1. Macular Degeneration Amanda Thompson Mrs. Jensen Block 3

2. Macular Degeneration  Affects NERVOUS SYSTEM  Eye disorder making it difficult to see  Affects the macula, part of retina for central vision  Caused by damage to the macula  2 types: dry and wet AMD  Because it does not affect peripheral vision, you will never lose sight completely OVERVIEW

3. Central Nervous System  Sensory reception  Sight, smell, taste, balance, hearing  CNS connects to PNS through nerves (axons)  Detects, interprets, and responds to changes in internal and external conditions

4. Healthy Macula vs. AMD Macula

5. Wet AMD ✱ More rare, also more serious ✱ Abnormal blood vessels grow beneath macula and retina, AKA choroidal neovascularization ✱ May leak blood or fluid, damaging macula

6. Dry AMD ✱ Much more common ✱ Occurs when retina gets thin and dried out ✱ Small yellow deposits, drusen, form beneath macula ✱ As drusen become more prominent, sight is lost

7. Population Affected  Nearly 8.5 million people are affected by macular degeneration in the U.S. alone (1.75 million are in the advanced stages)  Only about 10% have wet, 90% dry  Who will get it? -Women -People over age 65 have much higher risk -Obese or inactive persons -Smokers -Light Pigmented Eyes -People with a family history of AMD

8. Treatments Dry AMD  No FDA approved treatments are available for this type of AMD  A few are in clinical trials  Strong evidence has shown that supplements of vitamins A, C, and E can slow the progression of the sight loss  Recommended to wear UV protection over eyes Wet AMD  Lucentis -monthly eye injections inhibiting the proteins that stimulate new blood vessel growth  Macugen -eye injections of therapeutic molecule attacking new blood vessel growth proteins inside the eye every six weeks  Photodynamic Therapy -injection of Visudyne in the arm which is activated in retinal blood vessels by laser shining into the eye, producing chemical reaction that kills new blood vessels

9. Trial #1  Purpose:  This trial is aimed towards dry AMD. The implant is a small capsule that contains human retinal pigment epithelium cells. These cells have been given the ability to make CNTF and release it through the capsule membrane into the surrounding fluid. In this study, two different CNTF dose levels will be used: a high dose and a low dose, as well as a sham surgery (or placebo) group.  CNTF is Ciliary Neutrophic Factor  Neurotrophic factors are agents with a promising ability to retard progression of neurodegenerative diseases and are effective in slowing photoreceptor degeneration in animal models of retinitis pigmentosa. A Study of an Encapsulated Cell Technology (ECT) Implant for Patients With Atrophic Macular Degeneration

10. Trial #2  Purpose:  Human fibroblasts and possibly other human somatic cells may be reprogrammed into induced pluripotent stem (iPS) cells by the forced expression of transcription factors (1-5). The iPS cells seem to share many properties with human embryonic stem cells.Induced pluripotent stem cells potentially may be useful in the future as an unlimited source of cells for transplantation.The major goal of the project is to develop human iPS cells from cell cultures from skin biopsies or the patient's hair. The iPS cells will be developed primarily for modeling diseases and drug discovery as well as basic research, and for developing the technology that may eventually allow the use of iPS cells for future transplantation therapy. The iPS cells developed in the course of this application are not intended for use in transplantation therapy. Future development of iPS cells for clinical transplantation therapies will be subjected to the appropriate authorization by ethical and regulatory committees. Development of iPS From Donated Somatic Cells of Patients With Neurological Diseases

11. Trial #3  Purpose:  The objective of this study is to evaluate the effects of 2 intravitreal injections with Ranibizumab or Avastin on endothelial function in subjects with neovascular macular degeneration compared to patients with dry AMD. VEGF-Antagonism and Endothelial Function in Age- Related Macular Degeneration (AMD)

12. Bibliography ✱ Age-related macular degeneration. (2009, December 11). Retrieved December 12, 2009, from RNIB: http://www.rnib.org.uk/eyehealth/eyeconditions/conditionsac/Pages/ amd.aspx  Age-Related Macular Degeneration. (2009, October). Retrieved December 12, 2009, from National Eye Institute: http://www.nei.nih.gov/health/maculardegen/armd_facts.asp  Ciliary neurotrophic factor (CNTF) for human retinal degeneration: Phase I trial of CNTF delivered by encapsulated cell intraocular implants. (2006, February 27). Retrieved December 13, 2009, from Pub Med Central: http://www.ncbi.nlm.nih.gov:80/pmc/articles/PMC1383495/  Haddrill, M. (2009, September). Macular Degeneration Treatment. Retrieved December 12, 2009, from All About Vision: http://www.allaboutvision.com/conditions/amd-treatments.htm  Roberts, D. (n.d.). Numbers of People with Macular Degeneration and Other Retinal Diseases. Retrieved December 12, 2009, from MD Support: http://www.mdsupport.org/library/numbers.html