One optometrist’s personal experience with age-related macular degeneration (AMD) and nutritional supplementation

Background: Age-related macular degeneration (AMD) is the leading cause of blindness in ageing western societies and accounts for greater than 50% of all US visual disability. This report describes the 25-year history of a 66-year-old optometrist who has successfully endured AMD. Case Report: Visual acuity and serial retinal photographs from 1983 to 2009 as various nutritional modalities and non-dietary lifestyle changes were introduced. After starting lutein-based nutritional supplements beginning at approximately 15 years from diagnosis, the optometrist’s Snellen visual acuity improved in his right eye from 20/40 to 20/25 with a subjective improvement in distortion, but eventually regressed to 20/70-20/80 with some increase in metamorphopsia. The left eye, initially 20/30, improved to 20/15 and has remained stable at 20/20 with complete resolution of metamorphopsia and near complete resolution of a parafoveal scotoma. Fundus photographs demonstrate a reduction in soft and hard drusen count over time in each retina and possible parafoveal repigmentation of atrophic areas with later addition of higher dose zeaxanthin. Conclusions: AMD is a nutritionresponsive disease. The carotenoids, lutein and zeaxanthin appear to be particularly robust therapeutic components of nutritional supplement formulations.

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Changes in visual acuity in patients with dry form of age-related macular degeneration after low-energy light therapy and medication

Oftalmologicheskii Zhurnal ◽

10.31288/oftalmolzh201652228 ◽

2016 ◽

Vol 63 (5) ◽

pp. 22-28

Author(s):

A. Sergienko ◽

◽

N. Dzyuba ◽

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Light Therapy ◽

Low Energy ◽

Age Related Macular Degeneration ◽

Age Related

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Genetic biomarkers in the VEGF pathway predicting response to anti-VEGF therapy in age-related macular degeneration

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2019-000273 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000273

Author(s):

Irina Balikova ◽

Laurence Postelmans ◽

Brigitte Pasteels ◽

Pascale Coquelet ◽

Janet Catherine ◽

...

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Treatment Response ◽

Multiple Testing ◽

Age Related Macular Degeneration ◽

Patient Specific ◽

Multiple Testing Correction ◽

Anti Vegf ◽

Age Related ◽

Vegf Pathway

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.

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Incidence of elevated intraocular pressure after intravitreal injection in Japanese patients with age-related macular degeneration

Scientific Reports ◽

10.1038/s41598-021-91832-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Maiko Maruyama-Inoue ◽

Tatsuya Inoue ◽

Shaheeda Mohamed ◽

Yoko Kitajima ◽

Shoko Ikeda ◽

...

Keyword(s):

Risk Factors ◽

Intraocular Pressure ◽

Macular Degeneration ◽

Intravitreal Injection ◽

Odds Ratio ◽

Japanese Patients ◽

Age Related Macular Degeneration ◽

Age Related ◽

Elevated Intraocular Pressure ◽

History Of

AbstractThe purpose of this study was to report the incidence of elevated intraocular pressure (IOP) after intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) in Japanese patients with age-related macular degeneration (AMD). A retrospective study of chart review of patients who underwent ≥ 10 intravitreal anti-VEGF injections between April 2009 and December 2019 was conducted. Elevated IOP was defined as IOP ≥ 25 mmHg at one visit. Cases with elevated IOP resulting from IVI were identified. Furthermore, the association between elevated IOP and some parameters, as the risk factors that influence elevated IOP, was investigated. A total of 402 eyes of 370 patients were included in this study. Twenty-eight eyes of 26 patients (7.0%) were identified as cases with elevated IOP after IVI. The mean time of elevation after baseline was 50.6 ± 26.5 months. History of glaucoma (p = 0.021; odds ratio, 5.85), treatment modality (p = 0.019; odds ratio, 6.32), and total number of injections (p = 0.003; odds ratio, 1.03) were significantly associated with elevated IOP. A late complication of elevated IOP is associated with IVI in patients with AMD. Particularly, history of glaucoma and treat and extend regimen with frequent injections were found to be risk factors of elevated IOP.

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