Macular Degeneration News

Does Hormone Use Lower Risk of Advanced Macular Degeneration in Women?

BOSTON, April 2008 — Declining levels of the hormone estrogen may contribute to development of advanced forms of age-related macular degeneration (AMD) in postmenopausal women, according to researchers at Brigham and Women's Hospital and Harvard Medical School.

A study found a 48 percent lower risk of developing advanced forms of macular degeneration among post-menopausal women who took estrogen as part of hormone replacement therapy. The risk was even lower for postmenopausal women who previously had taken oral contraceptives.

But in what researchers said was an unexpected finding, the risk of developing early forms of macular degeneration was 34 percent higher in women who, at the time of the study, used hormone replacement therapy. Women who had given birth had a 26 percent lower risk of developing early AMD. Past oral contraceptive use in this group was not a factor.

The study involved about 75,000 postmenopausal women who participated in the Nurses' Health Study. Between 1980 and 2002, 554 of the women developed early-stage macular degeneration, and 334 had late-stage AMD, which can cause loss of central vision.

Study results were published In the April issue of Archives of Ophthalmology.

Discovery May Lead to Therapies for "Dry" AMD

MONTREAL, February 2008 — Researchers in Montreal have identified an underlying cause of the "dry" form of age-related macular degeneration (AMD), a discovery that could lead to development of new therapies.

Sainte-Justine Hospital and Universite de Montreal scientists said they now have a better understanding of processes that cause accumulations of lipids (fats) in the inner back of the eye (retina), which can lead to eye damage associated with macular degeneration.

"This discovery brings us one step closer to treating dry AMD, which could significantly improve the quality of life of seniors who are most affected by this eye disease," said Universite de Montreal professor and study co-author Huy Ong, PhD.

Study results were published in the February issue of the medical journal PLoS Medicine.

African Americans May Have Less Risk for

BALTIMORE, February 2008 — African Americans may have less risk of developing advanced macular degeneration (AMD) than Caucasians, according to recent findings by Johns Hopkins School of Medicine scientists.

Early signs of AMD include formation of yellowish spots (drusen) in the inner back of the eye (retina), where vision processing occurs. In a study involving 2,520 participants of average ages of 73.5 years, researchers found that larger drusen and those closer to the eye's center were more likely to occur in Caucasians than in African Americans.

Study authors concluded that more Caucasians than African Americans were likely to develop advanced and potentially blinding forms of macular degeneration. Researchers said more research is needed to determine why African Americans are less likely to have significant degenerative changes associated with AMD, such as those that occur in central portions of the retina.

Smoking Increases Macular Degeneration Risk by Nearly 50 Percent

BEAVER DAM, Wis., January 2008 — Smoking boosts risks of developing age-related macular degeneration (AMD) by nearly 50 percent, reveals a recent analysis of about 3,500 Beaver Dam, Wis. residents undergoing eye-related studies since 1987. The finding was reported in the January issue of Archives of Ophthalmology.

Study results also show that, of people who have macular degeneration, smokers on average were more likely to develop the eye disease at a younger age:

• Current smokers (69.2 years)
• Former smokers (72.3 years)
• Non-smokers who have never smoked (74.4 years)

Researchers noted that it's difficult in modern times to assess eye damage caused by secondary exposure to smoke, partly because of new laws that now restrict smoking in public areas.

British Agency Reverses Stand on Restricting Lucentis for AMD

LONDON, January 2008 — A British health advisory agency has reversed an earlier cost-saving proposal that allows government reimbursement for Lucentis treatments only for the second eye of individuals diagnosed with advanced or "wet" age-related macular degeneration (AMD), which can cause blindness.

The National Institute for Health and Clinical Excellence (NICE) has issued a revised proposal, with "draft" status ending Jan. 14, which would allow Lucentis to be injected in any affected eye of British citizens when treatments are capped at 14 per eye.

If additional treatments are needed, NICE officials say the Lucentis manufacturer (Genentech, San Francisco) has agreed to provide additional doses at no cost.

NICE officials say Lucentis is an effective though expensive drug capable of stabilizing vision loss in most people with advanced AMD. About 25 percent of affected eyes achieve vision improvement after regular Lucentis treatments, which cost more than $2,000 per dose.

In another recent development, Genentech announced that a much cheaper version of Lucentis, known as Avastin, will be sold directly to any physicians who choose to use the drug off-label for treating AMD. Avastin is not FDA-approved as an AMD treatment.

Late last year, Genentech made the controversial decision to cease selling Avastin directly to compounding pharmacies that had been repackaging the cancer drug for use as an AMD treatment.

In its recent announcement, Genentech said physicians choosing to use Avastin as an AMD treatment can purchase the drug directly and designate where they want it shipped — including to compounding pharmacies.

[Read more about the Avastin vs. Lucentis debate.]