Age-related macular degeneration, commonly referred to as AMD, is one of the world’s most common causes of severe eyesight loss in older people. Populations across the globe, especially in Singapore, are ageing, making treatment for this condition increasingly salient.
There are two types of AMD: Wet AMD, where blood vessels grow under the macula, causing fluid to leak into the retina, and dry AMD, where cellular debris gradually damages light-sensitive cells in the eye, leading to a loss of vision. Dry AMD accounts for most AMD cases. Untreated, patients will first experience partial vision loss, and eventually total blindness. Pinpointing the cause of degeneration in ageing eyes is an ongoing quest.
Currently, treatments available only target early to mid-onset AMD patients. Treatments used to slow the growth of blood vessels in the eye, called anti-VEGF therapies, are aimed at wet AMD, while retinal injections that address inflammation have been recently approved for dry AMD.
However, there is currently no treatment that combats the progressive and irreversible loss of retinal cells for advanced-stage AMD patients of both types. Excitingly, scientists at the Centre for Vision Research at Duke-NUS have now harnessed the potential of human pluripotent stem cells, or stem cells capable of giving rise to several cell types, to develop cells that function similarly to human foetal retinal cells.
These retinal cells have been shown to partially restore vision in preclinical models, and the research team is currently refining the therapy for clinical trials. At the same time, we are also developing a new method of restoring vision by creating a two-layered retinal scaffold—a synthetic replacement for two layers of retinal cells, photoreceptors and a retinal pigment epithelium, which enables the photoreceptors to detect light.
Most significantly, these therapeutic retinal cells—developed with the help of a protein called laminin—could potentially be transplanted into the eyes of patients with irreversible retinal cell loss, with the hope that the transplanted cells will integrate with the patients’ eye circuitry. This work hinges on a matter of processing information: we hope that the patients’ brains will be able to perceive and decode optical information when it is received from the transplanted cells.