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Dry AMD 

While these are small early studies, they point the way for less invasive treatments - vaccination or eye drops. 

            Copaxone is being used to treat dry AMD with a weekly vaccination in an attempt to reduce or eliminate drusen.  Half the patients received the drug and half a sham injection.  The percentage of drusen which shrank or disappeared in the Copaxone group was 19.1% and in the sham treatment group was 6.5%.  The study also provided information about what type of drusen might respond best to the treatment.

             MC-1101 is an eye drop under investigation for dry AMD.  The drug affects the blood flow in the choroidal layer of the retina.  Circulation seems to play a major role in both dry and wet AMD.  This was a small study to determine the safety of repeated doses - seven times over three days.  Both the AMD subjects and those with normal eyes tolerated the drug well.  There were some differences between the two types of subjects and this will also serve for further research.

Wet AMD

For wet AMD, one of the goals of these experimental therapies is to reduce the number of intravitreal injections of Anti-VEGF (Lucentis or Avastin).

Transplantation of RPE (retinal pigment epithelium)

Thirteen patients underwent this experimental surgery, which removed the hemorrhage and the membrane and then translocated a sheet of the patient's own RPE.  Vision was improved in some patients and the graft of cells survived.  This research, which was conducted in China, shows that this is a potential treatment for wet AMD.

Radiation Therapy

• Epiretinal Brachytherapy
  
  This clinical trial is being conducted with patients who have previously had treatment with Lucentis or Avastin.  50 subjects underwent a surgery which introduced a source of radiation into the eye which remained in place for 4-5 minutes and then was removed.  16 patients have reached the six month post treatment point.  The results indicate that this radiation treatment may reduce the need for further injections with Lucentis or Avastin while maintaining vision.
  
• Oraya Iray
  
  This therapy involves an external radiation, followed by injections of Lucentis. There were 12 patients in the study. Leakage improved in 6cases, was stable in 5 cases and worse in 1 case. It did reduce the timing of repeat injections of anti-VEGF.
  
• Proton Beam
  
  The purpose of this investigation is to study the safety of using low dose proton beam radiation with Lucentis. Six subjects in the study were treated with four monthly injections of Lucentis and one treatment with proton beam. The results showed the treatment was safe in these patients and that the proton beam treatment may increase the effect of Lucentis treatment for those who were newly diagnosed.

Positive safety and tolerance data were reported for numerous other therapies being studied.  While it is too early to report on these small studies, the safety results mean that the researchers will continue to expand their testing.  These include investigations into monoclonal antibodies, complement factor 5 and substances that may affect VEGF production.  

Nutrition

Nutrition is always a popular subject for research, including the ongoing Age-Related Eye Disease Study (AREDS) that first provided positive evidence for the use of nutritional supplementation.  The studies provided further support for the use of Omega-3 (fish oil), antioxidants and zeaxanthin.  Many studies involved measurement of the macular pigment density.  Research has indicated that people with AMD have a less dense pigment in the macula.  Being able to document increased macular pigment after using supplements would support the use of these vitamins and minerals.

Smoking and Effect on Treatment

This study contains extremely important information for those receiving treatment for wet macular degeneration.  We know that smoking is the number one controllable risk factor for macular degeneration.  From research reported at ARVO, we now also know that people who continue to smoke during anti-VEGF treatment (Lucentis or Avastin) receive less benefit from the injections than people who stop smoking.