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Taking aim at macular degeneration.



Ongoing trials of promising new treatments could revolutionize the field and offer hope to people with macular macular adjective Related to 1. A macule 2. The macula  degeneration--an unpredictable disease that remains the leading cause of blindness in the United States.

To learn more about the emerging therapies under investigation, MU spoke with ophthalmologist ophthalmologist /oph·thal·mol·o·gist/ (of?thal-mol´ah-jist) a physician who specializes in ophthalmology.

oph·thal·mol·o·gist
n.
A physician who specializes in ophthalmology.
 Dr. Thomas A. Ciulla, a highly regarded expert and author on macular degeneration.

"We're on the cusp of many exciting breakthroughs with a host of new drugs on the horizon," says Dr. Ciulla, who is also an assistant professor at Indiana University School of Medicine The Indiana University School of Medicine is the medical school of Indiana University, part of the Indiana University Purdue University at Indianapolis (IUPUI) campus located in Indianapolis, Indiana. Established in 1903, the school had an initial class of 25 students. . "Previously, we used treatments that were 'destructive' to treat MD. For example, we would laser a patient's retina to stop wet macular degeneration from progressing to the center of the retina. Laser is a fancy way of cauterizing or destroying tissue. Often, laser causes a blinding scar and in at least half the patients, it didn't work; blood vessels would continue to grow, sometimes more vigorously. Recently we've learned that certain growth factors, such as vascular endothelial growth factor Vascular endothelial growth factor (VEGF) is an important signaling protein involved in both vasculogenesis (the de novo formation of the embryonic circulatory system) and angiogenesis (the growth of blood vessels from pre-existing vasculature).  (VEGF VEGF vascular endothelial growth factor. ), are responsible for the new blood vessels under the patient's retina. We're now developing several drugs that target VEGF to prevent blood vessels from growing or expanding. Within the next few years, several drugs will hopefully be approved and available for general use.

Three new drugs are currently in final phase III testing. In general, patients with recent onset of wet macular degeneration may be eligible for one of these studies.

"One drug made by Genentec is called Lucentis (ranibizumab), an antibody fragment injected in the eye that is designed to bind to to contract; as, to bind one's self to a wife s>.

See also: Bind
 and inhibit VEGF," explains Dr. Ciulla.

"Another medication in phase III trials is Macugen from Eyetech and Pfizer. Macugen is an anti-VEGF aptamer that binds to and thus inhibits the activity of VEGF when injected in the eye.

"Finally, Retaane (anecortave acetate) made by Alcon, also in phase III trials, is a steroidal compound that is injected around the eye."

The drugs might also someday be used to treat other eye disorders, such as diabetic retinopathy and venous occlusions.

"VEGF is potentially the key growth factor in macular degeneration, because it mediates the growth of abnormal blood vessels," notes Dr. Ciulla. "Many other eye diseases involve abnormal blood vessel growth in and under the retina. Diabetic retinopathy, for example, involves the growth of blood vessels not under the retina, as is the case in MD, but on the surface of the retina and into the vitreous vitreous /vit·re·ous/ (vit´re-us)
1. glasslike or hyaline.

2. vitreous body.


primary persistent hyperplastic vitreous
 cavity. When blood vessels are pulled, they can tear. As they fracture, blood is released into the vitreous cavity, and many diabetics will have hemorrhage into the eye. These drugs may be beneficial for diabetic retinopathy.

"Another common cause of blindness is venous occlusion, which involves a very similar process to diabetic retinopathy, where blood vessels can grow on the surface of the retina and into the vitreous cavity and cause bleeding. In addition, because the vein is blocked, the blood flow in the eye is backed up and the retina will swell, a condition called macular edema that causes symptoms very similar to MD. We are starting a trial using Macugen to investigate its potential for macular edema induced by vein occlusions."

"When I started eight years ago, retinal and vitreous diseases were largely surgical disorders," concludes Dr. Ciulla. "Many of these diseases had poor prognoses, and many patients lost vision regardless of what we did.

"Now we're on the horizon of a very exciting time with many novel drugs to potentially treat MD, diabetic retinopathy, and venous occlusions."

People interested in learning more about ongoing trials may visit alconlabs.com for Retaane; genentech.com for Lucentis; and eyetech.com for Macugen.

Foods High in Lutein/Zeaxanthin

Kale kale, borecole (bôr`kōl), and collards, common names for nonheading, hardy types of cabbage (var.  

Spinach

Mustard greens

Yellow corn

Broccoli

Green peas (pod)

Pumpkin

Collard greens Noun 1. collard greens - kale that has smooth leaves
collards

cole, kail, kale - coarse curly-leafed cabbage
 

Summer (yellow) squash

Brussels sprouts

Green olive

Green peppers

Green bean

Plums

Peach, orange, tangerine tangerine: see orange.
tangerine

Small, thin-skinned variety of the mandarin orange species (Citrus reticulata deliciosa) of the rue family (citrus family).
, avocado, kiwi fruit, rhubarb rhubarb: see buckwheat.
rhubarb

Any of several species of the genus Rheum (family Polygonaceae), especially R. rhaponticum (or R. rhabarbarum), a hardy perennial grown for its large, succulent, edible leafstalks.
.
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Publication:Medical Update
Geographic Code:1USA
Date:Sep 1, 2004
Words:648
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