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Anti-Inflammatory Drugs Offers Hope for Treatment of
Age-Related Blindness
April 27, 2005 – Researchers may have stumbled on a
drug treatment that will stop the development of age-related macula
degeneration (AMD), the leading cause of blindness in senior citizens
and all people over 55. In a study of rheumatoid arthritis patients
treated with anti-inflammatory drugs, they were found to be 10 times
less likely to develop AMD.
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Vision Samples
National Eye Institute |
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AMD View |
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The scientists reviewed 993 rheumatoid arthritis
patients in Saskatchewan aged 65 years or older who, on average, had
been living with the condition since age 51. Only three had developed
AMD, where about 30 cases could be expected in a similarly-aged group
from the general populace.
AMD is strongly associated with increasing age,
particularly after age 60. AMD rises dramatically in whites over age 80;
more than one in 10 white Americans over age 80 has vision loss from
AMD.
The study by researchers at the University of
British Columbia and University of Saskatchewan was recently published
in the Neurobiology of Aging. It was a joint effort of neurologist Dr.
Patrick McGeer of UBC and rheumatologist Dr. John Sibley of the U of S.
"Age-related macular degeneration is like
Alzheimer's disease of the eye, with retinal deposits called drusen
acting like amyloid deposits in the brain found in Alzheimer's," says
McGeer, a UBC professor emeritus in the Kinsmen Laboratory of
Neurological Research and expert in the use of non-steroidal
anti-inflammatory drugs (NSAIDS).
"It was natural for us to look at the rheumatoid
arthritis population," says Sibley, a U of S professor of medicine and
head of the division of rheumatology. "They have been followed closely
for more than 40 years with particular attention paid to retinal changes
because medication widely used for rheumatoid arthritis can create
visual problems."
It is already accepted that NSAIDS reduce the incidence of bowel cancer.
Fifteen years ago, McGeer and Sibley found the first of a growing body
of evidence that NSAIDS may also help reduce the incidence of
Alzheimer's. However, Sibley says this is the first time a link has been
identified between anti-inflammatories and macular degeneration.
The researchers emphasize that further study is
required to confirm their findings, but if they are corroborated, anti-inflammatories
would be the first approach for this intractable disease. Related
questions such as optimum dosage and when to begin treatment need to be
answered. Also, since NSAIDS can have side effects such as stomach
upset, ulcers and stress on kidneys, they are not appropriate for
everyone and criteria for high-risk patients that would benefit from
their use will need to be defined.
Macular degeneration is the most common cause of
severe vision loss in much of the world, especially among the elderly.
The condition causes light-sensitive cells in the macula, or central
portion of the retina, to degenerate. The macula is responsible for
perceiving fine visual detail. Early signs of macular degeneration
include blurring of vision when performing detailed tasks like reading
or sewing.
AMD is the most common form of the disease and
causes permanent loss of central vision. There are two forms of AMD –
wet and dry – with more than 85 per cent of cases being the dry form,
for which there is no effective treatment.
McGeer and Sibley's work was supported through the
Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS)
consortium through grants from the United States National Institutes of
Health. Additional funding was provided through the Jack Brown and
Family Alzheimer's Disease Foundation and the estate of George Hodgson.
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