105
Geographic Atrophy
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categories 3 and 4 to advanced AMD (25% in 5
years), however, in the group with GA away from the
center (category 3), this reduction was not statisti-
cally significant. Despite of that the AREDS Report
nº 8 concluded, that those with noncentral GA also
should consider taking a supplement of antioxidants
plus zinc
(4,12)
.
Macular xantophylls and polyunsaturated fatty acids
seem to be associated with a lower risk of advanced
age-related macular degeneration
(59,60)
. Because of that
antioxidant effect of macular pigments as lutein, zea-
xanthin and omega-3 fatty acids has been tested in the
Age-related Eye Disease Study 2 (AREDS 2)
(59,61)
.
Low dietary glycemic index also seems to reduce the
risk of evolution to advanced AMD
(61)
. Other behav-
ioral factors such as stop smoking and control of BIM
may play an important role on prevention
(13)
.
7.2 New treatments
So far there is no proven drug treatment for dry AMD.
However, several trials are investigating many strategies
regarding three major targets: Neuroprotection, oxida-
tive stress protection and suppression of inflammation
(62)
.
Ciliary neurotrophic factor (CNTF) is a potential new
treatment protecting photoreceptors of degeneration.
CNTF is released from an encapsulated cell device
implanted in vitreous cavity
(63,64)
.
ACU-4429 is a modulator of visual cycle, inhibiting the
generation of lipofuscin precursors and is selective to rod
system
(62)
.
OT-551 is a new topical anti-inflammatory, antiang-
iogenic and antioxidant agent, that protects photorecep-
tor cells by inhibiting lipid peroxidation
(64,65)
.
POT-4 is a C3 inhibitor administered as an intravitreal
gel and suppresses local inflammation
(66)
. Other inflam-
mation suppressor is fluocinolone acetonide, a glucocor-
ticoid used as an intravitreal implant.
Although currently there is no drug proven effective, in
the next decade some of the research lines will probably
be able to find a more effective treatment for the atrophic
form of AMD.
