Brief Lay Background
Age-related macular degeneration (AMD) affects 700,000 people in the UK and is the leading cause of blindness in the elderly. There are two advanced types of AMD: dry and wet. People with wet AMD may lose sight due to the growth of abnormal blood vessels into the macula, the central part of the retina (the light sensitive tissue at the back of the eye that sends signals to the brain).
Wet AMD is treated with drugs called VEGF inhibitors that need to be injected into the eyes. These drugs aim to stop the growth of the abnormal blood vessels. However, nearly a third of patients do not respond or respond poorly to the therapy (known as “non-responders”). The blood vessels continue growing and the leakage persists in non-responders despite intensive VEGF inhibitor therapy.
What problem/knowledge gap does it help address?
It is not currently understood why some patients cannot benefit from existing therapy, and currently, no other therapies are available for the non-responders.
Clinical studies have found that the diseased macular blood vessels in non-responders are often larger than the vessels in responders. In a laboratory setting, it has been reported that VEGF inhibitors can stop the growth of smaller abnormal blood vessels, but not larger ones. A group of cells, called “macrophages”, can help diseased blood vessels to grow in wet AMD. The team have found that the blood vessels that do not respond to current therapy have many more of these cells around them.
Aim of the research project
To use cells from AMD patients to understand the fundamental differences in blood vessel cells and cells called macrophages between people who respond to anti-VEGF therapy and those who do not. The team will explore how macrophages affect blood vessels’ responses to the therapy in responders and non-responders.
Potential impact on people with sight loss
If successful, the team will identify important pathways and molecules that further studies could target to develop treatments for non-responders. Additionally, with further research, these molecules may also be used as ways of predicting treatment outcomes, enabling doctors to design personalised treatment plans.
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