Parkinson Drug May Prevent and Delay AMD

Newswise — RPB-supported researchers have made a significant discovery that might lead to the delay or prevention of the most common cause of blindness in the elderly: age-related macular degeneration (AMD).

Patients who take the drug L-DOPA (for Parkinson Disease, Restless Legs or other movement disorders) are significantly less likely to develop AMD and, if they do, it is at a significantly later age.

"There are only limited and highly invasive therapies for those with AMD and no known preventative treatment," said Brian S. McKay, PhD, Department of Ophthalmology and Vision Science, University of Arizona. "Our findings imply that L-DOPA may be repurposed to prevent or delay AMD."

Here's how the multi-institution team of scientists made the discovery.

The investigators had been conducting basic research into albinism, which causes profound vision loss and changes in the structure of the eye, especially the retina, and specifically the macula, the area of the retina that is associated with central vision lost in AMD.

The retina pigment epithelium is a critical support layer of tissue in the retina that fosters macula development and keeps it healthy through L-DOPA signaling. L-DOPA is made in pigmented tissues, and it has been known for a long time that lower risk for AMD is associated with darker pigmentation;

Blacks have a five-fold lower risk for AMD than Whites. The researchers postulated that signaling through the L-DOPA receptor may underlie racial disparities in AMD incidence.

To test this, they examined the health records of 37,000 patients at the Marshfield Clinic for individuals with AMD, or those taking L-DOPA, or those with both AMD and taking L-DOPA.

In patients who were given L-DOPA before being diagnosed with AMD, their AMD was diagnosed 8 years later than those not taking L-DOPA. These results were then confirmed in a much larger data set of 87 million patients, and the study was expanded to include prevention and delay of "wet" AMD, the most devastating form of the disease.

"Developing a new drug costs more than $2 billion and takes 13.5 years from discovery to market. Drug repositioning does not require anywhere near those costs," said lead author Murray Brilliant, PhD, Director at the Center for Human Genetics at the Marshfield Clinic Research Foundation.

"Our methods illustrate the power of precision medicine research -- using the electronic medical records of large numbers of patients -- to test unexpected drug interactions and find new uses for old drugs."

"The results suggest a new path forward in our fight against AMD that may even include a strategy to prevent those at risk of the disease from ever developing it," McKay said. "In the end, L-DOPA may not be the drug that ends the disease, but the pathway identified here is likely to be a key observation as the search for a cure continues."

This work was supported by Translational Sciences, The National Human Genome Research Institute, Research to Prevent Blindness, Bright Focus, The Edward N. & Della L. Thome Memorial Foundation, the Wisconsin Genomics Initiative, National Eye Institute, the Marshfield Clinic and the University of Arizona.

Falls and Brawls Top List of Causes for Eye Injuries in United States

Hospital costs for ocular trauma rise 62 percent over a decade, according to study presented at AAO 2015, the annual meeting of the American Academy of Ophthalmology

Newswise, November 16, 2015 – Falling and fighting top the list of major causes of eye injuries resulting in hospitalization over a 10-year period, according to research presented today at AAO 2015, the 119th Annual Meeting of the American Academy of Ophthalmology. 

Falling was the No. 1 cause of eye injuries overall and accounted for more than 8,425 hospitalizations. Researchers also found that the cost to treat eye injuries at hospitals rose by 62 percent during that period and now exceeds $20,000 per injury.

Serious ocular trauma injuries include orbital fractures and being pierced by objects. These injuries can be expensive to treat, and in many cases are preventable. 

With that in mind, researchers at Johns Hopkins University decided to identify the most common causes of eye injuries as well as the associated hospital costs so that prevention efforts could be better targeted. Such interventions could perhaps lower eye injury rates and overall health care costs for eye trauma inpatient visits.

They identified a sample of nearly 47,000 patients ages 0 to 80 diagnosed with ocular trauma from 2002 to 2011 using a national health care database. They examined the total cost of hospitalization, cause of injury, type of injury and length of hospital stay. The researchers then grouped injured people by age. 

Their findings include:

•Falls are the leading cause of eye injury: Most of the 8,425 falls recorded happened to those 60 and older. Among the types of falls, slipping caused nearly 3,000 eye injuries. Falling down stairs was cited as a cause of eye injury 900 times.
•Fighting was second most common cause of ocular trauma: In total, nearly 8,000 hospitalizations for eye injuries were caused by fighting and various types of assault. “Unarmed fight or brawl” came in at No. 2 overall among specific causes of eye injuries requiring hospitalization, but was the top cause reported for ages 10 to 59.
•Kids injured in accidents, vehicle collisions and by sharp objects: For children ages 10 and under, the leading cause of eye injury was being struck by accident by a person or object. Car crashes and accidentally being pierced or cut by a sharp object (such as scissors) were second and third on the list of causes.
•The median cost of treating these eye injuries shot up from $12,430 to $20,116 between the years 2002 to 2011, an increase of 62 percent. The researchers found costs to be higher at large hospitals and for older patients. Income did not correlate with costs. However, the Johns Hopkins team says that other factors not included in the study could play a role, too.

“While we have some clues, we still can’t be certain why it’s more expensive to get treated for an eye injury now than before,” said Christina Prescott, M.D., Ph.D., the study’s lead researcher and an ophthalmology professor at the Wilmer Eye Institute at Johns Hopkins University. 

“It could be related to drug prices or administrative costs. Either way, it’s clear we need more targeted interventions to help reduce these types of injuries, many of which are preventable.”

Members of the media who would like a copy of the poster or wish to speak to an expert about the findings should contact the American Academy of Ophthalmology Public Relations Department at media@aao.org.

Economic Trends in Eye-Related Hospitalizations (PO118) was presented at AAO 2015, the 119th annual meeting of the American Academy of Ophthalmology. 

Known as the place "Where all of Ophthalmology Meets,"™ the Academy’s annual meeting takes place Nov. 13-17 at the Sands Expo/Venetian in Las Vegas. It is the largest ophthalmology conference in the world. For more information, see AAO 2015 highlights.

About the American Academy of Ophthalmology

The American Academy of Ophthalmology, headquartered in San Francisco, is the world's largest association of eye physicians and surgeons, serving more than 32,000 members worldwide. 

The Academy’s mission is to advance the lifelong learning and professional interests of ophthalmologists to ensure that the public can obtain the best possible eye care. For more information, visit http://www.aao.org.

The Academy is also a leading provider of eye care information to the public. The Academy's EyeSmart® program educates the public about the importance of eye health and empowers them to preserve healthy vision. EyeSmart provides the most trusted and medically accurate information about eye diseases, conditions and injuries. OjosSanos™ is the Spanish-language version of the program.

Visit http://www.geteyesmart.org or http://www.ojossanos.org to learn more.