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Senior Citizen Health & Medicine
Drug Treatment Slows Macular Vision Loss in
Diabetics
Inspired by ranibuzumab (Lucentis) slowing vision
loss in people with macular degeneration
 December
15, 2006 - Encouraged by the effect of the drug ranibuzumab (Lucentis)
to slow the loss of central vision in people with macular degeneration,
John Hopkins Wilmer Eye Institute scientists injected the drug into the
eyes of 10 people losing their sight from macular edema and saw promise
in its ability to stem a common precursor of blindness in diabetics,
which involves the same central light-sensitive area of the retina (the
sensitive area at the back of the eye).
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Macular edema is a common precursor of blindness in
diabetics, which involves the same central light-sensitive area of the
retina. It is one of many complications of diabetes and a first stage of
diabetic retinopathy (a disease of the retina, especially one that is
noninflammatory and associated with damage to the blood vessels of the
retina).
Diabetic retinopathy affects 5.3 million Americans
18 and older.
Over the course of several months of therapy, every
patient in the preliminary Hopkins study could read at least two more
lines on the standard eye chart, the researchers said.
Moreover, the thickness of the patients’ maculae,
the central part of the retina responsible for seeing fine details,
decreased an average of 85 percent. The American Journal of
Ophthalmology published the team’s findings in their December issue.
"The results are impressive," says Quan Dong
Nguyen, M.D., M.Sc., an assistant professor of ophthalmology at the
Wilmer Eye Institute at Johns Hopkins, "although we will not know until
we begin a larger clinical trial what the long-term benefits of the drug
might be."
The Hopkins group believes that ranibuzumab
interferes with a protein that spurs the growth of unwanted blood
vessels in the back of the eye. Vascular endothelial growth factor, or
VEGF, is released when the oxygen supply in the eye is restricted by
blood vessel damage related to diabetes.
In a self-preserving attempt to acquire more
oxygen, the VEGF signals for the creation of new blood vessels, which
almost always damage, rather than improve, vision by blocking light’s
entry onto the retina.
"We’ve suspected for awhile that ranibuzumab’s
ability to shut down VEGF’s signaling would do the trick because it’s
highly likely that VEGF is the culprit when it comes to diabetic macular
edema," says Nguyen.
More than 4 million diabetics in the United States
have diabetic retinopathy and, according to the National Eye Institute,
one in 12 of those experience at least some vision loss.
Macular edema, a first stage of retinopathy, occurs
when, over time, excess uncontrolled blood sugar damages the tiny blood
vessels in the eye, causing fluid and fat to leak onto the retina at the
back of the eye. The swelling interferes with focus and blurs vision.
Making matters worse, a lack of oxygen often then triggers VEGF’s
production cycle.
All 10 subjects in the study had some vision loss
at the start of the clinical trial, in which ranibuzumab was
administered at the one, two, four and six month marks. The thickness of
each patient’s macula was also measured at each point in the study using
an advanced digital imaging technique.
"Within a week, several patients experienced
dramatic reductions in the thickness of their maculas, and there were
further improvements with each injection," says Peter Campochiaro, M.D.,
the Dolores and George Eccles Professor of Ophthalmology at The Johns
Hopkins University School of Medicine, who is also an investigator in
the study.
Ranibuzumab is marketed for treatment of
neovascular macular degeneration by Genentech Inc. under the brand name
of Lucentis.
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