Age-related macular degeneration (AMD) is one of the leading causes of blindness. Both the dry variety, in which macula thins with age and the wet variety, in which abnormal blood vessels grow in the back of the eye and damage the macula, do not cause complete blindness. However, AMD results in a loss of central vision, making it difficult to see faces, read or do close up work like cooking.
While there are treatments such as anti-VEGF injections and photodynamic therapy (PDT)—a combination of injections and laser treatments, they don’t work for everyone or work for a limited amount of time. Not to mention, some come with side effects. As scientists continue to explore new ways to treat AMD, some of their discoveries are surprising.
Cellular Mechanisms
A study done at the University of Rochester Flaum Eye Institute examined the cellular mechanisms behind AMD. Researchers used human stem cells and studied the genes linked to both AMD and a rare form of inherited blindness called macular dystrophies. As a result of their work, they identified a key protein involved in the early stage of the disease.
Scientist found that a large amount of a protein called tissue inhibitor of metalloproteinases 3 (TIMP3) in AMD samples. TIMP3 limits the activity of enzymes called matrix metalloproteinases (MMPs). These enzymes are vital for eye health. Compromised MMP activity leads to an increase in an enzyme that promotes both inflammation and the development of drusen —deposits of lipids and proteins that are early indicators of AMD.
Researchers used a small-molecule inhibitor to stop the activity of the enzyme linked to inflammation and they were able to reduce the drusen formation in their study model. This suggests that targeting this cellular pathway could help prevent the development of AMD.
A Common Supplement Could Reduce the Risk of AMD
Researchers at Case Western Reserve School of Medicine and the Cole Eye Institute investigated the potential link between the use of melatonin—an over-the-counter supplement and sleep aid—and the risk of developing AMD. Researchers used data from TriNetX, a database of anonymized medical records from healthcare organization between December 2023 and March 2024.
Scientists looked at the records of over 200,000 people, in the following ages groups who both have and didn’t have AMD: 50 years or older, 60 years or older, and 70 years or older. Their analysis suggested that melatonin may reduce the risk of AMD, as it has been shown to block certain processes that contribute to the disease. It not known whether it can prevent AMD from developing, since other factors play a role in the disease, such as lifestyle and access to healthcare. These findings provide a basis for more research on the effectiveness of melatonin as a treatment for AMD.
Once again medical research highlights what may be possible. The work done at the University of Rochester Flaum Eye Institute demonstrates that understanding the cellular mechanisms behind AMD could lead to new treatment targets. Meanwhile, research at Case Western Reserve School of Medicine and the Cole Eye Institute revealed that a common supplement may reduce the risk of AMD. Of course, more work needs to be done. Still, both projects demonstrate how research is paving the way toward better patient outcomes.