Antonio Macedo and Ida Nilsson, looking at an image of the eye taken with the equipment in the optometry lab at Linnaeus University

Researchers investigate the way for more effective treatment for age-related vision impairment

Age-related changes in the macula are the most common cause of vision loss in the elderly. Those who suffer from the serious form of the disease have to go through repeated treatments to keep the disease progression under control.
A new research project is investigating why some people respond better to the treatment than others and why the disease never stops coming. Hopefully, this can lead to more effective, safer and cheaper treatments in the future.

Age-related macular degeneration is the most common cause of vision loss in the elderly. In Europe, some 60 million people suffer from this irreversible disease. Most people have a mild type in which vision gradually and slowly declines over a long period of time.

However, roughly one tenth suffers from an aggressive type, so-called wet age-related macular degeneration, which means that small, fragile blood vessels form behind the retina. When these vessels burst, the vision cells are damaged, which often results in severe vision impairment.

Demanding treatment

Wet age-related macular degeneration can be treated with injections given directly into the eye. However, currently, there are many issues with this treatment method. For example, the injections  only help temporarily and must be repeated throughout life, as new blood vessels continue to form in the eye. For some patients, with severe symptoms and both eyes affected, this can be as often as one treatment a month. The treatment is both demanding for the patient and costly for healthcare services.

“The injection treatment serves two purposes. The first is to dry up the leakage from existing blood vessels, and the second is to prevent the formation of new blood vessels. The treatment stops the vision loss temporarily but rarely helps the patient recover vision already lost”, explains Antonio Macedo, associate professor at the Department of Medicine and Optometry at Linnaeus University.

Antonio macedo
In people who suffer from wet age-related macular degeneration, fragile blood vessels form behind the retina. When these burst, there is a leakage of blood and fluid which can damage the vision cells. Antonio Macedo, associate professor at the Department of Medicine and Optometry shows what these changes look like in the eye.

New research project

Antonio Macedo leads a new research project that studies why the results of the injection treatment varies from person to person. At the present, it is unclear why some people respond better to the treatment than others.

“We need to understand why the blood vessels continue to come back despite treatment and if there is a way for us to counteract this or come up with supplementary treatments”, Macedo continues.

One hypothesis is that how well the patient responds to the treatment is linked to the patient’s levels of certain cytokines, inflammation substances that can be detected in the blood.

In order to study if this is the case, the researchers will follow the treatment of a number of patients who are treated for the disease at the Kalmar County Hospital. The patients will continue to visit the healthcare services as usual, but their blood will be analyzed to make comparisons between the levels of cytokines.

In this research project, researchers within optometry and chemistry will collaborate with the ophthalmology healthcare services.

“Our assumption is that we will discover higher levels of key cytokines in patients who under-respond to the treatment”, Macedo concludes.

Can lead to more effective treatment

Thus, the aim is to find common denominators in the blood of patients who respond well to treatment and in those who don’t. In addition,,  findings can help the researchers to decide which factors determine if the treatment is expected to be successful or not.

Having this knowledge is important for a number of reasons. It makes it possible for the healthcare services to make use of the existing treatment for patients to whom it’s most beneficial. It also gives a basis for development of more effective treatments in the future.

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The research project “Chronic inflammation in patients treated for neovascular age-related macular degeneration - investigating new treatment pathways” has been appointed this year’s FORSS project by Forskningsrådet i sydöstra Sverige, FORSS, which is co-financing the project.