that stage — Bailey said primary care clinicians can support their patients by encouraging lifestyle changes. 'The low hanging fruit is healthy diet and active lifestyle, and those overlap with so many other benefits,' he said. 'The thought of vision changes can help patients decide, 'This is actually worth it.'' For patients who have progressed to intermediate AMD, Bailey stressed the importance of making sure patients are taking supplements and that they receive regular dilated slit lamp exams. Some people start vitamins and take them for years without seeking additional follow-up from an ophthalmologist. Patients also should be reminded about the importance of tools such as the Amsler grid or electronic home monitoring for detection of warning signs for progression of disease. An Amsler grid, which Bailey prefers for home use, is unlikely to detect changes in someone with early AMD. 'Regular Amsler grid testing would probably be most important for someone who has intermediate AMD or more advanced AMD in one eye,' as it can identify early changes in the good eye, he said. 'If you develop wet macular degeneration, we want to catch that as soon as we can, because the treatment is very effective at halting progression,' he added. Patients undergoing monthly treatments with anti-VEGF drugs should be reminded of the importance of adhering to a regular regimen. 'It's a treatment, not a cure,' Bailey said. 'If you withhold that treatment, sometimes they can lose ground that we can't regain.' But helping patients avoid late AM — and the need for intravitreal injections — should be the goal. Bernstein said he has seen some people with early AMD who have already developed visual problems. He often finds they have low levels of macular pigment related to poor diet or some type of malabsorption syndrome. He starts them on supplements and looks forward to seeing them at follow-up. 'I have patients come back, and they're seeing better,' he said. 'A lot of their symptoms better.' Bernstein reported research support from Kemin, Bausch + Lomb, and Heidelberg Engineering. He also has been a speaker for DSM-Firmenich and OmniActive. Bailey and Keenan reported no conflicts of interest.
Yahoo
23-05-2025
- Health
- Yahoo
Bayer wins EU watchdog's endorsement for longer Eylea treatment intervals
(Reuters) -German drugmaker Bayer on Friday won an endorsement by the European Medicines Agency to extend the intervals between shots of its anti-blindness treatment Eylea, giving it a potential edge over Roche's rival treatment Vabysmo. Bayer said in a statement the European Medicines Agency recommended that eye drug Eylea, at a high dose of 8 mg, can be injected at intervals of up to six months to treat wet age-related macular degeneration and diabetic macular oedema. Bayer shares were up 2.5% at 0717 GMT, surpassing a gain of 0.7% in the Stoxx Europe 600 Health Care index. Eylea, an injection against the leading causes of blindness among the elderly, is currently approved in the EU for treatment intervals of up to five months. Bayer has developed it jointly with Regeneron. Vabysmo, a major driver of revenue growth for Switzerland's Roche, is cleared to be given at intervals of up to four months. The EU commission has the final say on drug approval but it typically follows the medicines agency's opinions. Bayer said that decision is expected within the next few weeks. Sign in to access your portfolio
Reuters
23-05-2025
- Business
- Reuters
Bayer wins EU watchdog's endorsement for longer Eylea treatment intervals
May 23 (Reuters) - German drugmaker Bayer ( opens new tab on Friday won an endorsement by the European Medicines Agency to extend the intervals between shots of its anti-blindness treatment Eylea, giving it a potential edge over Roche's (ROG.S), opens new tab rival treatment Vabysmo. Bayer said in a statement the European Medicines Agency recommended that eye drug Eylea, at a high dose of 8 mg, can be injected at intervals of up to six months to treat wet age-related macular degeneration and diabetic macular oedema. Bayer shares were up 2.5% at 0717 GMT, surpassing a gain of 0.7% in the Stoxx Europe 600 Health Care index. Eylea, an injection against the leading causes of blindness among the elderly, is currently approved in the EU for treatment intervals of up to five months. Bayer has developed it jointly with Regeneron (REGN.O), opens new tab. Vabysmo, a major driver of revenue growth for Switzerland's Roche, is cleared to be given at intervals of up to four months. The EU commission has the final say on drug approval but it typically follows the medicines agency's opinions. Bayer said that decision is expected within the next few weeks.
National Post
13-05-2025
- Health
- National Post
BrightFocus Foundation Awards Nearly $13M to 50 Scientists for Alzheimer's, Macular Degeneration, and Glaucoma Research
Article content New grant funding supports cutting-edge scientific ideas across risk reduction, earlier detection, and new treatments for diseases of mind and sight. Article content Article content CLARKSBURG, Md. — Private research nonprofit BrightFocus Foundation today announced nearly $13 million in grants to support early investigative research into Alzheimer's disease, macular degeneration, and glaucoma. This includes $7.3 million to its Alzheimer's Disease Research program, $3.8 million to its Macular Degeneration Research program, and $1.8 million to its National Glaucoma Research program. Article content 'With recent major cuts to federal research funding, private foundations like BrightFocus are more essential than ever—stepping up to keep promising research alive, nurture early-career scientists, and accelerate breakthroughs.' Guided by scientific advisory committees of world-renowned researchers in the field, BrightFocus invests in highly innovative, experimental research and creative ideas with the most promise to foster a better understanding of disease onset, improve early detection and diagnosis, develop new treatments, and—ultimately—lead to cures. This year's grants were awarded to scientists in 10 countries including the U.S. Article content 'This year's grant awards represent some of the boldest, most cutting-edge ideas in vision and brain health research,' said BrightFocus President and CEO Stacy Pagos Haller. 'With recent major cuts to federal research funding, private foundations like BrightFocus are more essential than ever—stepping up to keep promising research alive, nurture early-career scientists, and accelerate breakthroughs.' Article content BrightFocus Foundation's research programs are supported entirely by private donor contributions from the public and corporate and foundation grants; BrightFocus receives no government funding. Learn more about how to support our work. Article content A complete list of the new research projects will be available this summer on BrightFocus' website, with additional details forthcoming upon the completion of individual agreements with the partnering institutions and scientists. Article content Over 7 million Americans aged 65 and older are living with Alzheimer's disease, a progressive, terminal brain disorder that has no known cause or cure. Unless scientists can unlock the secrets of this disease, the number of cases is expected to triple by the year 2050. Grant recipients are studying a range of approaches spanning different areas of the brain and body to better understand the disease's onset and progression. Article content Alzheimer's Disease Research grant recipients: Article content Katerina Akassoglou, PhD The J. David Gladstone Institutes Article content Federica Anastasi, PhD Barcelonaβeta Brain Research Center (Spain) Article content Isabelle Aubert, PhD Sunnybrook Research Institute (Canada) Article content Daniel Bos, MD, PhD Erasmus University Medical Center Rotterdam (Netherlands) Article content Todd J. Cohen, PhD University of North Carolina at Chapel Hill Article content Joshua Emmerson, PhD Washington University in St. Louis Article content Ghazaleh Eskandari-Sedighi, PhD University of California, Irvine Article content Anllely Fernandez, PhD Indiana University Article content Hongjun Fu, PhD The Ohio State University Article content Laura Fumagalli, PhD Flanders Institute for Biotechnology (Belgium) Article content John Hardy, PhD, FRS University College London (U.K.) Article content Joseph Herdy, PhD The Salk Institute for Biological Studies Article content Sarah Elise Heuer, PhD Brigham and Women's Hospital Article content Jack Humphrey, PhD Icahn School of Medicine at Mount Sinai Article content Ksenia Kastanenka, PhD Massachusetts General Hospital Article content Jr-Jiun Liou, PhD University of Pittsburgh Article content Jae-eun Miller, PhD Columbia University Article content Miguel Moutinho, PharmD, PhD Indiana University Article content Carolina Ochoa-Rosales, PhD Adolfo Ibáñez University (Chile) Article content Omar Peña-Ramos, PhD Baylor College of Medicine Article content Cyril Pottier, PhD Washington University in St. Louis Article content Marcos Schaan Profes, PhD Icahn School of Medicine at Mount Sinai Article content Nader Saffari, PhD, MSc, BSc University College London (U.K.) Article content Monica Santisteban, PhD Vanderbilt University Medical Center Article content Feng Tian, PhD Beth Israel Deaconess Medical Center Article content Rebecca Wallings, DPhil Indiana University Article content Justyna Dobrowolska Zakaria, PhD Northwestern University – Chicago Campus Article content Damian Zuloaga, PhD University at Albany Article content Macular Degeneration Research Article content Twenty million U.S. adults have macular degeneration—the leading cause of vision loss in Americans aged 65 and older. Early detection and treatment are crucial to slowing the disease progression and preventing permanent vision loss. Grant recipients are exploring a wide range of innovative scientific approaches, from exploring ways to regenerate damaged cells to determining the influence of early-life events and lifestyle factors on disease risk. Article content Macular Degeneration Research grant recipients: Article content Mohajeet Balveer Bhuckory, PhD Stanford University School of Medicine Article content Ana J. Chucair-Elliott, PhD University of Oklahoma Health Sciences Center Article content Charles DeBoer, MD, PhD Stanford University School of Medicine Article content Ashley Farre, PhD University of Idaho Article content Valencia Fernandes, PhD University of California, San Francisco Article content Masayuki Hata, MD, PhD Kyoto University (Japan) Article content Ruchi Sharma, PhD National Eye Institute, NIH Article content Nobuhiko Shiraki, PhD Duke University School of Medicine Article content Daisy Yao Shu, PhD University of New South Wales (Australia) Article content Jerzy Szablowski, PhD William Marsh Rice University Article content Amir Mani Varnoosfaderani, PhD University of Chicago Article content Joëlle Elise Vergroesen, PhD Erasmus University Medical Center Rotterdam (Netherlands) Article content National Glaucoma Research Article content Around 4 million U.S. adults have glaucoma—a leading cause of blindness in the U.S. caused by damage to the optic nerve. Because there are often no early symptoms, as many as half of those affected may not even know they have it until irreversible vision loss has occurred. Although there is no cure, early detection and treatments can help slow the disease's progression. Article content Grant recipients are investigating a wide range of scientific approaches, including novel treatments, early detection methods, and efforts to protect and regenerate retinal ganglion cells that could preserve or restore vision. Article content National Glaucoma Research grant recipients: Article content Brad Fortune, OD, PhD Legacy Research Institute Article content Tatjana Jakobs, MD Schepens Eye Research Institute of Mass. Eye and Ear Article content Colleen McDowell, PhD University of Wisconsin-Madison Article content Rob Nickells, PhD University of Wisconsin-Madison Article content Gavin Roddy, MD, PhD Mayo Clinic, Rochester Article content Dorota Skowronska-Krawczyk, PhD University of California, Irvine Article content Dan Stamer, PhD Duke University Article content Karl Wahlin, PhD University of California, San Diego – Health Sciences Article content Pete Williams, PhD Karolinska Institute (Sweden) Article content Benjamin Xu, MD, PhD University of Southern California Article content BrightFocus encourages researchers with groundbreaking ideas to apply for a 2026 grant. Application information is available at Article content BrightFocus Foundation is a premier global nonprofit funder of research to defeat Alzheimer's, macular degeneration, and glaucoma. Through its flagship research programs — Alzheimer's Disease Research, Macular Degeneration Research, and National Glaucoma Research— the Foundation has awarded over $300 million in groundbreaking research funding since its inception in 1973 and shares the latest research findings, expert information, and resources to empower the millions impacted by these devastating diseases. Learn more at Article content Article content Article content Article content Article content Article content
