By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

In 1972, Johnny Nash released his number one hit in the United States, Canada and South Africa titled I Can See Clearly Now. Johnny was a rhythm and blues singer who was influenced by the reggae sound. He collaborated with Bob Marley, one of the pioneers of reggae, to sing and produce records. Johnny was a very prolific song writer throughout his career. Interestingly, he sang the theme song for the animated cartoon series The Mighty Hercules that ran from 1963 to 1965,

So why the message to see clearly now?

Researchers have made some significant advances in eye health specifically with macular degeneration in the last few years. Several of these discoveries have completed clinical trials and have been forwarded to the FDA for approval in the United States.

Macular degeneration or referred to as age-related macular degeneration (AMD) is the leading cause of vision loss in older adults primarily over the age of 60 years. The macula is part of the retina of the eye and AMD causes a loss of vision in the central portion of the eye. This makes it difficult to do every day tasks such as read and drive.

There are two types of AMD known as wet and dry. Early stages often have no noticeable symptoms with the more significant symptoms occurring in the later stages. The late stage is referred to as geographic atrophy. Eye exams are essential for detecting the disease before the late stages occur. The treatments for the two types of AMD are very different.

The most common type is dry AMD and it has three stages simply known as early, intermediate, and late. Dry AMD usually progresses slowly and can occur in one eye or both eyes. With age, the macula thins and clumps of protein known as drusen grow in the retina of the eye blocking vision.

Two known risk factors for dry AMD are smoking and a family history of AMD. Quitting smoking is an important way to reduce the risk of AMD. There are limited treatments available for dry AMD.

No FDA-approved drugs or supplements are known to prevent early dry AMD from occurring, but studies sponsored by the National Institutes of Health have identified AREDS2 supplements role in reducing the progression of intermediate AMD to late stage AMD. AREDS2 supplements are the preferred product over the original AREDS supplements.

AREDS2 supplements contain two important ingredients for eye health and this second version eliminated another ingredient. The two important antioxidants in the AREDS2 products are lutein and zeaxanthin. Make sure your supplement contains both ingredients or ask your pharmacist for advice. Some eye health products may only contain lutein and not provide the essential zeaxanthin component. The newer AREDS2 supplements have removed the beta-carotene ingredient. Beta-carotene is the vivid orange, yellow, and red coloring in many vegetables and the body converts it to vitamin A. The reason this supplement was removed from the current AREDS2 products is due to research showing an increased risk of lung cancer when the supplement was ingested in those who smoked.

Scientists are researching some very promising avenues for dry AMD. One area of investigation is targeting changes in the retina by altering the complement cascade to stop the production of drusen. Currently, two drugs with complement cascade activity are in clinical trials in the United States and the results have been submitted to the FDA. Both of these drugs are injected directly
into the eye for treatment.

On February 17, 2023, the FDA approved the first of these drugs known as pegcetacoplan with a brand name of Syfovre. This drug is not a cure, but rather a mechanism to slow progression of geographic atrophy and stall vision loss.

Another research strategy being evaluated for dry AMD is to replace vision cells in the eye with other cells. This research is still in progress and only early data are available. Stay tuned!

The less common wet AMD develops when blood and fluid leak into the retina due to new or abnormal blood vessels growing under the retina. This form of AMD results in a faster loss of vision compared to dry AMD.

Several FDA-approved drugs are available to slow the progression of wet AMD and more are in clinical trials. Most of the current therapies are injected directly into the eye for treatment and block a protein called vascular endothelial growth factor or VEGF for short! On January 28, 2022, the FDA approved a new dual acting agent combining VEGF blocking activity with a second mechanism blocking angiopoietin-2 in the eye. The drug is faricimab (Vabysmo).

Research continues to explore other mechanisms to solve the leading cause of vision loss in those over the age of 55 years. Talk to your healthcare professional today for more information.

Make sure to get your eyes examined, so you can see clearly now and in the future.

ONU HealthWise is offering COVID-19 vaccines as well as flu shots Monday through Friday from 10:00 a.m.-5:00 p.m. The bivalent COVID-19 vaccines are available. Clinics are Monday through Friday from 4:00-6:00 p.m. Please call the pharmacy for information.

ONU HealthWise Pharmacy
419-772-3784