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AMD needs multiple individualized strategies for treatment
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PARIS — Age-related macular degeneration is a multifactorial disease in which no single treatment strategy can work and an individualized approach is necessary, according to a guest lecturer at the meeting of the French Society of Ophthalmology.
 Alan Bird |
“AMD is a multifactorial disease and represents a large spectrum of changes,” Alan Bird, MD, said. “The various tissues involved are the choroid, the Bruch’s membrane, the [retinal pigment epithelium] and photoreceptor cells. The magnitude of change in these tissues varies enormously from one patient to another. This is not surprising, given that many genes and many environmental factors are involved.”
Current therapeutic strategies include reducing lipofuscin accumulation in the retinal pigment epithelium, mobilizing the proteins of Bruch’s membrane and using zinc buffering methods, among other strategies.
“Each one of them may be useful for some patients but not others,” Dr. Bird said. “We need more accurate phenotyping of patients in order to select those who are suitable for a specific therapeutic approach and for whom another therapeutic approach should be excluded.”
Trials should record the photoreceptor cell population accurately, using techniques such as psychophysics, electrophysiology and reflectometry.
“This would make therapeutic trials more likely to succeed. But at the end of it all, we are not going to have a single treatment for AMD, but a multitude of treatments addressing specific, individual age-related and pathological changes,” he said.
- Disclosure: Dr. Bird has no relevant financial disclosures.