UPDATE Macular Degeneration
Summer 2025
Long-Term Visual Outcomes of Patients With nAMD Treated With Anti-VEGF Therapy Lost to Follow-Up
Jeffry D. Gerson, O.D., F.A.A.O.
This is interesting and important. Bottom line: If you are getting treated for wet AMD and stop going to follow-ups, you are proven to not do as well as if you follow the schedule set by the treating doctor. Sounds obvious, but like everything else, we need data/science to prove it.
Researchers evaluated the long-term visual outcomes of patients with neovascular age-related macular degeneration (AMD) who were lost to follow-up (LTFU) during treatment compared with those with continuous follow-up (CFU).
A retrospective study was conducted on patients diagnosed with neovascular AMD who received anti-VEGF therapy from 2010 to 2022. The patients were classified into: a long-term LTFU group (LTFU for more than 6 months); short-term LTFU group (LTFU for 2 months to less than 6 months); and the CFU group. Researchers conducted a comparative analysis of baseline characteristics, factors related to visual prognosis, and differences in the occurrence of severe vision loss.
A total of 169 patients were classified into 43 in the long-term LTFU group, 57 in the short-term LTFU group, and 69 in the CFU group. The mean follow-up duration was 57.12 ± 31.68 months. No significant difference was found in baseline visual acuity (logMAR) among the long-term LTFU, short-term LTFU, and CFU groups (0.76 ± 0.54, 0.68 ± 0.51, and 0.72 ± 0.54, respectively; p=0.734). The final visual acuity was significantly lower in the long-term LTFU group (1.12 ± 0.79) compared with the short-term LTFU group (0.65 ± 0.62) and the CFU group (0.65 ± 0.56)(p<0.001), and the change in visual acuity was significantly greater in the long-term LTFU group (0.36 ± 0.69) compared with the short-term LTFU group (-0.03 ± 0.64) and the CFU group (-0.07 ± 0.58)(p=0.001). Long-term LTFU was significantly associated with changes in visual acuity from the baseline to the final visit (p=0.002) and severe vision loss (p=0.002).
Researchers wrote, in patients with neovascular AMD, those in the LTFU group for more than six months during treatment had worse long-term visual outcomes than those with regular follow-up or shorter LTFU durations.
SOURCE: Nam KT, Yun C. Long-term visual outcomes of patients with neovascular age-related macular degeneration treated with anti-VEGF therapy lost to follow-up. Graefes Arch Clin Exp Ophthalmol. 2025 Mar 20. doi: 10.1007/s00417-025-06798-6. Epub ahead of print. PMID: 40111518
A Young Man with the Heart of GOLD- Running for Rita
By: Donna Auger
I had the pleasure of meeting Maxim Rappy through his father, Floyd Rappy. Floyd informed me that his son, Maxim, was going to be running in the Brooklyn Half Marathon in honor of his grandmother. Maxim’s grandmother had developed age-related macular degeneration (AMD) and he wanted to contribute and bring awareness to our organization to help find a cure for this sight stealing disease.
Maxim is 28 years old. He works in higher education as an Admissions Counselor at the prestigious American Academy of Dramatic Arts in Manhattan, New York. From an early age Maxim has been passionate about athletics and music. He played competitive baseball, soccer and basketball during his school years. Additionally, he has played the drums throughout his early years, and continues to.
Maxim will be wearing our logo on his tank top during the race. Floyd, owner of the graphic design firm, Studio Rappy, designed the tank top for Maxim to wear while running in the Brooklyn Half Marathon.
I had the opportunity to speak with Maxim on the phone. Below is the interview.
Donna: Why did you pick the Macular Degeneration Association as the recipient of these funds?
Maxim: I was looking for a smaller non-profit to help to fund research to find a cure for AMD. I loved the message and mission the Macular Degeneration Association has.
Donna: What got you started wanting to help people?
Maxim: From a very young age, I have always felt a calling to help people see their inner light. This led to me co-leading an organization called Rising Stars. I supported children with disabilities through opportunities for them to play baseball, soccer, basketball, and track.
Donna: Tell me about your grandmother.
Maxim: My grandmother, Rita Kern, whom we called, “Nannie”, was an extraordinary woman! She was a voracious reader, loved her crossword puzzles and General Hospital shows, and adored her family.
My Nannie and Papa moved from Brooklyn, New York to Westchester, New York to help raise my older sister, Arianna and me. As Arianna and I got older, our Nannie and Papa moved down to West Palm Beach, Florida. We always looked forward to going to Nannie and Papa’s. We would swim in their town pool, play Rummikub and Uno, and go to Einstein’s Bagels and Panera Bread. Once my Nannie started losing her sight, and my Papa passed away, she moved back to New York to be close to family. Though her world was getting smaller with not having the full ability to do her crossword puzzles and watch her General Hospital shows anymore, she kept her spirits high. Discovering an art class in her assisted living facility at The Atria, Nannie’s spirits stayed high; in addition to seeing her family multiple times a week and being at all family birthdays, holidays and life events. One memory I will always cherish of my
Nannie was the way her and I could laugh together like we were both kids again!
Donna: Where did your grandmother go for help?
Maxim: My Nannie went to the Lighthouse Guild in Manhattan to learn how she can live better with her deteriorating sight, purchase helpful technology and even get new glasses. I helped her pick out a pair of fashionable glasses to keep her youthful spirits up. In honor of her, I now wear her glasses, replacing the lenses with my prescription.
Donna: When is the Brooklyn Half Marathon taking place? How do people donate to your cause?
Maxim: The Brooklyn Half Marathon will be on Sunday, April 27th starting at 7:00am and going until about noon! It will be near Prospect Park in Brooklyn, New York.
Update: “Race Day was amazing—such a great turnout and so much support from the community.” I completed the Half Marathon in 1 hour and 49 minutes, and I’m thrilled to share that we raised well over our $1,000 goal for the Macular Degeneration Association. I wore the “Running for Rita” tank top throughout the race—it was a meaningful reminder of why I was running.
Valeda® Light Delivery System: The First FDA-Approved Treatment for Dry AMD
Photobiomodulation (PBM) is a new treatment that was recently approved (November 2024) by the United States Food & Drug Administration (FDA) for patients with dry age-related degeneration (AMD) to improve vision. PBM utilizes specific light wavelengths to improve the way the retinal cells function. The Valeda® Light Delivery System (Valeda) delivers multiwavelength PBM treatment with 3 different wavelengths that act on differing targets to improve overall retinal health and disease outcomes. Many physicians and patients are very excited that an earlier, non-invasive treatment for patients with dry AMD is available.
The FDA authorization of Valeda reflects an extensive review of clinical trial data evaluated for safety, efficacy, and robustness of study results, all supporting the positive utility of this treatment for patients with dry AMD.
Multiple trials have assessed the safety and how well Valeda works. At Month 24, approximately 63.7% of PBM-treated eyes responded significant vision gain, of which 20 percent were able to see approximately 2 lines better on the standard eye chart! The trial also noted other benefits such as a reduction in disease progression and improved quality of life. Further, the treatment was found to be very safe and does not require anything invasive like injections or surgery!
Valeda is an in-office treatment device that some eye doctors will have in their offices. It should be noted that not only is this not a one-time treatment, but that if applied according to the study, patients will need to be treated 9 times over a 3 week period of time up to 3 times a year. Each treatment should take less than 10 minutes, and is painless and easy!
It is very exciting to have yet another option in the fight against AMD, and especially one that can be used earlier than injections. If you have further interest, ask your eye care provider if they know of an office with this treatment option!
The eSight GO
By: Jeffry Gerson, OD, FAAO- Medical Director for the Macular Degeneration Association
When we were at our recent in person seminar in Denver, we had the opportunity to have a representative showing the group the eSight GO. Although this is a low vision device, I feel that it is so elevated, that it is in a whole different category.
I have written about low vision in the past, and how important it is to be familiar with this category. Often, AMD patients are told “there is nothing else that can be done”. Although this may be true from a medical perspective, this is usually not the case from a visual performance/functionality perspective. Whether it is a low-tech magnifier or incredible digital devices like the eSight GO, there is usually something that can help those with vision loss to be able to function better.
Back to the eSight GO…
eSight GO is a wearable electronic vision aid designed for individuals with central vision loss from conditions like age-related macular degeneration. It uses a high-definition camera that captures real-time video, which is then enhanced and projected onto two high-contrast OLED screens in front of the user’s eyes in what looks and feels similar to a pair of glasses. It allows users to adjust contrast, zoom, brightness, and color filters to personalize their visual experience depending on lighting and activity. It runs on a rechargeable battery that offers several hours of use per charge, and can significantly improve functional vision, enabling tasks like reading, watching TV, and recognizing faces.
eSight GO comes with training and support services to help you adapt and get the most from the device. If you are frustrated by conventional magnifiers or glasses, eSight GO offers a life-changing alternative that restores access to activities they thought were lost.
If you haven’t tried the newest devices available, you really don’t know how beneficial they can be. There are many devices beyond eSight GO, but I wanted to point it out here. Please ask your eye care providers to help you find a low vision provider if you don’t already have one.
If you are interested in more information about eSight, please check out www.esighteyewear.com
Your Gut and Your Eyes: How a Healthy Gut Microbiome Can Help Protect Your Vision
If you’re living with macular degeneration, you’ve likely heard about vitamins, antioxidants, and eating leafy greens to protect your eyes. But did you know that the health of your gut may also play a key role in the health of your retina?
In fact, the famous ancient physician Hippocrates once said, “All disease begins in the gut.” While that might sound like an overstatement, modern science is showing us just how right he may have been—especially when it comes to conditions like age-related macular degeneration (AMD). This connection is sometimes called the “gut-retina axis.”
What Is the Gut Microbiome?
Inside your digestive system lives a complex community of trillions of bacteria, fungi, and other tiny organisms. This is called your gut microbiome. These microbes aren’t just sitting there—they help your body digest food, produce vitamins, fight off infections, and control inflammation.
A healthy gut has the right balance of good bacteria that work with your body, while an unhealthy gut (called gut dysbiosis) has more harmful bacteria that can contribute to disease, including diseases of the eye.
How Does the Gut Affect the Eyes?
Your gut and your eyes might seem like two completely separate systems, but they’re surprisingly connected through the immune system and bloodstream. When the gut is healthy, it helps reduce harmful inflammation throughout the body. When it’s not, inflammation can rise—and this can damage sensitive tissues in the eye, like the retina.
Researchers have found that people with AMD often have signs of gut dysbiosis. Their gut bacteria tend to produce more inflammatory substances and fewer protective compounds like short-chain fatty acids (SCFAs), which help regulate the immune system and reduce inflammation.
This inflammation can affect the retina, the part of the eye responsible for sharp, central vision. Over time, chronic inflammation may accelerate the damage that leads to AMD, especially the “dry” form that progresses slowly.
What Causes an Unhealthy Gut?
Diet is one of the biggest factors. Diets high in processed foods, added sugars, refined carbs, and unhealthy fats (like those found in fried foods and packaged snacks) can promote the growth of harmful bacteria in the gut.
On the other hand, diets rich in fiber from fruits, vegetables, legumes, and whole grains feed the good bacteria. Fermented foods like yogurt, kefir, sauerkraut, and kimchi contain natural probiotics—live bacteria that can help rebalance the gut.
Certain medications, especially antibiotics, can also disrupt your gut microbiome. Chronic stress and lack of sleep are other factors that can throw the gut out of balance.
How Can You Support a Healthy Gut?
If you’re looking to support your gut—and in turn, possibly slow the progression of AMD—here are some tips:
- Eat More Plant-Based, Fiber-Rich Foods
Fiber is fuel for beneficial bacteria. Aim to eat a variety of vegetables, fruits, whole grains, nuts, seeds, and legumes each day. Leafy greens, sweet potatoes, and berries are especially good for eye health too.
- Include Fermented Foods
Add probiotic-rich foods to your diet like plain yogurt, kefir, miso, sauerkraut, and kombucha. These can help restore balance to the gut microbiome.
- Limit Processed Foods
Avoid ultra-processed snacks, fast food, and sugary drinks, which can promote inflammation and gut imbalance.
- Consider a Mediterranean Diet
This eating pattern—rich in olive oil, vegetables, legumes, fish, and whole grains — has been shown to benefit both the gut microbiome and reduce the risk of AMD progression.
- Manage Stress and Sleep
Chronic stress and poor sleep can negatively affect your gut bacteria. Try to incorporate calming activities like walking, deep breathing, or meditation.
- Talk to Your Doctor About Probiotics
Some people may benefit from a probiotic supplement, especially after a round of antibiotics. Ask your eye doctor or nutrition specialist if this is right for you.
The Bottom Line
Although more research is needed, scientists are increasingly confident that the gut plays a key role in eye health. By taking care of your digestive system—through food, lifestyle, and possibly supplements—you may be able to support not just your general health, but also the health of your eyes.
You have more power than you think when it comes to protecting your vision. And one of the most important steps may start in your gut.
This summary is based on research and insights from Dr. Julie Poteet, OD, CNS, and the growing field of gut-retina science. For a more in-depth look at the gut microbiome and ocular health.
Laser safety.
Leo Semes, OD — Professor Emeritus of Optometry and Vison Science, University of Alabama
Lasers are encountered daily. Their applications include medical, scientific, commercial, military, industrial and everyday uses. The first laser was built in 1960 and is regarded as one of the greatest inventions of the twentieth century (https://en.wikipedia. org/wiki/Laser). LASER is the acronym for light amplification by stimulated emission of radiation. Because many devices operate at low power and emit very focused visible light, their energy is directed and easily avoided. Think: laser pointers. Higher powered devices that are utilized for the above-mentioned applications are labeled with specific warnings for the safety of operators and bystanders.
I have personally evaluated patients who have been the victims of laser exposure that resulted in ocular damage. The first was an individual who was accidentally exposed in a military laboratory to a very brief but powerful beam that resulted in irreversible damage to his right eye. His visual performance in that eye is like someone with advanced macular degeneration. Another case involved a graduate student who was “playing laser tag” with a lab mate and suffered only from a prolonged visual afterimage and no apparent permanent damage. Only decades of observation will determine his outcome.
This brings us to the subject of laser safety for commonly used laser devices. Are laser pointers a significant hazard? Will the supermarket scanner cause visual damage? What about a laser gunsight or laser level? The scientific literature has documented some cases recently of apparent laser-pointer damage from supposedly incidental and momentary exposure. Most of these cases that resulted in reduced vision fail to completely document the full nature of the incident. And, reading carefully, the victims likely had pre-existing visual loss.
But what about intentional and prolonged exposures to low-powered lasers like pointers, gunsights or measuring levels around the house? These devices are classified as 3B, have output less than 500 milliwatts and a very narrow visible beamwidth (https://www. lasersafetyfacts.com/styled-2/labels3B.html). Such hand-held lasers have been reported to result in permanent visual impairment when viewed for prolonged periods of time. The occurrences that have been reported in the scientific literature appear to come from intentional exposures by “distracted” individuals. Most affected individuals are under the age of 18 years.
So, what is the bottom line? Lasers serve many useful purposes when employed according to safety guidelines. Deviation from these or intentional misuse/abuse can result in permanent visual impairment. So, don’t let anyone in the household stare at a laser gunsight or focus the beam of a laser pointer at the eye for prolonged periods of time. And adhere to warning labels for medical, scientific, commercial, military, or industrial lasers if you encounter these.
MATTERS OF VISION! 2025 In-Person Program SeriesIn-Series
Learn about the latest developments, treatments & research for macular degeneration, diabetic eye disease and low vision.
MATTERS OF VISION! 2025 In-Person Program Series In-Series
July 12th — Lexington, KY- Doubletree Suites by Hilton Lexington- 2601 Richmond Rd, Lexington, KY 40509
July 19th — Little Rock, AK-Hilton Garden Inn North Little Rock- 4100 Glover Lane North Little Rock, AK
Aug. 9th — Lafayette, LA- DoubleTree by Hilton Lafayette 1521 West Pinhook Road. Lafayette, Louisiana 70503
Aug.23rd — Richmond, VA- HOTEL & SPA/SHORT PUMP 12042 West Broad Street Richmond VA 23233
Sept. 6th — Costa Mesa, CA- Hilton Orange County/Costa Mesa 3050 Bristol Street, Costa Mesa CA 92626
Sept. 20th — Saint Petersburg-Tampa, FL-TBD
Oct. 4th — San Antonio, TX- Embassy Suites by Hilton San Antonio Brooks 7610 S. New Braunfels, San Antonio, TX 78235
Oct. 13th — Gainesville, FL- Hotel Indigo Gainesville – Celebration Pointe 5020 SW 30th Lane, Gainesville, FL 32608
Please visit MacularHope.org/programs/for the listing of Virtual programs coming soon.
To register for in-person programs please call (855)962-2852.
All programs are Free and will start @ 8:30 am with breakfast – Gainesville, FL program is an afternoon program and will include lunch. Registration is required – Breakfast or lunch is ordered based on the number of attendees.
We look forward to welcoming you.
HOW TO GIVE
Phone, Mail or Online
Phone: Please call (941)893-4387 today to speak to one of our Donor Services Representatives.
Mail: Send your check or money order today payable to:
MACULAR DEGENERATION ASSOCIATION
5969 Cattleridge Boulevard, Suite 100 | Sarasota, FL 34232
Online: Please visit www.macularhope.org today and click on the Donation tab.
Stocks, Securities, Mutual Funds and IRAs
Please give serious consideration to the donation of stock and mutual fund shares as this offers numerous opportunities
to make a most gracious gift and receive tax advantages.
Wills, Bequests and Planned Gifts
Please give serious consideration to the designation of MDA in your Will, Charitable Trusts, Life Insurance, Appreciated
Securities and Real Estate as this offers preplanned giving opportunities that will serve the macular community for
years to come. Please call Lynne Henry (941)893-4389 at the Macular Degeneration Association, today, for personal
assistance in initiating this effort.
The following language has been reviewed and is deemed a legally acceptable form for including such a bequest in a will:
“I give and bequeath to the Macular Degeneration Association, 5969 Cattleridge Blvd. Suite # 100 Sarasota, FL 34232
for discretionary use in carrying out its aims and purposes, (the sum of $_____) or ( a sum equal to _______% of
the value of my gross estate at the time of my death under this will or any codicil hereto).”
The Macular Degeneration Association Federal ID number is 27-3025707
MEMORIAL AND HONOR GIVING
Honor a family member, friend or special event by donating to MDA. Pay tribute to someone you love whose life
has been impacted by macular degeneration. In lieu of flowers, please consider designating Macular Degeneration
Association as your charity of choice.
WORKPLACE GIVING
Launch a Giving Campaign
Please consider leading a team at work by encouraging your colleagues and staff to join together to help those
living with macular degeneration. Launch a workplace giving campaign today.
Ask about Matching Gifts
Many gracious employers double or even triple charitable donations made by individual employees. Some companies
will match gifts made by retirees and or their spouses. Contact your employer for matching gift eligibility
as this allows you to maximize your personal donation.
Thank you!