Eye spy

Upfront is a quick look at the latest developments from Stanford Medicine.

Medical school researchers have found a way to predict which patients with age-related macular degeneration will progress to a stage of the disease that can quickly cause blindness if left untreated.

AMD is the leading cause of blindness and central-vision loss among adults older than 65. An estimated 10 million to 15 million people in the United States suffer from the disease, in which the macula — the key area of the retina responsible for vision — shows signs of deterioration.

Until now, there has been no way to tell which patients will progress to AMD’s most advanced stage, in which abnormal blood vessels accumulate underneath the macula and leak blood and fluid, causing irreversible damage to the macula if not treated quickly. Only about one of every five people with AMD progress to this stage, but it accounts for 80-90 percent of all legal blindness associated with the disease.

Treatments typically involve injections directly into the eyeball, a painful prospect that makes treating people any sooner than absolutely necessary a non-starter. Doctors and patients have to hope the next office visit will be early enough to catch the advanced stage at its onset, before it takes too great a toll.

In a study published in Investigative Ophthalmology & Visual Science, a team led by Daniel Rubin, MD, assistant professor of radiology and of biomedical informatics, derived a method of accurately predicting whether — and, importantly, how soon — a patient with mild or intermediate AMD will progress to the most advanced stage. The new method, which employs imaging data that’s already commonly collected in eye doctors’ offices, will allow ophthalmologists to make smarter decisions about how soon to schedule an individual patient’s next office visit to optimize the chances of detecting AMD progression before it causes blindness. 

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