Macular Degeneration

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MacularDegeneration

• Amanda Thompson
• Mrs. Jensen Block 3

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Macular Degeneration

• Affects NERVOUS SYSTEM
• Eye disorder making it difficult to see
• Affects the macula, part of retina for central
  vision

OVERVIEW

• Caused by damage to the macula
• 2 types dry and wet AMD
• Because it does not affect peripheral vision, you
  will never lose sight completely

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Central Nervous System

• Sensory reception
• Sight, smell, taste, balance, hearing
• CNS connects to PNS through nerves (axons)
• Detects, interprets, and responds to changes in
  internal and external conditions

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Healthy Macula vs. AMD Macula
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Wet AMD

• More rare, also more serious
• Abnormal blood vessels grow beneath macula and
  retina, AKA choroidal neovascularization
• May leak blood or fluid, damaging macula

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Dry AMD

• Much more common
• Occurs when retina gets thin and dried out
• Small yellow deposits, drusen, form beneath
  macula
• As drusen become more prominent, sight is lost

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Population Affected

• Nearly 8.5 million people are affected by macular
  degeneration in the U.S. alone (1.75 million are
  in the advanced stages)
• Only about 10 have wet, 90 dry
• Who will get it?
• -Women
• -People over age 65 have much higher risk
• -Obese or inactive persons
• -Smokers
• -Light Pigmented Eyes
• -People with a family history of AMD

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Treatments

• Dry AMD

• Wet AMD

• No FDA approved treatments are available for this
  type of AMD
• A few are in clinical trials
• Strong evidence has shown that supplements of
  vitamins A, C, and E can slow the progression of
  the sight loss
• Recommended to wear UV protection over eyes

• Lucentis-monthly eye injections inhibiting the
  proteins that stimulate new blood vessel growth
• Macugen-eye injections of therapeutic molecule
  attacking new blood vessel growth proteins inside
  the eye every six weeks
• Photodynamic Therapy-injection of Visudyne in the
  arm which is activated in retinal blood vessels
  by laser shining into the eye, producing chemical
  reaction that kills new blood vessels

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Trial 1
A Study of an Encapsulated Cell Technology (ECT)
Implant for Patients With Atrophic Macular
Degeneration

• Purpose
• This trial is aimed towards dry AMD. The implant
  is a small capsule that contains human retinal
  pigment epithelium cells. These cells have been
  given the ability to make CNTF and release it
  through the capsule membrane into the surrounding
  fluid. In this study, two different CNTF dose
  levels will be used a high dose and a low dose,
  as well as a sham surgery (or placebo) group.
• CNTF is Ciliary Neutrophic Factor
• Neurotrophic factors are agents with a promising
  ability to retard progression of
  neurodegenerative diseases and are effective in
  slowing photoreceptor degeneration in animal
  models of retinitis pigmentosa.

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Trial 2
Development of iPS From Donated Somatic Cells of
Patients With Neurological Diseases

• Purpose
• Human fibroblasts and possibly other human
  somatic cells may be reprogrammed into induced
  pluripotent stem (iPS) cells by the forced
  expression of transcription factors (1-5). The
  iPS cells seem to share many properties with
  human embryonic stem cells.Induced pluripotent
  stem cells potentially may be useful in the
  future as an unlimited source of cells for
  transplantation.The major goal of the project is
  to develop human iPS cells from cell cultures
  from skin biopsies or the patient's hair. The iPS
  cells will be developed primarily for modeling
  diseases and drug discovery as well as basic
  research, and for developing the technology that
  may eventually allow the use of iPS cells for
  future transplantation therapy. The iPS cells
  developed in the course of this application are
  not intended for use in transplantation therapy.
  Future development of iPS cells for clinical
  transplantation therapies will be subjected to
  the appropriate authorization by ethical and
  regulatory committees.

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Trial 3
VEGF-Antagonism and Endothelial Function in
Age-Related Macular Degeneration (AMD)

•   Purpose
• The objective of this study is to evaluate the
  effects of 2 intravitreal injections with
  Ranibizumab or Avastin on endothelial function in
  subjects with neovascular macular degeneration
  compared to patients with dry AMD.

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Bibliography

• Age-related macular degeneration . (2009,
  December 11). Retrieved December 12, 2009, from
  RNIB http//www.rnib.org.uk/eyehealth/eyeconditio
  ns/conditionsac/Pages/amd.aspx
• Age-Related Macular Degeneration . (2009,
  October). Retrieved December 12, 2009, from
  National Eye Institute http//www.nei.nih.gov/hea
  lth/maculardegen/armd_facts.asp
• Ciliary neurotrophic factor (CNTF) for human
  retinal degeneration Phase I trial of CNTF
  delivered by encapsulated cell intraocular
  implants . (2006, February 27). Retrieved
  December 13, 2009, from Pub Med Central
  http//www.ncbi.nlm.nih.gov80/pmc/articles/PMC138
  3495/
• Haddrill, M. (2009, September). Macular
  Degeneration Treatment . Retrieved December 12,
  2009, from All About Vision http//www.allaboutvi
  sion.com/conditions/amd-treatments.htm
• Roberts, D. (n.d.). Numbers of People with
  Macular Degeneration and Other Retinal Diseases.
  Retrieved December 12, 2009, from MD Support
  http//www.mdsupport.org/library/numbers.html