Vision Saver

By Christine Gorman

Julia Levy of Vancouver still remembers the day in the mid-1980s when her heart broke. She was sitting across the dining-room table from Dorothy Coppens, her vibrant 85-year-old mother, who had just been found to be suffering from macular degeneration, an incurable deterioration of the central portion of the retina that is the leading cause of blindness in people 60 and older. "Your face is just a brown smear," Coppens told her daughter. "I guess I'll never see your face again."

Like a lot of folks, Levy had never heard of macular degeneration. Unlike most, she was in a position to do something about it. One of the co-founders of a biotech company called QLT PhotoTherapeutics, Levy worked with David Dolphin of the University of British Columbia to develop Visudyne, a drug that uses light rays to combat the severest form of the disease. Although their research couldn't help Levy's mother, who died in 1996, it has passed muster with a scientific advisory panel to the U.S. Food and Drug Administration. Last week the panel recommended that the FDA approve Visudyne as a treatment. If the agency agrees, the drug, which would be marketed by CIBA Vision, could be available in the U.S. early next year.

As exciting as the news about Visudyne is, there are some important caveats to bear in mind. The drug is not a cure. At best, it preserves the status quo. It will not restore vision that has already been lost. Nor does it work for everyone. Company officials estimate that only one-quarter to one-half of the 200,000 or so Americans who develop the severest form of macular degeneration each year will benefit. But for them, it could be the window on the world that allows them to maintain their independence.

No one knows what causes macular degeneration. In 90% of the cases involving older people, the retina wears thin and abnormal deposits called drusen start to appear. This is the so-called dry form of the disease, in which vision deteriorates slowly, if at all. Still, it should be checked periodically since complications can occur.

The other 10% of cases are the "wet" form, in which abnormal blood vessels spread across the back of the eye, obscuring vision. Former TIME editor-in-chief Henry Grunwald has evoked the wet form's unrelenting course in his new book Twilight, a piercing reflection on his growing blindness.

Visudyne works only on wet macular degeneration, and produces the best results in patients whose retinal abnormalities occur mostly in what is known as the classic pattern. Doctors inject the drug into a vein in the patient's arm; from there it quickly spreads through the body. The drug concentrates wherever new blood vessels are being formed. But it doesn't start destroying those blood vessels until it is activated by pulses of light from a non-heat-generating laser. Since the light is shone into the eye, only the abnormal growths in the retina are targeted. Patients have to stay out of the sun for 24 to 48 hours after treatment to avoid sunburn.

Such innovation doesn't come cheap. Treatment is expected to run $1,200 a session, and most patients will require more than one course of therapy a year. But when you're talking about preserving the priceless gift of sight, the expense may seem well worth it.

For more on Visudyne, call 800-821-2450 or visit www.visudyne.com You can e-mail Christine at gorman@time.com