Age-Related Macular Degeneration Clinical Trial
Official title:
A Case Control Study of Age-Related Macular Degeneration (AMD) Examining Gene Expression Patterns in Circulating Monocytes From Peripheral Blood Samples
This study will examine skin and blood cells for genetic changes related to the development
of age-related macular degeneration, an eye disease that can significantly impair the ability
to read, drive, and carry out daily activities. It is the most common cause of vision loss in
people over the age of 50.
People with age-related macular degeneration and healthy normal volunteers age 50 years or
older may be eligible for this study. Candidates will undergo a medical history, physical
examination and eye examination with dilation of the pupils. Photographs of the eye will be
taken with a special camera.
Study participants will have blood drawn three times (no more than 6 tablespoons each time)
and will undergo three skin biopsies. For the skin biopsy, an anesthetic is injected under
the skin and a small piece of skin-approximately 1/4-inch cube-is removed. The blood draws
and biopsies will be done at 7- to 10-day intervals. In most cases, a single biopsy is done
at each visit, but it may be necessary to take-at most-one additional biopsy from the other
arm during the same visit. Patients will return for one follow-up visit 7 to 10 days after
the last biopsy for examination of the biopsy site and removal of any stitches.
The results of this study may provide investigators information needed to develop new means
of diagnosing and treating age-related macular degeneration.
Age-related macular degeneration (AMD) represents the most common cause of blindness in
patients over the age of 50. While both hereditary and environmental factors appear to play a
role in the pathogenesis of the disease, no common genetic mutations have been identified.
This pilot study is intended to test the feasibility of evaluating the patterns of expression
of genes that may be involved in the pathogenesis of AMD. The genes of interest are involved
in the process of wound repair, cell injury and cell death. We hope to access the expression
of these genes, but in tissues taken from non-ocular sites, in patients with AMD and in
patients without AMD.
Biopsied skin fibroblasts and circulating monocytes from 62 patients will be obtained; 14
without AMD, 14 with at least one large (greater than 125 microns) druse, with geographic
atrophy and/or choroidal neovascularization from AMD, 10 with geographic atrophy only, and 20
with choroidal neovascularization and/or disciform scar. The gene expression patterns from
these tissues will be examined through various techniques including polymerase chain
reaction, Northern blot analysis, differential display and microarray technology. The genetic
expression patterns in patients with AMD will then be compared to age-matched control
subjects. The primary outcome will be to determine the feasibility of obtaining skin and
monocyte samples from patients with AMD, extracting RNA from these samples, and studying gene
expression patterns. This study will provide investigators with information needed to develop
subsequent studies of potential diagnostic tests.
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