Age-related macular degeneration (AMD) is the leading cause of vision loss for Canadians over the age of 50, which is troubling, as the baby boomer population aged cases are set to double over the next 15 years.

While the treatment of AMD was revolutionized by the advent of anti-VEGF therapy, there is room for improvement. In the wet form of AMD, vision loss is caused by the growth of abnormal blood vessels. Anti-VEGF drugs can prevent vision loss by stopping the formation of new blood vessels. Indeed, anti-VEGF drugs are so effective at treating a variety of retinal diseases that ophthalmologists sometimes refer to them as the ‘parmesan cheese’ of eye disease; just sprinkle a little on everything, because it generally seems to help.

New strategies to combat AMD

Dr. Przemyslaw Sapieha is determined to find an alternative treatment. In his role as the Canadian Research Chair in Retinal Cell Biology in the Department of Ophthalmology at the University of Montreal, Dr. Sapieha is collaborating with an international team of researchers to develop new strategies to combat AMD.

“The story of AMD illustrates how research can change the future” explains Dr. Mary Sunderland, Director of Research and Education at the Foundation Fighting Blindness. “Just ten years ago, there wasn’t much that could be done to treat AMD. Today anti-VEGF drugs can prevent vision loss, and in some cases, even reverse the effects of the disease.”

In his search for better AMD treatments, Dr. Sapieha has been focusing on the eye’s rich omega-3 fatty acids, such as docosahexaenoic acid (DHA). Although we are accustomed to thinking about lipids/fats as nothing more than a place where energy is stored, they also play important biological roles. Failures in some of these roles can cause a variety of diseases, including AMD.

“Just ten years ago, there wasn’t much that could be done to treat AMD. Today anti-VEGF drugs can prevent vision loss, and in some cases, even reverse the effects of the disease.”

Our bodies don’t make certain omega-3s so we have to get them in the foods we eat, such as salmon and flax seeds. Many studies of wet AMD have emphasized the benefits of taking omega-3s as a supplement. However, these studies have been somewhat inconclusive, raising questions about the best course of action.

Research on omega-3s

In 2013, the Foundation Fighting Blindness began funding Dr. Sapieha’s AMD research, which focuses on the effects of omega-3 fatty acids on abnormal blood vessel growth in wet AMD.

With the help of Dr. Flavio A. Rezende, Head of Retina, Department of Ophthalmology, Maisonneuve Rosemont Hospital, Dr. Sapieha’s  team set out to evaluate the effects of omega-3 supplements in patients with wet AMD who were also receiving anti-VEGF injections into the eye. Their exciting results showed that the patients who received omega-3s had significantly lower levels of VEGF-A in the eye than did those in the control group. Lower levels of VEGF signify lower risk of wet AMD.

By understanding this effect, his team aims ultimately to develop new forms of omega-3 supplements for treating wet AMD. “Research is transforming the way we think about AMD,” says Dr. Sunderland, “Dr. Sapieha’s research gives us hope that the best is yet to come.”