MACULAR DEGENERATION.
THE DISEASE IS CONSIDERED THE
LEADING CAUSE OF BLINDNESS IN OLDER AMERICANS.
THERE'S NO CURE FOR THE CONDITION, AND NO
TREATMENT FOR ITS MOST COMMON FORM, WHICH ACCOUNTS FOR 85
PERCENT OF CASES.
BUT DR.
ANDREW LAM, A MACULAR DEGENERATION SPECIALIST SAYS
THAT DOESN'T MEAN THERE'S NO HOPE FOR PATIENTS, LIKE EVELYN
CALLEVA, AND OTHERS.
I FIRST ASKED DR.
LAM -- WHAT IS MACULAR DEGENERATION?
MORE AND MORE YOUNG PEOPLE ARE GETTING INVOLVED IN POLITICS
>> IT IS A LEADING CAUSE OF BLINDNESS, OF LEGAL BLINDNESS OF
AMERICANS OVER 50.
IT IS PROBABLY THE LEADING CAUSE AND IT IS THE CONDITION OF THE
MACULA WHICH IS IN THE RARE PART OF THE EYE.
IT'S PART OF THE RETINA IT'S WHAT WE SEE STRAIGHT AHEAD FINE
DETAIL LIKE SEEING WORDS AND READING FACES.
THE PHOTORECEPTORS CAN LITERALLY DEGENERATE.
BLURRY CENTRAL VISION AND THERE ARE TWO TYPES.
>> YEAH, THERE'S TWO TYPES, DRY -- SO WHAT'S THE DIFFERENCE
BETWEEN ONE IS MORE TREATABLE THAN THE OTHER RIGHT THERE?
>> THE DRY KIND IS THE MORE PREV
PREVALENT. 80 TO 90% OF THOSE HAVE THE DRY
KIND AND ACTUALLY THAT'S THE PREFERABLE TO HAVE.
IT MOVES SLOWLY.
YOU CAN HAVE MACULAR DEGENERATION FOR YEARS AND HAVE
VERY LITTLE CHANGE IN YOUR VISION.
THE WET DEGENERATION IS MORE ACUTE WHICH IS 10 TO 15% OF
PATIENTS WHICH IS CHARACTERIZED BY LEAKING OR BLEEDING BLOOD
VESSELS UNDER THE MACULA WHICH SEVERELY DISTORTS THE VISION AND
CAUSE SEVERE VISION LOSS.
>> 2K50U9 SEE THAT IN THE -- DO YOU ACTUALLY SEE THAT IN THE
EYE?
>> YES.
WE CAN GO IN THERE WITH OUR LENSES AND SEE LEAKING BLOOD
VESSELS, AND WE HAVE VARIOUS IMAGING TECHNIQUES LIKE A
SCANNER THAT CAN CLEARLY SHOW THE FLUID UNDER THE MACULA.
>> EVELYN, YOU'RE A PASSIONATE OF DR.
LAM?
>> YES.
>> HOW DID YOU FIRST BECOME AWARE THAT YOU HAD MACULA
DEGENERATION.
>> WHEN I WAS GOING TO MY OPHTHALMOLOGIST HE POINTED IT
OUT TO ME AND POINTED ME TO DR.
LAM.
>> DO YOU MIND IF YOU HAVE THE DRY OR WET FORM.
>> I HAVE THE DRY IN ONE AND WET IN THE OTHER.
>> WOW!
I DIDN'T THINK OF THAT POSSIBILITY.
YOU'RE TREATING TWO THINGS AT THE SAME TIME.
>> MOST PEOPLE START OUT HAVING THE DRY FORM FOR A PERIOD OF
TIME AND THEN WHAT CAN HAPPEN IT CAN CONVERT INTO THE WET FORM.
IT DOESN'T MEAN YOU STOP HAVING THE DRY FORM.
>> AND IT SEEMS LIKE WE'RE HEARING ABOUT THIS MORE.
IS IT BECAUSE PEOPLE ARE BEING DIAGNOSED MORE OFTEN OR IT'S
BECOME A LARGER PROBLEM OR WHAT DO YOU THINK?
>> IT'S THE AGING POPULATION WE'RE ALL LIVING LONGER.
50 YEARS AGO PEOPLE DIDN'T REALLY TALK ABOUT MACULAR
DEGENERATION PEOPLE DIDN'T LIVE TO REALIZE IT'S A PROBLEM.
WE'RE LIVING LONGER AND WE'RE HEALTHIER OUR STANDARD OF CARE
IS MUCH GREATER AND AS YOU WERE ALLUDING TO, WE HAVE TREATMENTS
THAT CAN ACTUALLY DO SOMETHING ABOUT IT.
IT WASN'T THAT LONG AGO, WHEN I WAS IN TRAINING I STILL REMEMBER
WE DIDN'T HAVE ANY EFFECTIVE TREATMENTS FOR THE WET DISEASE.
PEOPLE WOULD COME IN WITH SEVERE VISION LOSS WE REALLY WOULDN'T
DO MUCH FOR THEM WHICH WAS QUITE DEPRESSING AND NOW WE DO SOME OF
TREATMENTS.
>> HOW ARE YOU WORKING WITH EVELYN AND HOW IS IT GOING?
>> THE NATURAL HISTORY OF WET MACULER DEGENERATION WILL GET
LOSS.
YOU RETAIN YOUR PERIPHERAL VISION --
>> IT STARTS TO GET VERY CLOUDY.
>> DISTORTED AND CLOUDY THAT'S RIGHT SO THE MEDICINES THAT WE
USE ARE ACTUALLY INJECTIONS IN THE EYE.
WE NUMB THE EYE, IT DOESN'T HURT OR SOMETIMES YOU FEEL A LITTLE
PINCH OR PRESSURE AND IT'S VERY TOLERABLE AND EVELYN CAN SPEAK
TO THAT, I HOPE.
THE MEDICINES ARE 234067 STABILIZING THE VISION WHICH
ISES A MAJOR VICTORY BECAUSE THE NATURAL HISTORY IS JUST TO KEEP
LOSING VISION AND SOME PEOPLE GETS -- SOME PATIENTS GET
IMPROVEMENT.
>> YOU'VE BEEN SEEING DR.
LAM FOR ABOUT 4 YEARS.
WHERE ARE YOU, HOW IS YOUR VISION?
>> ACTUALLY I'VE NOTICED IT LATELY IT'S A LITTLE BIT BETTER.
MOST OF MY DIFFICULTY IS WHEN I'M READING, IT BECOMES VERY
BLURRY BUT WITH ADEQUATE LIGHTING AND SOMETIMES A
MAGNIFYING LENS I DON'T HAVE A PROBLEM.
>> SO YOU'VE MADE A FEW ADJUSTMENTS THERE BASED ON WHAT
YOU NOTICED.
>> YES, YES.
>> AND IS THAT SOMETHING YOU RECOMMEND TO YOUR PATIENTS MAYBE
LIFESTYLE CHANGES TO MAYBE HELP THEM IN THE INTERIM.
>> TO BE HONEST PEOPLE OFTEN ASK ME WHAT CAN I DO TO TRY TO
IMPROVE MY CHANCES OF NOT GETTING MACULAR DEGENERATION OR
THE RISK OF IT NOT GETTING WORSE.
IT'S AGE-RELATED.
IT'S ACTUALLY CALLED AGE-RELATED MACULAR DEGENERATION.
THERE'S A LIMIT TO WHAT WE CAN DO TO INHIBIT IT SHORT OF
MEDICATIONS.
YOU ALLUDED TO THE FACT THAT ONE HAS A TREATMENT.
THAT'S ACTUALLY THE WET MACULAR DEGENERATION WHICH IS THE WORSE.
THE DRY MACULAR DEGENERATION ALTHOUGH A LOT OF RESEARCH IS
BEING DONE IN THAT AREA REALLY DOESN'T HAVE A TREATMENT YET.
>> YOU MENTIONED IN THE AGE PEOPLE BUT SOMEONE IS 48 YEARS
OLD IS BEING DIAGNOSED.
IT TECHNOLOGY GETTING BETTER SO WE'RE SEEING IT EARLIER IN FOLKS
AND HELPING THEM OR IS THIS BECOMING SOMETHING THAT'S A
PROBLEM FOR YOUNGER PEOPLE?
>> WELL, I DON'T THINK -- WE'VE ALWAYS BEEN ABLE TO CLINICALLY
DIAGNOSE THE CONDITION SO I DON'T THINK THERE'S A REAL
CHANGE IN THE PREVALENCE OF IT AMONG YOUNG PEOPLE.
WE THINK BASICALLY IF YOU'RE OVER 50 IT'S ESSENTIALLY OLD
ENOUGH TO POSSIBLY GET SOME SIGNS OF DRY MACULAR
DEGENERATION.
THE TREATMENTS THAT WE'RE WORKING ON TO BASICALLY SLOW
DOWN THE WORSENING OF DRY MACULAR DEGENERATION.
THERE'S DEFINITELY A LOT OF COMPANIES, A LOT OF RESEARCH
STUDIES WORKING TOWARDS THAT.
>> AND IN TERMS OF PREVENTION, IS THAT -- IS IT ABOUT WEARING
SUNGLASSES?
IS THAT REALLY KIND OF THE ONLY THING YOU CAN BE DO?
YOU SEE LITTLE KIDS WEARING SUNGLASSES NOW.
>> WE DO THINK IT'S BENEFICIAL TO LIMIT YOUR EXPOSURE.
SOME SUNGLASSES IS GREAT.
BUT IT'S NOT SOMETHING SO OBVIOUS THAT WE TELL PEOPLE TO
WEAR SUNGLASSES TO ALL THE TIME.
>> ANOTHER IS GENE THERAPIES AND WHEN YOU READ ABOUT THEM IT
SEEMS LIKE THE STUFF OF SCIENCE FICTION BUT DO YOU THINK THERE'S
ACTUALLY HOPE FOR PEOPLE THAT YOU MIGHT CURE THIS ONE DAY?
>> ABSOLUTELY.
THERE'S DEFINITELY HELP.
IF YOU LOOK AT 10 YEARS AGO AGAIN WE DIDN'T HAVE THESE
MEDICATIONS AND PEOPLE WERE LITERALLY GOING BLIND BEFORE OUR
EYES AND WE COULDN'T DO MUCH.
10 YEARS FROM NOW I'M SURE THERE'S GOING TO BE WONDERFUL
OPTIONS.
PEOPLE -- WE'RE STUDYING STEM CELL THERAPY IN PARTICULAR.
GENE THERAPY AS WELL.
GENE THERAPY HAS A LOT OF PROMISE FOR INHERITED RETINAL
DISEASES NOT NECESSARILY LIKE MACULAR DEGENERATION.
>> WHICH IS THE FORM ANYONE COULD GET?
>> IT ALL DEPENDS ON YOUR GENETIC HISTORY.
WITH THE GENE THERAPY YOU HAVE TO IDENTIFY A MALFUNCTIONAT GENE
AND YOU HAVE TO REPLACE IT OR FACT BUT IF IT'S A
MULTIFACTORIAL DEGENERATION WHICH IS AGE WHICH NOBODY WILL
BE ABLE TO CHANGE IT'S MORE DIFFICULT TO FIND A TARGET BUT
STEM CELLS HAVE A LOT OF PROMISE.
THERE'S DEFINITELY EARLY-PHASE STUDIES BEING DONE WHERE
ESSENTIALLY IF YOU WERE ABLE TO TAKE A STEM CELL AND POSSIBLY
REJUVENATE OR REGROW FUNCTIONAL RETINAL CELLS UNDER THE MACULA,
THAT COULD BE AMAZING BUT IT IS IN A VERY EARLY STAGE BUT
BELIEVE ME, A LOT OF PEOPLE ARE WORKING ON THIS.
>> SOMETHING ELSE I WANT TO ASK YOU ABOUT IS COST.
YOU WROTE AN OP-ED BACK IN 2015 FOR THE "WASHINGTON POST" AND
YOU POINTED OUT THERE'S A $50 TREATMENT THAT YOU ARE QUITE
FOND OF VERSUS A $2,000 TREATMENT.
>> THAT'S RIGHT, THAT'S RIGHT.
>> ARE YOU STILL -- DO YOU STILL BELIEVE THAT THE $50 IS JUST AS
EFFECTIVE AS THE $2,000.
>> I DON'T ONLY BELIEVE IT BUT WE KNOW IT'S TRUE FROM SCIENCE.
SO THIS IS A VERY INTERESTING TOPIC THAT ESSENTIALLY TOUCHES
ON MUCH OF THE DRUG COSTS AND THE CONTROVERSY OVER DRUG COSTS
IN OUR COUNTRY BRIEFLY.
WE HAVE 3 MEDICATIONS FOR WET MACULAR DEGENERATION.
ONE IS CALLED AVASTIN AND THAT'S VERY INEXPENSIVE.
ABOUT 50 BUCKS A DOSE AND TWO OTHER ONES IS CALLED LUCENTIS
AND ILEAH AND THEY'RE ABOUT $2,000 PER DEUCE.
>> THEY DO THE SAME THING.
>> THEY DO THE SAME THING BUT SOME STUDIES HAVE SHOWN VERY
SLIGHT DIFFERENCES IN MAYBE THE OCT STUDY THAT WE DO THAT SHOWS
HOW MUCH DRYING OF THE MACULA THERE IS BUT PRACTICALLY
SPEAKING THEY'RE EASEL SAFE AND EFFECTIVE.
IF ONE DOESN'T WORK YOU CAN ALWAYS SWITCH TO SEE IF THE
OTHER ONE WORKS.
MOST OF THE TIMES WHEN THAT HAPPENS THERE'S VERY LITTLE
DIFFERENCE IN MY EXPERIENCE.
IT'S AN ONGOING DEBATE WHICH IS VERY INTERESTING AND HAS A LOT
OF RAMIFICATIONS FOR A NATURAL -- OUR HEALTH SYSTEM.
MORE AND MORE YOUNG PEOPLE ARE GETTING INVOLVED IN POLITICS
THESE DAYS - AND ELECTED TO OFFICE.