News Releases

December 1998

Macular degeneration pioneering research from the Emory Eye Center

Macular degeneration, a disease of the retina, is the leading cause of blindness among Americans over age 55. The macula is about the size of this “O” and is located in the center of the retina, the area we use for reading and central vision.

The wet or exudative form of macular degeneration can significantly damage vision. This blinding disorder results when abnormal blood vessels form and leak fluid and blood underneath the retina — in the layer of the retina in the back of the eye called the choroid. The choroid’s blood vessels, combined with tissue, can form a scar-like membrane under the retina and block central vision.

The Emory Eye Center is one of the country’s leading centers for macular degeneration research. Below are some of the treatments currently under investigation at Emory for the wet form of age-related macular degeneration.

AREDS
Information: National Eye Institute, 301-496-5248, or www.nei.nih.gov

The Emory Eye Center is the only center in the South involved in a National Institutes of Health-sponsored study evaluating whether antioxidants and zinc can slow or arrest progression of age-related macular degeneration. This five-year study, called Age-Related Eye Disease Study (AREDS), is no longer enrolling patients. The patients already participating in AREDS will be followed at least until 2000, at which time study results will be published.

CAPT
Patient information: Ann Ervin, 404-778-2423

The Eye Center is conducting the Complications of Age-Related Macular Degeneration Prevention Trial (CAPT) to determine whether laser treatment is effective in preventing severe vision loss from wet macular degeneration.

Patients who have drusen, or yellowish deposits under the retina, are particularly at risk for developing abnormal blood vessels in the choroid (called choroidal neovascularization or CNV) that leak and form scar tissue. A majority of patients with severe vision loss from age-related macular degeneration have CNV. Research has shown that photocoagulation laser treatment can seal leaking blood vessels and limit vision loss for some patients. Laser treatment also can make drusen disappear. What is not known is whether laser treatment can decrease the risk of developing sight-stealing CNV.

Candidates must be 50 years of age or older, have 10 large drusen, have a visual acuity of 20/40 or better in both eyes, and have no other eye disease affecting vision. Study participants will be randomized to receive laser treatment to one eye, while the other eye will be observed. They will be followed for four years.

INTRAVITREAL INJECTIONS
Patient information: Debbie Gibbs, 404-778-5815

Emory is studying whether an experimental new drug, called NX1838, can safely and effectively halt the progression of wet age-related macular degeneration. The drug is injected directly into the vitreous, the jelly that fills the eye. Candidates for the study must be 50 years of age or older and must have a visual acuity worse than 20/200. Participants in this Phase I study will receive one injection.

RETINAL TRANSLOCATION SURGERY
Patient information: Rhonda Waldron, 404-778-3691

Retinal translocation is an experimental new treatment involving two procedures. During the first inpatient procedure, a surgeon shifts the retina aside to move the critical vision zone away from the underlying leaking blood vessels of the choroid. A few days later after the area has healed, the surgeon uses a photocoagulation laser to seal the leaking blood vessels in the choroid during an outpatient procedure. Since the laser can destroy photoreceptors on the retina and cause blind spots, it is important to move the central vision zone first.

Patients who qualify for this treatment have had a relatively recent onset of symptoms (within two to three months) with evidence of leaking or bleeding in a small area of the macula. They should have no history of laser treatment in the affected eye. The risks of this treatment are still being determined, since only small number of patients have been treated. Several participants report that their vision has improved significantly, while a few patients have actually lost vision, a risk of undergoing the procedure.

SST
Patient information: Jayne Brown, 404-778-4430

The Eye Center is one of 15 centers participating in the Submacular Surgery Trials (SST), which are sponsored by the NIH. An alternative to photocoagulation laser therapy, which can cause blind spots, submacular surgery involves removing the leaking area of the choroid that extends into the center of the macula. The goal of the trials is to determine whether submacular surgery can stabilize or improve vision.

Researchers will enroll patients, who will be followed for four years, into one of three trials, depending on the extent of disease and level of visual acuity. Patients who have had previous laser surgery or have other eye diseases affecting vision are not candidates.

VIP TRIAL
Information:
Judy Johnson, 404-778-4725

Emory is one of a number of centers worldwide participating in the Verteporfin in Photodynamic Therapy Trial (VIP). Photodynamic therapy is an experimental outpatient procedure during which researchers inject a dye that concentrates in the abnormal blood vessels of the choroid. The dye is activated by a red laser light shined onto the retina. The purpose of the VIP trial is determine whether this procedure is safe and effective in preventing new blood vessel growth and halting vision loss.

This study is no longer recruiting patients at this time. More data on this trial should be available in 2000.

NOTE: There are several forms of macular degeneration. The dry or atrophic type is the most common type — affecting nearly 70 percent of all cases — and results as the macula’s tissues age and break down, causing a gradual vision loss. There are no treatments available for this type. This fact sheet highlights treatments for wet macular degeneration, which is the most blinding form. There are other forms of macular degeneration which affect children or result from injury, infection, or inflammation.

Media Contact: Joy H. Bell
jbell@emory.edu
404-778-3711

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