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Telescope for Macular Degeneration?

FDA Eyes Implantable Miniature Telescope When All Else Fails to Treat Macular Degeneration
WebMD Health News
Reviewed by Louise Chang, MD

April 23, 2008 -- Could an implantable miniature telescope give macular degeneration patients a vision boost when they run out of other options? An FDA advisory panel takes up that question later this week.

Macular degeneration, the leading cause of severe vision loss in people over age 60, slowly steals central vision, which is needed for tasks such as reading and driving. Central vision gradually goes from being a little fuzzy to near blindness.

The Implantable Miniature Telescope (IMT), made by VisionCare Ophthalmic Technologies of Saratoga, Calif., is the first of its kind. It's 4 millimeters long and designed for people with central vision loss in both eyes from end-stage age-related macular degeneration.

"End-stage" means that "there's nothing we can do that will medically improve that eye," says ophthalmologist Bill Lloyd, MD, who writes WebMD's Eye on Vision blog.

Good candidates for the telescope have severely impaired vision but aren't totally blind, Lloyd says. Patients can only get the telescope in one eye, because they need their other eye for peripheral vision, which the telescope reduces.

In the telescope's clinical trial, patients' vision improved and so did their quality of life. "It's a promising device," Lloyd says.

Kathryn Colby, MD, PhD, director of joint clinical research at the Massachusetts Eye and Ear Infirmary in Boston, agrees. "I think it's a very good device for people for whom there are no other options," says Colby, who participated in the telescope's clinical trial.  "I have probably 60 patients on a waiting list that are waiting for the FDA to make its decision."

But the telescope isn't a cure -- and it does have risks. "It doesn't give people back their 20-year-old eyes which are normal in every other way. So it's very important for patients to have realistic expectations going into this," Colby says.

About Macular Degeneration

"The macula is the central-most area of your vision," Lloyd says. "Think about a map of the United States -- the macula of your retina is like Kansas City. It's a relatively small piece of real estate compared to the entire map. But nonetheless, so much of our visual input, which is 70% of what we experience in life, is processed by that tiny little island of dense photoreceptors."

In end-stage macular degeneration, "that's gone," Lloyd says. But "you still have plenty of other real estate that's not as good, not as rich in photoreceptors."

"Unfortunately," Lloyd says, the density of the photoreceptors in these outlying areas is not as precise as it was in the macula... It's not the same as seeing 20-20, but it's certainly much better."


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