Sarah Goodwin

Kathi Ovnic
Holly Korschun
November 17, 1998


Macular degeneration, a disease of the retina, is the leading cause of blindness among Americans over age 55. The macula is about the size of this "O" and is located in the center of the retina, the area we use for reading and central vision.

The wet or exudative form of macular degeneration can significantly damage vision. This blinding disorder results when abnormal blood vessels form and leak fluid and blood underneath the retina-in the layer of the retina in the back of the eye called the choroid. The choroid's blood vessels, combined with tissue, can form a scar-like membrane under the retina and block central vision.

The Emory Eye Center is one of the country's leaders in macular degeneration research. Below are some of the treatments currently under investigation at the Eye Center for the wet form of age-related macular degeneration.


The Eye Center is the only center in the South involved in a National Institutes of Health-sponsored study evaluating whether antioxidants and zinc can slow or arrest progression of age-related macular degeneration. This five-year study, called Age-Related Eye Disease Study (AREDS), is no longer enrolling patients. The patients already participating in AREDS will be followed at least until 2000, at which time study results will be published.


The Eye Center is conducting the Complications of Age-Related Macular Degeneration Prevention Trial (CAPT) to determine whether laser treatment is effective in preventing severe vision loss from wet macular degeneration.

Patients who have drusen, or yellowish deposits under the retina, are particularly at risk for developing abnormal blood vessels in the choroid (called choroidal neovascularization or CNV) that leak and form scar tissue. A majority of patients with severe vision loss from age-related macular degeneration have CNV. Research has shown that photocoagulation laser treatment can seal leaking blood vessels and limit vision loss for some patients. Laser treatment also can make drusen disappear. What is not known is whether laser treatment can decrease the risk of developing sight-stealing CNV.

Candidates must be 50 years of age or older, have 10 large drusen, have a visual acuity of 20/40 or better in both eyes, and have no other eye disease affecting vision. Study participants will be randomized to receive laser treatment to one eye, while the other eye will be observed. They will be followed for four years.

Intravitreal Injections

Emory is studying whether an experimental new drug, called NX1838, can safely and effectively halt the progression of wet age-related macular degeneration. The drug is injected directly into the vitreous, the jelly that fills the eye. Candidates for the study must be 50 years of age or older and must have a visual acuity worse than 20/200. Participants in this Phase I study will receive one injection.

Retinal Translocation

Retinal translocation is an experimental new treatment involving two procedures. During the first inpatient procedure, a surgeon moves the retina aside without detaching it. The purpose of this procedure is to move the critical vision zone away from the underlying leaking blood vessels of the choroid. A few days later after the area has healed, the surgeon uses a photocoagulation laser to seal the leaking blood vessels during an outpatient procedure. Since the laser can destroy photoreceptors on the retina and cause blind spots, it is important to move the central vision zone first.

Patients who qualify for this treatment have had a relatively recent onset of symptoms with evidence of leaking or bleeding in a small area of the macula. The risks of this treatment are still being determined, since only small number of patients have been treated. Several participants report that their vision has improved significantly, while a few patients have actually lost vision, a risk of undergoing the procedure.


The Eye Center is one of 15 centers participating in the Submacular Surgery Trials (SST), which are sponsored by the NIH. An alternative to photocoagulation laser therapy, which can cause blind spots, submacular surgery involves removing the leaking area of the choroid that extends into the center of the macula. The goal of the trials is to determine whether submacular surgery can stabilize or improve vision.

Researchers will enroll patients, who will be followed for four years, into one of three trials, depending on the extent of disease and level of visual acuity. Patients who have had previous laser surgery or have other eye diseases affecting vision are not candidates.


The Eye Center is one of a number of centers worldwide participating in the Verteporfin in Photodynamic Therapy Trial (VIP). Photodynamic therapy is an experimental outpatient procedure during which researchers inject a dye that concentrates in the abnormal blood vessels of the choroid. A red laser light shined onto the retina activates the dye. The purpose of the VIP trial is determine whether this procedure is safe and effective in preventing new blood vessel growth and halting vision loss.

This study is no longer recruiting patients at this time. More data on this trial should be available in 2000.

NOTE: There are several forms of macular degeneration. The dry or atrophic type is the most common type-affecting nearly 70 percent of all cases-and results as the macula's tissues age and break down, causing a gradual vision loss. There are no treatments available for this type. This fact sheet highlights treatments for wet macular degeneration, which affects 10 percent of sufferers and is the most blinding form. There are other forms of macular degeneration, which affect children or result from injury, infection, or inflammation.




  • The Emory Eye Center currently participates in 16 multicenter clinical trials in retina, cornea and glaucoma.
    • The Eye Center has five endowed chairs, four endowed professorships and 12 other named endowments.
  • The Eye Center has been named one of the best eye centers in the country by U.S. News & World Report for the five years the newsmagazine has had a ranking for ophthalmology (1994-1998). The ranking is based on a reputational survey among ophthalmologists in the country.
    • Ophthalmology Times, a professional journal for ophthalmologists, ranked the Eye Center as the eighth best eye center in the country in 1996, as having a top 10 residency program in 1997, and as the fifth best eye center in the country in 1998. The journal surveyed peers ­ chairmen and residency directors from all U.S. academic eye centers ­ for the ranking.
  • In fiscal year 1997-98, Eye Center researchers were awarded approximately $5 million in new grants.
    • Support for research is provided primarily by the National Eye Institute, a division of the NIH. The Eye Center is one of the top ten NIH-funded eye research institutions in the U.S. Additional funding is provided by state, industry, and private foundations and other contributors. The Eye Center's basic science research has been aided over the past 10 years with a NIH core grant that supports structural biology, molecular biology, biochemistry, epidemiology and biostatistics. The Eye Center has had a NIH training grant for the past 12 years with continued support through 1999.

    For more general information on The Robert W. Woodruff Health Sciences Center, call Health Sciences Communication's Office at 404-727-5686, or send e-mail to

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