Research priorities agreed to stop early age-related macular degeneration (AMD) turning into late AM
Three leading sight loss charities, Blind Veterans UK, Fight for Sight and the Macular Society, have joined forces in the global fight against age-related macular degeneration (AMD). The main objective of the collaboration, which is called Action Against Age-Related Macular Degeneration (AAA), is to facilitate the funding of medical research aimed at finding an effective treatment for early-stage age-related macular degeneration (AMD). The charities, together with Wellcome Genome Campus Advanced Courses and Scientific Conferences, brought together 42 international clinical and basic scientists, 16 members of eye charities and other funders, and two patients in a retreat-like workshop in June 2017. The retreat entitled ‘How to stop early AMD turning into late AMD?’ was a gathering of experts in different areas of both basic and clinical research on age-related macular degeneration (AMD). AMD is the commonest cause of visual impairment in the developed world and, to date, there is no intervention that slows or prevents the early disease progressing to blinding neovascularization or geographic atrophy. The aim of this Retreat was to establish research priorities for the next few years to rapidly develop effective treatment(s) or strategies to help prevent individuals with early AMD progressing to late blinding disease. The retreat included four sessions in which research priorities in different areas relevant to AMD were debated. The sessions were:
The key challenges for finding an intervention for early AMD.
Complement pathways and AMD.
From genetics to targets.
Other potential targets to slow the progression of early AMD.
The final session summarised the research priorities which will help to develop a research strategy to find a way of preventing early AMD progressing to blinding disease. The agreed research priorities are:
Cohorts for longitudinal studies of genetically-defined, highly-informative subject subsets.
Ageing changes in the choroid-photoreceptor complex.
Development of models of choriocapillaris endothelium and retinal pigment epithelium (RPE) ageing.
Integrated approach to understanding how ARMS2/HTRA1 polymorphisms drive disease risk.
Understand lipid and membrane handling in the choroid-photoreceptor complex.
Approaches to revitalising Bruch’s membrane.
Support for a drug development programme and studies of therapeutic access to RPE-photoreceptor complex.
Understanding mechanisms of impaired dark adaptation in early AMD (both to support appreciation of how early disease develops as well as developing a potential ‘marker’ of early disease).
Work with other programmes to develop imaging/functional tests for early disease.
Further our understanding of how the innate immune system drives disease.
Regarding infrastructure priorities, the participants considered seed corn funding to be most important, followed by the facilitation of academic and commercial partnerships, and non-clinical researcher capacity building. Cathy Yelf, Chief Executive of the Macular Society said:
“Age-related macular degeneration is a devastating condition which is affecting more and more people globally as our population ages. Collaboration is essential to tackle the growing sight loss epidemic. The retreat was a very positive step with leading UK and international academics and clinicians and the pharmaceutical industry coming together to address this urgent problem.”