Innovative therapies

Review of advances in macular degeneration treatment

Gene therapy and stem cell therapies offer two different avenues of reaching the same goal. Gene therapy involves the introduction of healthy genetic material to the patient in order to adjust the patient's cells. Stem cell therapy involves introducing whole stem cells to the patient. Other approaches include directly transplanting healthy cells or a miniature telescope into the eye.

Basic complementary treatment

None of the advances in technology should replace attention to basic essential ingredients of vision protection.

• Protect your vision from damaging effects of UV and blue sunlight with amber colored UV resistant sunglasses.
• Pay attention to your diet, avoid toxic/damaging additives and include juicing for maximum benefit.
• Get exercise, stop smoking, manage your mental health.
• Supplement your diet with essential nutrients to support healthy vision.

2016: Stem cell therapy

With increasing pilot studies in stem cells there have been some breakthrough reports. After initial clinical trials it takes some years for therapies to pass through phase-two and phase-three clinical trials before they can be offered to everyone.

An Israeli company has developed a proprietary stem cell technology which involves injecting retinal pigment (RPE) cells into the macula. The RPE cells are grown from stem cells. These young cells are free from the effects of aging. Learn more.

2015: Stem cell breakthrough

Researchers in Japan were able to create pluripotent stem cells from almost any cell in the body. This breakthrough involves modifying a patient's own cells genetically so that they are like embryonic stem cells. Natural stem cells have the ability to turn into any kind of other cell. This process essentially reverses the process by taking a cell back to its basic genetic structure and achieving pluripotency. Learn more about this stem cell breakthrough.

2013: Gene therapy

English researchers found that the photoreceptor cells in retinopathy could be revived following insertion of genes into patients' eyes. This trial may lead to more options for curing macular degeneration. Learn more.
Source: Oxford University, 2013, BBC News

2013: Stem cell clinical trial

The first clinical trial using stem cells to treat macular degeneration was approved by the Japanese government in 2013. This trial will use stem cells, which are capable of differentiating into a number of cell types, taken from the adult patients. Using cells from the patient's body lessens the likelihood of rejection. This approval is a first and is a major step in the field of stem cell research. The Riken Center reported in 2015 that the first patient to receive this treatment has shown improvement. Read more.
Source: Riken Center, Kobe.

2012: Fat stem cells

Researchers discovered a new stem cell type located in human body fat that can be used as an adjunct in healing, among other things, macular degeneration. The idea is that stem cells have the capacity to grow into anything once placed in the appropriate environment. The discovery arose by accident. The trial was intended to grow cells from fat collected from liposuction. A lab equipment failure result in death of all of the cell samples except vigorous stem cells which survived, giving rise to further research. Learn more.

2012-2013: Miniature Implanted Telescopes

A miniature telescope was developed by Centrasight that improves peripherial detail sensing to compensate for lost central vision, although the peripherial vision is lessened. . Source: Centrasight.

Another miniature telescope developed in 2012 uses tiny mico-optical wide-angle lenses and replaces the natural lens. The magnification is about 2:1 allowing a significant vision improvement. Learn more about implantable telescopes. Source: Vision Care Opthalmic Technologies

2012: Transplanted photoreceptor cells

In an animal study scientists transplanted, via injection, immature photoreceptor (rod) cells into mice with night blindness. It is easier to transplant rod cells than cone cells. The treated mice were able to navigate a dim light maze, while the controls could not do so. Read more.
Sources: Restoration of vision after transplantation of photoreceptor, Nature, 2012; BBC News, 2012

2011: Fractal nanotechnology

Nanotechnology took a step forward in the quest to cure AMD with the development of "nanoflowers" - nano-sized metal particles that grow like fractals and be able to communicate with neurons in the eye. Fractals, those physically irregular, but mathematically beautiful patterns have the capacity to capture light at the retina and convey it to the optic nerve with tremendous accuracy - as opposed to current electronic chips which are not fractal in structure and which are not as effective.
Source: Medical News, Learn more.

2011: Implanted polymer semiconductors

Scientists know how to use a video camera attached to glasses to transmit light information to a device implanted on the retina. Italian scientists demonstrated that using polymer semiconductors, can improve image quality. They were working on new methods for these semiconductors to communicate directly with the brain to, for example, add color to what they can see.
Source: Technology Review

2010: FDA approval for stem cell research

In 2010 researchers moved another step forward when the FDA approved use of stem cells to treat macular degeneration. This opened the way for scientists to begin human testing of the new techniques.
Source: Medscape

2010: Müller cells

Inspired by the capacity of fish and newts to regrow lost parts of their anatomy, researchers at the University of San Diego applied for and received a grant from NIH to explore the potential of retinal cells to regenerate. They are looking specifically at Müller cells which are used by fish to regenerate nerve cells in their eyes. In the eye, Müller cells are living optic fibers that lie outside the retina in long cylindrical tubes that transmit light to the retina. Regeneration of nerve cells in humans is unknown, but scientists hope to determine how they can be manipulated or induced to do so by better understanding the role of Müller cells.
Source: www.eurekalert.org, 2010

2010: Inflammation cause

Scientists had previously determined that patients who had a form of the gene CFH, a protein involved in immune system regulation were more at risk for developing AMD - but the mechanics of why was not understood. The new discovery was that these people are more susceptible to inflammation in the eye that could lead to macular degeneration. The reason was that the particular protein was unable to reside in the proper location at a the Bruch's membrane layer near the retina. Without proper amounts of CFH in this location would cause or worsen inflammation that in turn would damage cells of the retina and eventually lead to AMD.
Source: Media NewsWire

2010: Miniature implantable telescope

The FDA approved an implant that is essentially a miniature telescope the size of a pencil eraser that can be implanted adjacent to the cornea to project a magnified image to the retina.
Source: technologyreview.com. Learn more.

2009: Stem cells to pigmented cells

British researchers figured out how to coax adult stem cells into turning into retinal pigment epithelium cells - which will provide a new option for patients with macular degeneration. These trials were done with lab animals who had been bred to display macular degeneration problems and the tests were performed both in vitro and in vivo.
Source: Pl0S One, Carr, et al, 2009

2009: Gene therapy to build new rods/cones

Pennsylvania School of Medicine researchers introduced a corrected copy of an essential gene into the retina of a patient with Leber's. The teen was able to build new rods and cones which ordinarily are not replaceable. Like other gene therapies, this technique - inserting a "corrected" gene into the retina - has potential benefits for macular degeneration treatment. Learn more.

2009: Photoreceptor cells from skin cells

University of Wisconsin researchers were able to grow photoreceptor cells from human skin cells using a gradual step-by-step progression called stepwise differentiation, in which cells were transformed step-by-step from skin cells to photoreceptor cells that could be implanted in the eye where they're needed to replace damaged photoreceptor cells. The new technology was of particular interest because while scientists have known that stem cells can grow into anything else, in this instance, non stem cells - skin cells - were used. It pointed to the fundamental universality and pretty much infinite flexibility that is possible in the body.
SOURCE: Modeling early retinal development with human embryonic and induced pluripotent stem cells, Meyer, et al, 2009

2005: Small interfering RNA (siRNA)

Small interfering RNA is a specific class of double-strand RNA, or RNA duplex which has the capacity to interfere with certain gene expressions. Researchers used clinical trials of siRNAs to turn off the activity of genes that were giving rise to macular degeneration. The researchers didn't note any safety concerns, such as an increase in IOP - the most common side-effects were tied to the injection procedure used to implement the therapy. Based on these results, phase 2 trials were approved by the FDA.
Source:www.docguide.com