UPDATE Macular Degeneration

Summer 2026

IN THIS ISSUE

What is Low Vision, and What can be done?

Research Update: Evaluating Combination Therapy in Patients with Wet AMD and Geographic Atrophy

Clinical Trials 101

Chairman’s Corner and updated locations for in-person meetings

GLP-1 Medications and Your Eye Health

Needles in the Eye for AMD

Beyond AREDS2: The Next Evolution in Nutritional Support for Macular Degeneration

Preserve & Protect Your Vision–

Donate Today

What Is Low Vision, and What Can Be Done?

By: W. Jarrod Long, OD, FIALVS

Low vision means difficulty seeing even with regular glasses, contact lenses, medicine, or surgery. For people with macular degeneration, the challenge is not complete blindness, but loss of central detail needed for reading, recognizing faces, watching television, driving, using a computer, managing medications, or enjoying hobbies. Other causes include diabetic eye disease, glaucoma, inherited retinal conditions, optic nerve disease, stroke-related vision loss, and eye injuries.

I am Dr. Jarrod Long, an optometrist with more than 30 years of experience helping patients with low vision. Low vision care is different from a routine eye exam. Instead of only asking, “Can we make the eye chart clearer?” we ask, “What do you need to see in your everyday life?” The answer may include special glasses, magnifiers, electronic devices, better lighting, glare control, contrast improvement, large print, or training with phones, tablets, and apps.

When you are told that nothing more can be done medically, ask your eye doctor whether low vision care could help. Bioptic telescopic glasses, full-diameter telescopes, reading telescopes, microscopic and prismatic glasses, hand and stand magnifiers, video magnifiers, and wearable technologies may all play a role. The right solution depends on the diagnosis, remaining vision, and the specific tasks on your wish list. The goal is simple: greater independence, confidence, and connection to the activities that matter most to you.

About Dr. Jarrod Long

Dr. Jarrod Long is an optometrist in Bloomington, Indiana, specializing in advanced low-vision and macular degeneration care to help patients maintain independence and an active daily life.

He founded Midwest Low Vision and the Macular Health Center, where he applies innovative treatments and functional vision solutions to support patients beyond their diagnosis.

Dr. Long serves on the Advisory Medical Board of the Macular Degeneration Association.

Midwest Low Vision: https:// midwestlowvision.com/

Research Update:

Evaluating Combination Therapy in Patients with Wet AMD and Geographic Atrophy

Advancing Vision Science Through Funding from the Macular Degeneration Association

Macular degeneration is typically categorized into two forms: non-neovascular (commonly referred to as “Dry” AMD), and neovascular (commonly referred to as “Wet” AMD). We have had FDA-approved treatments for wet AMD for 20 years now. As AMD progresses, we commonly see deterioration of the retinal layers, referred to as “Geographic Atrophy” or “GA”. For the last 3 years, we have been able to treat patients with GA with injections given into the eyes, as two pharmacologic agents have been approved by the FDA for this purpose.

Many patients end up developing more than one aspect of AMD; often patients with wet AMD develop GA as well. We are conducting a research project to evaluate patients with both types of AMD who may benefit from treatment with more than one agent. To obtain FDA approval, the conditions were evaluated separately.

There is growing evidence that patients could benefit from combination therapy. Our research has identified patients treated with more than one agent, and we are currently analyzing the data to identify trends in treatment and support the idea that patients may benefit from combination therapy.

Next update will be featured in the Fall Newsletter

Clinical Research Performed by Orange County Retina and Dr. Rajiv Rathod

CLINICAL TRIALS 101

Once a drug is available to you, it has already been through years, and sometimes a decade or more, of clinical trials. The company behind the drug has also likely spent a decade and over 1 billion dollars to ultimately get it to you.

But what are the steps to get a drug approved?

Testing unfolds in three main phases. Phase 1 trials are small. They are typically 20 to 100 healthy volunteers and focus almost entirely on safety, helping researchers understand how the drug moves through the body and what side effects occur.

Phase 2 expands to several hundred patients who actually have the condition being treated, beginning to evaluate whether the drug is effective while continuing to make sure it is safe.

Phase 3 is for large-scale confirmation and could involve thousands of patients across multiple sites, often compared against a placebo or an existing treatment. This is to build the statistical evidence the FDA needs to make a final decision. For eye-related drugs, such as those for AMD, Phase 3 trials include specialized endpoints like changes in visual acuity, retinal imaging measurements, and possibly patient-reported quality-of-life scores.

Once all three phases are complete, the drug maker submits a New Drug Application (NDA) to the FDA. If approved, the drug doesn’t simply disappear from scrutiny. A fourth phase of ongoing post-market study continues indefinitely, tracking real-world safety in a much broader population than any trial could capture. For ophthalmic drugs, this is especially important: conditions like macular degeneration are chronic, meaning patients may use a therapy for decades, and long-term effects need to be monitored.

If you want to find out about clinical trials and get more information, you can visit clinicaltrials.gov. You can sort by conditions and location to find someone near you who is conducting trials. Or you can ask your eye care provider about clinical trial sites/ investigators near you.

Jeffry D. Gerson, O.D., F.A.A.O. Medical Director- Macular Degeneration Association

Needles in The Eye for AMD

By Leo Semes, OD

Member, Medical Advisory Board, Macular Degeneration Association

The landscape of treatments for wet age-related macular degeneration (AMD) has undergone revolutionary advances over the past two decades. The FDA approval of Visudyne in 2000 displaced laser photocoagulation as the primary treatment. The strategy behind this photodynamic therapy was to stabilize fragile new vessel webs and maintain visual performance. This process involved injecting verteporfin into a vein in the arm and activating it using a specific light source directed into the eye. Apart from low-vision devices, little improvement in vision could be expected with either treatment.

The introduction of anti-vascular endothelial growth factor (VEGF) medications in 2004 is considered among the most significant therapeutic innovations in eye care. If you or someone you know suffers from the wet form of AMD, there may be familiarity with these approaches. The impact of intravitreal administration of anti-VEGF agents was transformative. Initial visual acuity improvement was observed for the first time and was later found to persist for 7 years or more. “Every silver lining has a cloud,” however, to paraphrase the Grateful Dead. Injections required closely scheduled follow-ups and frequent retreatment. Beyond those burdens, treatments are a lifetime proposition.

The first generation of anti-VEGF agents, including Macugen, Avastin, and Lucentis, had become household names during the first decade of the twenty-first century. The FDA approval of Eylea and Beovu in the next decade aimed to reduce treatment burden. This meant longer intervals between observations and, with newer protocols, fewer injections. This group targeted the primary driver of neovascularization, VEGF. Further research has

identified additional pathways that contribute not only to the subretinal neovascularization of AMD but to other aspects of retinal vascular instability (RVI).

Second-generation agents were also aimed at the angiogenic pathway of angiopoietin-2 (ang-2). These combination agents were then used to treat diabetic macular edema (DME) and macular edema following retinal vein occlusion (MDfVO). If you suffer from wet AMD or other causes of RVI, names like Vabysmo and Susvimo may sound familiar. Or perhaps direct-to-consumer advertising has caught your eye. These agents are intended to deliver faster, improved outcomes and prolonged efficacy.

Progress is also being made in the treatment of geographic atrophy (GA), the dry form of AMD. Equally visually devastating and more prevalent than the wet form, GA is characterized by relentless progression. Compounds that target the complement system, at the molecular level, have been available for over three years. Both Syfovre and Izervay have been shown to halt the progression of GA via intravitreal injection. While not as dramatic as vision improvements for wet AMD, these intravitreal injections represent a first step in the fight against dry AMD. Novel IVI treatments being evaluated for GA include neuroprotective agents, gene therapy, which may require only a single injection, and cell-based therapies.

Challenges up to this point have centered around durability and persistence, as represented by versions of Vabysmo® and Eylea-HD®, which are showing promise but still have a ten-year window before regression to baseline visual acuity. Implantable devices containing currently available compounds to extend treatment intervals and improve visual performance and anatomical stability have been introduced and proven to be clinically accepted. A significant hurdle with newer agents is insurance coverage. Your retina specialist may be making recommendations with these restrictions in mind.

On the horizon is a group of third-generation compounds that aim to further reduce treatment burden and target other contributors to RVI. These include the bi-and tri-specific drugs, tyrosine-kinase inhibitors, fusion proteins as well as an array of gene therapies. These emerging therapies may also employ alternative routes of administration including suprachoroidal (microneedle, microcannula), port delivery, subconjunctival, subretinal and implantable.

Upcoming treatments for both wet and dry AMD are promising. The future is even brighter than two decades ago. Stay tuned, but follow the recommendations of your eye care provider.

GLP-1 and Your Eye Health

GLP-1 medications have become very popular in the United States. About 1 in 5 Americans have used a GLP-1 medication at some point, and about 1 in 8 are currently taking one.

These medications were originally created to help people with type 2 diabetes manage their blood sugar. Today, they are also widely used for weight loss and weight management. In fact, GLP-

1 medications became the fastest-growing drug category in 2025.

There are now several well-known GLP-1 medications available, as well as many compounded versions advertised on television and online.

As with any medication, it is important to understand both the benefits and possible side effects. Many people have heard terms like “Ozempic face” or “Ozempic teeth.” More recently, questions have been raised about whether GLP-1 medications can affect eye health.

Protecting Your Vision

Before starting a GLP-1 medication, it is a good idea to have a comprehensive eye exam. A follow-up eye exam about one month after starting the medication is also recommended. ^(1,2&3)

Researchers have identified three eye conditions that may be associated with GLP-1 medications:

Diabetic retinopathy
Non-arteritic ischemic optic neuropathy (NAION)
Macular degeneration

Some studies suggest these medications may slightly increase the risk of developing or worsening these conditions. However, for many people, the overall health benefits of GLP-1 medications outweigh the potential risks.

Temporary Vision Changes

Some people may notice temporary vision changes when they first start a GLP-1 medication or when their dosage is increased. These changes are usually harmless and may include: ^(1,2 ^& ³⁾

Blurry vision as the eyes adjust to changes in blood sugar levels Dry eyes Vision that comes and goes Difficulty focusing

Recommendations from Eye Care Experts

The American Academy of Ophthalmology (AAO) and the American Optometric Association (AOA) recommend the following: ⁽¹ ^& ²⁾

1. Get a Baseline Eye Exam

Schedule a comprehensive dilated eye exam with an optometrist or ophthalmologist either within 12 months before starting a GLP-1 medication or within 1 month after starting it.

2. Seek Immediate Care for Vision Changes

Contact an eye doctor right away if you experience:

Sudden vision loss
New blurry spots in your vision
Changes in color vision

3. Continue Regular Eye Exams

Routine eye exams are especially important if you already have:

Diabetic retinopathy
Glaucoma
Age-related macular degeneration

Talk With Your Healthcare Providers

If you have concerns about GLP-1 medications, discuss them with both your prescribing physician and your eye care provider. Working together, they can help determine the best treatment plan for your overall health and vision. ^(1, ² ^& ³⁾

References:

American Academy of Ophthalmology (AAO) -1 American Optometric Association (AOA)-2 Northwestern Medicine-3

By Jeffry Gerson, OD, FAAO Medical Director, Macular Degeneration Association

Chairman’s Corner:

Dear Friends,

Summer is bursting onto the scene with the promise of barbeques, swimming, boating, and sun-soaked beach adventures. As you dive into these joyful moments, remember to shield your eyes and skin. Apply sunscreen generously and often, slip on sunglasses with UVA and UVB protection, and, ladies, top it off with a wide-brimmed hat.

In this newsletter, you’ll discover exciting updates on research made possible by your support, along with the latest insights on nutrition, treatments, technology, and breakthroughs in the field.

We are thrilled to introduce new programs crafted with your needs in mind.

Beginning in August, our in-person meetings will return in full swing at the following locations:

Cleveland, OH August 8 – Hilton Garden Inn East/Mayfield Village, Cleveland, OH 44143 Colorado Springs, CO August 15 – DoubleTree by Hilton Hotel Colorado Springs, located at 1775 Cheyenne Mountain Blvd, Colorado Springs, CO 80906 Phoenix, AZ August 22 – Hilton Phoenix Resort at the Peak, located at 7677 N 16th Street, Phoenix, AZ 85020 St. Louis, MO – August 29 – Hilton St. Louis Frontenac, located at 1335 South Lindbergh Blvd. St. Louis, MO 63131 Albuquerque, NM September 12 – Hyatt Place Albuquerque/Uptown, located at 6901 Arvada Avenue NE, Albuquerque, NM 87110 Arlington Heights, IL – September 19 (formerly Schaumburg): DoubleTree by Hilton Chicago–Arlington Heights, located at 75 W. Algonquin Road, Arlington Heights, IL 60005 Nashua, NH October 3 – Doubletree by Hilton Nashua, located at 2 Somerset Parkway, Nashua, NH 03063 Asheville, NC October 10 – A C Hotel Asheville Biltmore Village, 186 Hendersonville Rd, Asheville, NC 08803

We hope you’ll join us at one of these programs, where people come together to learn, connect, and uplift each other. Registration is now open. Sign up by emailing Donna (donna@macularhope.org) or by calling (855) 962-2852.

For the latest updates, visit MacularHope.org/ programs/.

We’re delighted to share that our virtual program videos are now available online at MacularHope.org/videos/. Plus, explore our brand-new Nutrition page with Dr. Julie Poteet; you’ll find fresh articles, helpful information, and delicious recipes added every month.

Visit: MacularHope.org/nutritional-series/

Living with age-related macular degeneration, geographic atrophy, and diabetic eye disease can be challenging. Remember, you are never alone on this journey. We are here to walk beside you, offering knowledge, compassion, and hope at every turn.

Thank you for standing with the Macular Degeneration Association. Together, we can create real and lasting change.

Sincerely,

Lawrence S. Hoffheimer

Chairman, Macular Degeneration Association

Beyond AREDS2: The Next Evolution in Nutritional Support for Macular Degeneration Julie A. Poteet, OD, MS, CNS, FOWNS

For more than two decades, the Age-Related Eye Disease Studies (AREDS and AREDS2), led by the National Eye Institute, have shaped how eye doctors approach nutritional support for age-related macular degeneration (AMD). These landmark clinical trials demonstrated that targeted nutritional supplementation could reduce the risk of progression from intermediate AMD to advanced vision-threatening disease by approximately 25%.

For many patients, AREDS2 became the standard of care. But science continues to evolve—and so does our understanding of AMD.

Today, researchers increasingly recognize that AMD is not simply a disease of aging eyes or drusen deposits. At a deeper biological level, AMD appears to involve mitochondrial dysfunction, chronic inflammation, oxidative stress, vascular compromise, and impaired cellular energy production long before significant vision loss occurs.

This emerging understanding is helping shape the next generation of nutritional support strategies, including the introduction of PreserVision AREDS3.

From Antioxidant Protection to Metabolic Support

The original AREDS and AREDS2 formulations focused heavily on antioxidants and carotenoids such as vitamins C and E, zinc, lutein, and zeaxanthin. These nutrients help protect retinal tissue from oxidative stress caused by light exposure and high metabolic activity within the retina.

While these nutrients remain critically important, researchers are now exploring whether supporting the metabolic health of retinal cells themselves may offer an additional layer of support.

The retina is one of the most energy-demanding tissues in the human body. To maintain vision, retinal cells require enormous amounts of energy generated by tiny structures inside the cell called mitochondria. Mitochondria are often referred to as the “power plants” of the cell because they convert nutrients into usable cellular energy.

As we age, mitochondrial function naturally declines. In AMD, this decline may become accelerated, contributing to inflammation, oxidative damage, impaired waste removal, and eventual retinal dysfunction.

Some researchers now believe that metabolic stress and mitochondrial dysfunction may occur before drusen become clinically visible.

Why B Vitamins Are Entering the Conversation

One of the most intriguing developments in AMD research is the growing interest in B vitamins—particularly vitamins B6, B9 (folate), and B12.

These vitamins play essential roles in:

Cellular energy production
Mitochondrial function
DNA synthesis and methylation
Nervous system health
Regulation of homocysteine levels

Homocysteine is a naturally occurring amino acid that, when elevated, has been associated with vascular dysfunction, oxidative stress, inflammation, and impaired blood flow. Elevated homocysteine has also been linked in multiple studies to an increased risk of AMD.

This is especially important because the retina depends heavily on healthy blood flow and oxygen delivery through its delicate microvascular network.

Unlike traditional antioxidants that primarily help neutralize free radicals, B vitamins may help support the metabolic and vascular systems that sustain retinal function upstream.

AMD is increasingly being viewed not solely as a disease of oxidative damage, but also as a disorder of cellular resilience and energy metabolism.

What Makes PreserVision AREDS3 Different?

PreserVision AREDS3 builds upon the scientific legacy of AREDS2 while incorporating additional nutrients intended to support retinal metabolism and homocysteine regulation.

The formulation retains the foundational AREDS2 ingredients—vitamins C and E, zinc, copper, lutein, and zeaxanthin—while adding B vitamins that participate in important metabolic pathways involved in cellular energy production and vascular health.

This does not mean AREDS2 is obsolete. Rather, AREDS3 reflects an evolution in scientific thinking.

Instead of focusing exclusively on antioxidant defense, newer nutritional strategies seek to support multiple interconnected pathways involved in retinal aging, including oxidative stress, inflammation, mitochondrial function, vascular health, and cellular metabolism.

Importantly, this approach reflects a broader movement in medicine toward supporting biological systems earlier in the disease process, before irreversible damage occurs.

Nutrition Still Matters Most

While supplements can play an important role, they should never replace a nutrient-rich diet and healthy lifestyle.

Research consistently shows that dietary patterns such as the Mediterranean diet are associated with a lower risk of AMD progression. Foods rich in omega-3 fatty acids, leafy green vegetables, colorful fruits and vegetables, legumes, nuts, and olive oil provide nutrients and bioactive compounds that support overall retinal and systemic health.

In many ways, food remains our most powerful daily tool for promoting healthy aging.

A Note About Supplements

While nutritional supplements can be an important part of an eye health strategy, they are not appropriate for everyone. Before beginning any new supplement—including products containing B vitamins—it is important to discuss your plans with your primary care physician or healthcare team. Your age, medical history, medications, kidney function, and other health considerations may influence which supplements are right for you. The best nutrition plan is one that is tailored to your individual needs.

Looking Ahead

The introduction of PreserVision AREDS3 reflects an exciting shift in how researchers and clinicians think about AMD.

The future of AMD management may involve not only protecting the retina from oxidative stress but also supporting the metabolic resilience of retinal cells themselves.

As our understanding of AMD biology continues to deepen, one message becomes increasingly clear: the earlier we support retinal health through evidence-based nutrition and healthy lifestyle choices, the greater opportunity we may have to influence the trajectory of disease.

For patients living with AMD—or hoping to preserve their vision for years to come—that is an encouraging direction for the future of eye care.

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.