Airman 1st Class Jessica Borrowman uses a fundus camera to take a photo of a patient's retina on Naval Air Facility Atsugi, Japan. File photo by Senior Airman Laura Muehl/ Illinois Air National Guard
NEW YORK, March 1 (UPI) -- Age-related macular degeneration remains a leading cause of vision loss in the United States, but new advancements could help manage and, in some cases, prevent its devastating symptoms, experts told UPI recently.
That would be good news for the more than 13 million people nationally who are affected by the condition, which progressively destroys the macula, or the part of the eye that provides sharp, central vision needed to see objects clearly.
More than one in 10 of people with age-related macular degeneration, or AMD, will see their symptoms progress so that they lose most or all of their vision, impacting their ability to perform day-to-day activities, including driving, and live independently, research indicates.
For nearly 20 years now, people with advanced AMD, which tends to affect older adults and worsen with age, have been treated with drugs called anti-VEGF therapies, which are injected into the affected eye every one to three months.
Though effective -- nine out of 10 people treated with anti-VEGF injections experience say their vision remains stable, while one in three report improvement -- the injections can cause pain and discomfort. Doctors sought less invasive options.
"Many drugs are being developed, and we are excited to have two new drugs recently approved by the Food and Drug Administration," ophthalmologist Dr. J. Fernando Arevalo told UPI in an email.
As with anti-VEGF therapies, with these newer drugs, "early treatment is associated to better vision," said Arevalo, chairman of the ophthalmology department at Johns Hopkins Bayview Medical Center in Baltimore.
One of the new treatments approved by the FDA, called the Port Delivery System, changes the way an older anti-VEGF therapy, ranibizumab, is administered, perhaps allowing people with age-related macular degeneration to "avoid monthly injections," Arevalo said.
Cleared for use by the FDA in November, the Port Delivery System is surgically inserted into the affected eye or eyes and delivers, by "slow release," the anti-VEGF drug ranibizumab, he said.
The implant only needs to be refilled every six months or so, according to Arevalo.
The other new option, approved by the FDA last week, is an anti-VEGF drug called faricimab, which is sold under the brand name Vabysmo, and it "has a longer duration of action" than older products, Arevalo said.
This longer duration of action, meaning it works longer than older drugs, could see age-related macular degeneration patients go as long as four months without need for follow-up injections, he said.
An ounce of prevention
Still, researchers are hoping to find ways people can avoid surgeries and injections, by not developing age-related macular degeneration in the first place.
To that end, researchers at the University of California-Davis found that adults who regularly eat a small serving of dried goji berries may be able to avoid or delay the development of age-related macular degeneration.
In a study published by the journal Nutrients in December, 13 healthy participants ages 45 to 65 years who consumed 28 grams, or about one ounce, of goji berries five times a week for 90 days increased the density of protective pigments called lutein and zeaxanthin in their eyes, the data showed.
These pigments filter out harmful blue light, provide antioxidant protection and help to protect the eyes during aging, study co-author Dr. Glenn C. Yiu told UPI in an email.
"Goji berries have a high concentration of macular pigments [that] can help filter out harmful light radiation," said Yiu, an associate professor of ophthalmology at the UC- Davis.
With these nutrients, the berries could offer "potential prevention or reduction of progression," he said.
Goji, which is also called wolfberry, boxthorn and matrimony vine and is native to China, is a thorny deciduous woody shrub, according to Penn State University Extension.
Eaten fresh, their taste can be bitter, though in dried form, the type used in the Davis study, they are similar to cranberries, the food blog SimplyHealthyFamily.org reports.
However, people at risk for age-related macular degeneration, typically White adults age 50 years and older, should wait for more, larger studies before expecting miracles from goji berries, Yiu said.
Still, people eating them in moderation are not likely to experience side effects, meaning they could provide a risk-free prevention strategy until more research becomes available, he said.
Nutrition-based prevention for age-related macular degeneration is hardly new, according to Johns Hopkins' Arevalo.
The National Eye Institute currently recommends a Bausch & Lomb formulation called AREDS2 for age-related eye diseases. It contains vitamins and antioxidants known to boost eye health and slow progression of macular damage, he said.
In addition, the acai berry has been touted for its anti-aging properties, though scientific research supporting its benefits is lacking, the National Center for Complementary and Integrative Health reports.
"Because goji berries are not a medication, but a natural food and ingredient that has anti-oxidant properties, I think people can consider trying to incorporate this into their diet," Yiu said.
There's an app for that
Meanwhile, a company called Balanced Media/Technology has been working with the Retina Foundation of the Southwest and researchers at Southern Methodist University to develop an app that uses automated software and a video game to diagnose AMD and other eye diseases.
The crowd-sourced original video game, called Eye in the Sky: Defender, uses embedded optical coherence tomography retinal images to effectively scan players' eyes for damage caused by disease, the developers said.
Optical coherence tomography is a non-invasive imaging test that uses light waves to take cross-section pictures of the retina, allowing ophthalmologists to see its individual layers and measure their thickness, according to the American Academy of Ophthalmology.
As players predict the path of the alien force in Eye in the Sky: Defender, they unknowingly learn to trace lines similar to those used to perform diagnostic measurements in optical coherence tomography, the developers of the game said.
When combined with an artificial intelligence platform developed by Balanced, the data collected in the game can be used to train a machine learning algorithm to analyze optical coherence tomography images more accurately, they said.
This would not prevent the onset of AMD, but it may speed its diagnosis, according to the developers, and earlier diagnosis means earlier treatment, which can improve results, Arevalo said.
"The use of gaming software, combined with optical coherence tomography imaging, forms a [disease] detection and monitoring tool," Matthew Levine, director of grants, partnerships and advocacy for the non-profit American Macular Degeneration Foundation, told UPI in an email.
This is "a very important advance [that] could lead to earlier and timelier interventions," said Levine, who was not involved in the development of the app.