Molecular medicine can be used to prevent and restore lost vision when the issues of age-related vision loss of catastropic proportions is rising from 17 million patients in recent times to 55 million by the year 2050.
These are the words of Stuart Richer, OD, PhD, speaking at the 10th annual meeting and International Conference on Recent Trends in Therapeutic Advancement of Free Radical Science, in Chennai, India today.
Dr. Richer says modern medicine is just beginning to evaluate data from the first cases where conventional medical and surgical efforts to restore lost vision had been exhausted and a molecular medicine approach was employed under compassionate use. Even other nutritional therapies including antioxidants were ineffective. Molecular medicine, where small molecules are utilized that can pass through the blood-retinal barrier and which can influence the genetic machinery inside living cells, appears to be very promising, says Dr. Richer.
While this therapy is still unproven, early data indicates larger trials are warranted. The first cases treated under a molecular medicine protocol provide evidence that not only can visual loss in the later years of life be preserved, but lost vision can be restored, particularly among the most severe cases of retinal disease or what is called advanced macular degeneration, says Dr. Richer.
"While I must qualify what I am saying by noting that the severity of retinal disease may improve on its own, I have now documented three consecutive cases where molecular medicine appears to have restored the normal architecture of the human retina and measurably improved visual function that could not be accomplished with conventional care. In one of these cases, vision improved when the patient took an oral a mineral-chelating antioxidant (Longevinex) and deteriorated when the patient ceased taking the antioxidant cocktail, which suggests cause and effect," he says.
Dr. Richer showed an audience of stunned researchers the first photographic slides of their kind - old, damaged retinas that are pocked with aging spots, hemorrhages and poor circulation, becoming more youthful and functional over a relatively short period of time. "We simply need to move to larger human trials where we can determine the reliability and safety of this approach. This can be accomplished within a year, we do not need to wait a decade to conclusively validate this approach," he says.
"The small molecules in the nutriceutical cocktail we used, such as resveratrol, quercetin, rice bran phytate, as provided in commercially-available product called Longevinex, appear to work synergistically and more powerfully in animal studies of heart disease, which is why it was chosen for compassionate use in these individual cases of age-related eye disease," says Dr. Richer.
These cases were deemed unsuitable by a retinal specialist for medical therapy, which consists of injecting an anti-growth factor drug directly into the eye. "There were no remaining options for these patients," says Dr. Richer.
The possibility of using an oral pill rather than injections directly into the eyes is likely to be more welcomed by patients. Such a pill would cost less than a dollar a day. Injectable drug therapy costs around $1000 per injection and six or more injections are often required.
Dr. Richer calls attention to the fact that many senior Americans remain active and drive automobiles but don't fully recognize their vision is fading, and they are developing blind spots, especially if these changes occur in one eye only. Age-related visual decline represents a major road hazard he emphasizes.
"We have growing evidence that molecular medicine can turn mortal heart attacks into non-mortal events and accelerate healing of a damaged heart, and now we are beginning to document that lost vision can be restored, sufficient to help senior adults maintain an active lifestyle, which includes driving an automobile," he says.
Dr. Richer's first case showing molecular medicine improved the vision of an 80-year old man was published in the journal Optometry in 2009.
Dr. Richer cautions patients with existing macular degeneration to be judicious in their use of nutriceuticals, such as resveratrol pills, since very low doses may be ineffective and mega-doses may actually generate free radicals and be toxic. He says the nutriceutical formula chosen for his study, unlike other resveratrol pills, was recently documented to be non-toxic at any tested dose.
"The human retina has tremendous regenerative capacity when molecular medicine is applied," says Dr. Richer. "We are just beginning to appreciate and document the value of small natural molecules that can pass through the blood-retinal barrier and influence the genetic machinery within living cells," he says.
Resveratrol, known as a red wine molecule, exhibits almost magical properties, promoting new blood vessels which speed healing after a heart attack, but doing the exact opposite in the retina, inhibiting the development of new blood vessels which can destroy vision.