Artistic rendering of choroidal neovascularization: new, damaging blood vessels (highlighted in red) growing from beneath and into the retina of a mouse. This blood vessel growth is typical of patients with wet age-related macular degeneration. Blue highlights the nuclei of cells. Green and yellow highlight expression of ANGPTL4. Credit: Alexander Sodhi, McDonogh School
In a study of eye fluid from 38 patients, Johns Hopkins Medicine researchers say they have found that levels of a specific protein appears to help accurately predict whether people with the wet form of age-related macular degeneration may need lifelong, frequent eye injections to preserve vision or if they can be safely weaned off the treatments.
The researchers say the protein could also be targeted by new therapies to halt vision loss among patients with the disorder, caused by abnormal growth of blood vessels that leak fluid or bleed into the portion of the retina needed for central vision
The researchers’ findings were published online June 2 in the Journal of Clinical Investigation Insight.
The team collected samples of eye fluid from 38 patients at the beginning of their treatment for macular degeneration at the Wilmer Eye Institute between 2013 and 2020 in two Maryland locations. These patients were then grouped based on the frequency with which they required treatment at the end of one year.
The researchers then screened the samples of each of these groups for proteins linked to the development of abnormal blood vessels. Among the proteins present, the researchers found that one, named angiopoietin-like 4, was present at higher levels in patients who required monthly treatment when compared with patients who were eventually able to reduce the frequency of injections or even stop treatment without further vision loss.
Using statistical models, Sodhi’s team found that relatively higher levels of angiopoietin-like 4 (higher than 4.22 ng/mL) accurately predicted actual clinical outcomes in the patient population, identifying with 91% sensitivity those patients who would continue to require monthly eye injections to preserve their vision.