Research priorities agreed to stop early age-related macular degeneration (AMD) turning into late AMD at Wellcome retreat

Three leading sight loss charities, Blind Veterans UK, Fight for Sight and the Macular Society, have joined forces in the global fight against age-related macular degeneration (AMD). The main objective of the collaboration, which is called Action Against Age-Related Macular Degeneration (AAA), is to facilitate the funding of medical research aimed at finding an effective treatment for early-stage age-related macular degeneration (AMD).

The charities, together with Wellcome Genome Campus Advanced Courses and Scientific Conferences, brought together 42 international clinical and basic scientists, 16 members of eye charities and other funders, and two patients in a retreat-like workshop in June 2017.

The retreat entitled ‘How to stop early AMD turning into late AMD?’ was a gathering of experts in different areas of both basic and clinical research on age-related macular degeneration (AMD). AMD is the commonest cause of visual impairment in the developed world and, to date, there is no intervention that slows or prevents the early disease progressing to blinding neovascularization or geographic atrophy. The aim of this Retreat was to establish research priorities for the next few years to rapidly develop effective treatment(s) or strategies to help prevent individuals with early AMD progressing to late blinding disease.

The retreat included four sessions in which research priorities in different areas relevant to AMD were debated. The sessions were:

• The key challenges for finding an intervention for early AMD.
• Complement pathways and AMD.
• From genetics to targets.
• Other potential targets to slow the progression of early AMD.

The final session summarised the research priorities which will help to develop a research strategy to find a way of preventing early AMD progressing to blinding disease. The agreed research priorities are:

• Cohorts for longitudinal studies of genetically-defined, highly-informative subject subsets.
• Ageing changes in the choroid-photoreceptor complex.
• Development of models of choriocapillaris endothelium and retinal pigment epithelium (RPE) ageing.
• Integrated approach to understanding how ARMS2/HTRA1 polymorphisms drive disease risk.
• Understand lipid and membrane handling in the choroid-photoreceptor complex.
• Approaches to revitalising Bruch’s membrane.
• Support for a drug development programme and studies of therapeutic access to RPE-photoreceptor complex.
• Understanding mechanisms of impaired dark adaptation in early AMD (both to support appreciation of how early disease develops as well as developing a potential ‘marker’ of early disease).
• Work with other programmes to develop imaging/functional tests for early disease.
• Further our understanding of how the innate immune system drives disease.

Regarding infrastructure priorities, the participants considered seed corn funding to be most important, followed by the facilitation of academic and commercial partnerships, and non-clinical researcher capacity building.

Cathy Yelf, Chief Executive of the Macular Society said: “Age-related macular degeneration is a devastating condition which is affecting more and more people globally as our population ages. Collaboration is essential to tackle the growing sight loss epidemic. The retreat was a very positive step with leading UK and international academics and clinicians and the pharmaceutical industry coming together to address this urgent problem.”

Nick Caplin, CEO of Blind Veterans UK said: “Blind Veterans UK currently supports more vision-impaired veterans than at any time in its 102 year history. It is an interesting and sad reflection that two thirds of the veterans we support today suffer from AMD. The projected rate of increase of AMD within the UK and globally is alarming. For Blind Veterans UK, this initial scientific meeting was a call to action to finding a successful intervention and to help millions of people avoid this devastating disease in years to come.  As the meeting report explains, we have now started our journey to finding that intervention.”

Michele Acton, CEO of Fight for Sight said: "People living with AMD tell us they want an intervention at the earliest possible stage to stop the condition progressing to the point where they start to lose their sight.  Fight for Sight exists to fund research to stop sight loss whatever the cause. We are delighted that the Macular Society and Blind Veterans share our commitment to invest in AMD research and the Wellcome conference was the first of many initiatives of the new partnership. Together we are committed to investing more resources into targeted research to make sight loss from AMD a thing of the past."