HIV, AIDS drugs to help AMD therapy?

HIV, AIDS drugs to help AMD therapy?

Antiretroviral drugs commonly used to treat HIV infections for decades could hold promise for 'dry' age-related macular degeneration (AMD) therapy.

"We're certainly going to see more and more macular degeneration, so any research into this field will essentially be a win-win for our patients."

Recently published in the journal Science, a study by researchers with the University of Kentucky found a link between nucleoside reverse transcriptase inhibitors (NRTIs) and an anti-inflammatory process that prevented the progression of geographic atrophy in mice.

Geographic atrophy involves the breakdown of retinal pigment epithelial (RPE) cells, a process researchers previously found linked to an accumulation of toxic molecules called Alu RNA. Because Alu RNA relies on reverse transcription, researchers theorized the NRTI drugs would prevent cell death, as well.

However, the results of a mouse model showed it wasn't NRTIs' ability to prevent reverse transcription, but the drugs' capacity for blocking inflammasomes that prevented retinal degeneration.

Researchers point out repurposing NRTIs could be beneficial to other inflammatory disorders, especially as they are already FDA-approved; however, the National Eye Institute points out further clinical trials are necessary.

What does this mean for optometry?
Steven G. Ferrucci, O.D., chief of optometry at Sepulveda VA Medical Center and professor at Southern California College of Optometry at Marshall B. Ketchum University, stresses further testing is certainly required before deeming NRTIs a viable option. He adds that additional studies are underway testing orally administered NRTIs versus intravitreal injections, but results in humans could still be further down the line.

"Time will tell whether or not these turn out to be viable or not," Dr. Ferrucci says. "But the take-home is there's a lot of research being done in macular degeneration, right now."

The leading cause of severe vision loss in adults over age 50, AMD is estimated to affect 1.8 million Americans while another 7.3 million with large drusen are at substantial risk for AMD-related vision loss.

The Centers for Disease Control and Prevention anticipate AMD to affect nearly 3 million people by 2020. Although 'wet' AMD can be treated if caught early enough, there currently is no cure for dry AMD and any loss in central vision cannot be restored.

Dr. Ferrucci says it's important for ODs to be aware of the latest in research and treatment options to help advise patients, but it's also important to temper expectations.

"With the aging population, we're certainly going to see more and more macular degeneration, so any research into this field will essentially be a win-win for our patients," Dr. Ferrucci says.

January 28, 2015

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