Martha Taggart, BrightFocus Science Writer: Raising Awareness of a Leading Cause of Vision Loss for Older Americans

Show Notes

In recognition of Age-Related Macular Degeneration Awareness Month, Sue Peschin talks with Martha Taggart, a science writer for the BrightFocus Foundation, about age-related macular degeneration, or AMD, an eye disease that is a leading cause of vision loss in older Americans.

Learn more about Martha: https://www.brightfocus.org/bio/martha-snyder-taggart

Watch our short films on AMD: https://www.youtube.com/watch?v=TrlWWCd7B4k

Episode Transcript

Sue Peschin:

Hello everyone and welcome to This is Growing Old, a podcast from the Alliance for Aging Research. I’m Sue Peschin, President and CEO of the Alliance for Aging Research. Today, in recognition of age-related macular degeneration awareness month, we’ll be talking about age-related macular degeneration, also known as AMD. Although AMD rarely causes complete blindness, it can lead to a loss of sharp central vision and cause legal blindness without proper treatment. Here with me today to talk more about AMD is Martha Taggart, a science writer for the BrightFocus Foundation. Martha, thank you so much for joining us today.

Martha Taggart:

Thank you, Sue for having me to talk about AMD. It’s an important topic and yeah, one of the leading causes of legal blindness in the world.

Sue Peschin:

Well, I’m excited that we’re going to dig in then. So first of all, please explain to our audience, what is age-related macular degeneration and how much of a problem is it for people as they grow older?

Martha Taggart:

Yes. Well, AMD it’s a disease that stems from biological causes including aging. It’s not from a virus or it’s not an infectious disease and it’s also not a normal part of the eyes’ aging. Many people, their vision, they have to get a stronger prescription as they grow older, or they have problems with close vision and have to get reader glasses, can’t thread a needle, and that’s due to other sort of mechanical problems in the eye. But AMD is a form of neurodegeneration, which means that the photoreceptors of the eye can actually die which are nerve cells, neurons. And this happens in part because as the eye ages, its maintenance level gets less strong. The maintenance needed to keep it functioning and that includes clearing it of toxins and getting oxygen and nourishment to the photoreceptors. All of that doesn’t work as well.

Martha Taggart:

And sometimes fatty deposits begin to build up in the eye, they’re called drusen and they can be the first sign of AMD. And as they build up, they can create further problems. Other problems are free radicals, kind of wacky molecules that are begin to collect in tissue from things from toxic exposures, to things like smoke, bad diet, exposure to sun and so forth. And all of this creates an inflammatory process in the eye and a disease process that begins to cause further wear and tear. And at its start, this can impact the tissues that surround the retina, which is at the very back of the eye that nourish the retina and the center of the retina, the macula, and when it gets worse, it can cause photoreceptors themselves to die, which leads to a loss of sight in macular degeneration in this central focus area.

Martha Taggart:

So you can still see the… It’s as if you’re looking at a picture and you could see everything around it, but you can’t see what’s in the frame and this can create a big problem for people. We’ve learned that as they age some of the things people fear most are loss of mind and loss of sight. And these are vital to our independence and our being able to function and enjoy life and imagine how scary it would be if you thought I’m not going to be able to focus in on the faces of my kids or my grandkids, or be able to recognize friends across the room.

Sue Peschin:

Okay. Well, this sounds like a lot is going on in the body at a very sort of deep level as this disease develops. Are there any warning signs that people should know about and what are the symptoms that happen maybe prior to actually losing you sight?

Martha Taggart:

Well, that’s the problem. There aren’t a lot of warning signs. The very earliest warning signs are picked up by a doctor in a special type of eye exam, which is different from getting your vision checked. It’s called a comprehensive eye exam. And it’s where the doctor looks into the back of your eye with special instruments. It requires a bit of time because you have to dilate the eye beforehand. And with that, your eye doctor can visualize these drusen developing and depending on where they are and how many there are, can get a sense of how advanced your disease is. So it’s recommended that people begin to get one of these comprehensive eye exams once a year, at least once every other year, once they hit 60 or so. And sometimes earlier if you have risk factors.

Martha Taggart:

And AMD can also cause some distortion of sight and to detect that what’s useful is something known as an Amsler grid. It’s basically like a tiny eye chart that has these lines on it. And if you have AMD the lines that are straight to anyone with a correct vision will appear wavy. And Amsler grids, BrightFocus, my organization puts out an Amsler grid on a refrigerator magnet that you can request for free by getting in touch with them. But those are some of the warning signs.

Sue Peschin:

That’s great to know. And how do people order the magnet from you all? Is there something on your website or an email that they should send?

Martha Taggart:

Call or write BrightFocus, all one word, and if you just Google it, the website should pop up. But yeah, just call and request it. If you go to the website, I would say just type in the search bar, Amsler grid, and it’s A-M-S-L-E-R to request it.

Sue Peschin:

Great. I’m glad you spelled it. I never would have guessed that. Okay. How is AMD treated?

Martha Taggart:

In its earliest stages, your eye doctor may just choose to wait and watch to see what’s happening in your eye if your vision isn’t threatened and also recommend that you follow an eye healthy diet, which is basically a Mediterranean type diet, the eye loves lots of leafy green vegetables and color on the plate. Fish, less red meat and starchy foods and exercise because exercise helps the blood flow, which carries nourishment and oxygen to the eyes. So, all those are good things and key to prevention and helping slow the diseases. Sun protection for your eyes and staying away from smoke. And in intermediate stages, there are eye vitamins that have been tested two huge clinical trials run by the National Eye Institute called the AREDS studies, Age-Related Eye Disease Studies. And that resulted in a proven vitamin regimen that helps slow down the disease.

Martha Taggart:

And there’s information about that all over the web, including at the BrightFocus site. Advanced AMD, the disease can take one of two forms. You can get wet AMD, which is by far the most common, 90%. By the way, this is when your vision really starts getting threatened. The loss of vision is threatened. In wet AMD, to compensate for this inflammation that’s going on in the eye, the eye will grow these leaky blood vessels, leaky, tiny blood vessels near the retina. And they’re a problem in themselves. They can obscure the vision and block nutrients to the cells and that needs to be stopped. So we’re lucky that there were really great drugs for this developed about 15 years ago and have been in use. They’re difficult. You have to have an injection in the back of the eye, eye injections, usually monthly. But having these injections has saved so much sight.

Martha Taggart:

In dry AMD or geographic atrophy is the advanced form of dry AMD, the cells atrophy, and a doctor looking at them will just see regions of dead cells on your retina and the macula and that’s how the disease has got named that. There hasn’t really been a treatment. It’s been a very scary situation for people with geographic atrophy. And now, thankfully there are some late stage clinical trials developing some new drugs for that. So really we’re in a very hopeful time also for geographic atrophy, thanks to research and it’s been a long time coming.

Sue Peschin:

Oh, that’s very good to hear, especially because it does seem like the difference between being in sort of a severe stage and the types of treatments that are currently available while there are definitely hopeful and helpful that there could be more work done in particularly in the area of dry AMD as you mentioned. So what type of research is BrightFocus investing in? What else is happening in research in this area?

Martha Taggart:

There’s a lot going on with AMD. BrightFocus is focusing at the very basic research levels on ways to preserve… To even prevent AMD by looking at some of the downstream indicators of it. Downstream, upstream, I always get those two confused, but before it actually develops into the disease. We put out a yearbook of all our grant projects in macular degeneration every year. And there are about 40 projects, totaling several million dollars that we’re funding right at this point in time. And some of the things that are going on for all these different types of the disease for wet AMD, which is the most common type, there’s a lot of development of new longer-acting anti-VEGF drugs that raise the hope that you might not have to get those injections every single month. You might be able to go longer.

Martha Taggart:

Already, there’s a drug on the market that’s got a longer interval of two months or four months, and they’re maybe eventually in late stage trials now. There are implants that would take you up to a six-month refillable so that your drug can just sit there in your eye and you won’t have to again, get the injection every month. And even a form of gene therapy that would essentially create a little drug factory in your eye. So conceivably a lifetime treatment. In geographic atrophy, researchers are looking for new therapies that essentially rescue the tissue. Usually, both types of AMD starts in the tissue that nourishes the retina. So looking at ways to rescue that tissue by infusing it with nutrients then and stopping the disease process. Some of them gene therapy-based and others just more of a traditional drug.

Martha Taggart:

And there’s also a lot of progress in research to regenerate sight. One of the problems AMD is… One of the things that makes it such a problem is that you can’t regenerate your eyes cells. And when vision is lost, it’s lost. But we’re looking at ways to even replace the tissue underneath the retina so that the photoreceptors don’t die. And there’s been a lot of progress and push in this direction in AMD too. It’s one of the best areas to restore a sight because you just have to keep those photoreceptors alive, you don’t have to wire it into the brain as you do with some other vision diseases.

Sue Peschin:

That’s fascinating. Thank you so much for that overview. Really good to hear about. What advice do you have for someone who has just received an AMD diagnosis?

Martha Taggart:

AMD has to be taken… If there’s an adjustment period of course, but you have to treat it kind of like any chronic disease where you begin to manage it as best you can on your own and with the help of your doctor. The first thing you need to do is make sure that you and your doctor are a good team. You make decisions together. You’re happy with the treatment approach and once that’s understood, then to follow that medical advice, because it’s really important to get your monthly injections if you have wet AMD and to take your AREDS vitamins if you’re in that intermediate stage. And before even that, to get those regular comprehensive eye exam so that your doctor can follow the progress.

Martha Taggart:

Then if you are diagnosed, you have to look at the other side of your house. You have to prepare for maybe developing low vision. And that means look at your lighting sources, make sure you have lots of light. Look at any dangerous spots. People with AMD and losing that central vision might have problems with stairs, they’re really important and landings in places where there’s a step down. Those have to be clearly marked with contrasting colors. And that you can actually bring experts into your house to help you. They’re called low vision specialists to help you make some of the adjustments that you need to make. There’s also a lot of adaptive equipment, technologies for being able to function at work and at home with lower vision. Computer screens can be adjusted in terms of background contrast. Size of type. You can get books on tape, books in large print.

Martha Taggart:

If you have the right smartphone, you can blow up the type on that, and even get phones with larger buttons to accommodate your low vision. And then foremost is just staying informed about your disease. And sometimes that can happen through support groups. Word of mouth is a really great way to get good information. And you can ask your eye doctor about support groups in the area. BrightFocus also has a monthly chat. You just go to our website or even go to Google and type in BrightFocus chats or BrightFocus macular chats and you will get on the list if you’re interested in listening to those once a month, we bring on an expert to speak. And we’re also forming a Facebook group called Community Circle. Again, just Google BrightFocus on Facebook or search BrightFocus on Facebook and that should put you in touch with that. Support groups can be a big help.

Sue Peschin:

That’s great. That is great to now and it’s also terrific to keep reminding people about your website. So thank you. We know February is AMD awareness month. How many people actually live with AMD and why do you think an awareness month is so important?

Martha Taggart:

Yeah, it’s estimated that 11 million Americans have AMD and I just did a rough look up, in contrast about 30 million Americans have heart disease and this is all forms beginning to later stages. And so thankfully AMD isn’t life-threatening as heart disease can be, but that’s still a sizable number of people when you think about a third as many people have this eye disease as do heart disease. So that’s about how many people and its awareness is so important. We’re so happy for the opportunity to partner with you to make people more aware of this disease in this awareness month, because it’s a disease that many people don’t know a lot about or know that they need to get these comprehensive eye exams with aging. We all cherish our sight, but sometimes we take it a little bit for granted and with AMD time lost can be vision loss. So knowing about it and getting things checked out before it gets to be a problem is really important.

Sue Peschin:

That’s a great, and I liked the tagline. The thing I was most surprised to learn about, and we learned about it through our Talk NERDY to Me program, because we have people with AMD that participate in that is how much smoking is a risk factor for AMD. You hear about lung cancer and even heart problems and all that related to smoking, but you rarely hear about AMD.

Martha Taggart:

Right. Right. But you can imagine what an irritant it is to the eye. And these neural tissues they’re really delicate when you think about… We don’t get to get it right up close to our brain tissue, but our eyes, even though the retina is in a protected spot in the back of the eye, but they’re exposed to a lot. And smoking is one of the biggest risks.

Sue Peschin:

I’m going to switch things up on you now, Martha, and I’m just going to ask you, when you were a kid, what did you imagine growing older would be like?

Martha Taggart:

When I was a five-year-old, that’s where I decided to put myself in time, grownups as we call them then, I didn’t really differentiate between people my parents’ age or my grandparents’ age, but they all seemed powerful. They seemed to know what they were doing and I never really imagined that they were struggling with really major issues. And when it comes to grandparents, they’re almost certainly struggling with a lot of changes in health issues and I never really imagined that that struggle was going on.

Sue Peschin:

I think that’s a really good point. It’s like we see them as having all the decision-making authority, right? They get to pretty much do whatever they want. And I think kids are less adept at picking up on issues. And also people were more stoic in previous generations. You weren’t supposed to talk about things. So what do you enjoy most about growing older now?

Martha Taggart:

Well, I actually kind of like the fact that you can be more stoic and resilient. I like the fact that you have that inner strength that whatever problem this day brings or this year doesn’t have to become your sole focus, because you’ve been tested before and you’ll get through this too, and that we have the capability of changing. I think that’s important to some extent fashioning our later years the way we want them to. There’s this Lena Dunham quote, she’s an unlikely role model for me maybe, but once I came across this quote from her that it was like something like, “I like the fact that life is long and things change.” And I thought, “That’s it. I like that too, Lena.” And I think that as we grow older, we can handle a lot of things if we just have the capability to adapt and to change where we need to. Look at how well people have been getting through this crazy past year. And so, that’s what I like, that sense of confidence and inner strength.

Sue Peschin:

I love it. I think that’s great. It’s so true. It’s like, as you get older, you realize you don’t just get one chance or something doesn’t have to be the end of the world. I think that’s a really good reminder. Martha, thank you so much for being on our show today. It’s really been wonderful talking to you.

Sue Peschin:

That’s all for this week’s episode, we encourage you to follow the Alliance on Facebook, Twitter, and Instagram. Visit us at agingresearch.org to learn more about age-related conditions, including AMD and the work that we’ve done with BrightFocus and some short films, diseases, and other issues that impact the health of older Americans are also located there. So please just check us out and subscribe now and rate us on Apple Podcasts, Google Podcasts, Spotify, or anywhere else you listen to podcasts. Thank you so much and have a great day.