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A routine operation to restore the sight of people with the most common cause of blindness will be available within a decade, scientists believe.
A team of British doctors said that a groundbreaking stem-cell treatment for age-related macular degeneration (AMD), which affects a quarter of people over 60 to some degree, should become widely available. The condition is responsible for the blindness of 14 million Europeans.
The doctors are recruiting patients for the first clinical trials, scheduled to take place within five years. The team said that, after earlier studies, they were confident of success.
AMD is caused by the failure of retinal pigment epithelial (RPE) cells – the support cells under the retina that process light. The macula – the central area of the retina – then degenerates and gradually knocks out central vision.
The doctors from University College London, Moorfields Eye Hospital in London and the University of Sheffield have already repaired the vision of a handful of patients with AMD using cells from the patients’ own eyes.
The London Project to Cure AMD, which was launched yesterday with £4 million funding from an anonymous American donor, intends to carry out the same operation using retinal cells grown in the laboratory from embryonic stem cells.
Stem cells are immature, dormant cells with the ability to turn into different cell types. Embryonic stem cells are obtained from early-stage embryos the size of a pinhead.
There are two types of AMD: “wet” and “dry”. While much progress has been made in tackling wet AMD, which is characterised by leaking blood vessels and accounts for 10 per cent of cases, no treatment is available for dry AMD. It is believed that the new development will offer hope even to patients with the dry form.
Lyndon da Cruz, a consultant ophthalmic surgeon at Moorfields Eye Hospital, has carried out an operation in a few patients with wet AMD to take cells from the healthy periphery of the eye and transplant them into the affected area.
The procedures have been successful but are associated with complications, take more than two hours and require two operations.
To make it quicker, easier and more widely available researchers at the University of Sheffield have grown RPE cells from embryonic stem-cell lines.
The hope is that this can be processed into a layer that can be injected into the patient’s eye during a simple 45-minute operation. Tests of the laboratory-grown RPE cells in rats with AMD showed that they restored vision.
Professor Pete Coffey, the project director from the Institute of Ophthalmology at University College London, said that although they had grown RPE cells successfully they now needed to make sure that the cells were safe enough to be used in humans.
“Using stem cells – which are far more adaptable – can only improve success of what has already been achieved and in addition establish this as a global therapy.
“The goal is within five years to have a cohort of patients to put the cells into,” said Professor Coffey, whose team is preparing the laboratory-derived cells for transplant. Given that AMD could affect up to one third of the population by 2070, with the majority suffering from dry AMD, the benefits could be substantial.
“The potential to create a treatment strategy for this condition is critical and may have a major impact on vision loss,” Mr da Cruz said.
He added that if in ten years the proposed 4mm by 6mm transplant patch of stem cells was not in global use, something major would have failed in the research.
“We have the RPE, we have the evidence that doing this can restore vision. [We are dealing with] practicality issues rather than a big unknown.”
More operations are also planned with patients’ own cells in those suffering from dry AMD to test the procedure’s effectiveness.
Barbara McLaughlan, from the Royal National Institute of Blind People, said that taking the research from the laboratory into human trials was exciting.
“This is particularly good news for the 150,000 people in the UK with dry AMD which currently has no treatment,” she said. “However, even if all goes well with this project, potential treatment being made available on the NHS is still five to seven years away.”
Last year The Times revealed that thousands of patients whose sight could be saved by the new drug Macugen were being denied treatment on the NHS on the ground of cost.
Later an insurance company offered to cover the cost of drugs for older patients for an annual premium equal to their age in years.
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