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You and Yours - Transcript 成人论坛 Radio 4 |
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TX: 29.07.09 - Eye Disease Cures PRESENTER: PETER WHITE |
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Downloaded from www.bbc.co.uk/radio4 THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 成人论坛 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. WHITE Now this is a potentially very exciting time for research into blindness, in particular Age Related Macular Disease or AMD, as it's known, which causes over half the blindness in the UK. We're seeing what are being described as groundbreaking advances in three distinct areas - drugs, stem cell therapy and in the last few weeks laser. But can you have almost too much good news when the press wants to put the most exciting gloss possible on it? Here are just a few recent examples of headlines: HEADLINES Pioneering laser eye op could prevent millions going blind. Blind to be cured with stem cells. Laser that can halt blindness. How stem cells on a contact lens can help the blind to see again. Blindness cured by stem cell miracle. Pioneering laser eye op could prevent millions going blind. WHITE So amidst all that hype how do you sort out fact from wishful thinking, instant cure for all from long term hope for some especially if you have the condition? Well I've been talking to Alan Bird, who's emeritus professor of medical ophthalmology and honorary consultant at Moorfield's Eye Hospital in London for an independent view. So how does he react to this kind of publicity? BIRD It's good to tell the public that a lot of research is going on and it's good to tell and keep the public educated on the way research is developing. But there's always a tendency for journalists to make everything terribly exciting and something's got to be wonderful when in reality it may be not wonderful but at least promising. We try and stop the press being overoptimistic but we have no control, of course, on what they write, so we have the dilemma as to either we don't talk to the press at all or we try and influence the press or we just have to let them print what they wish and we can hope to stop them being overoptimistic. WHITE But what is actually driving this because after all Professor Bird the press aren't getting these stories out of thin air are they - what's the relationship between the press and the ophthalmic profession, is there perhaps an element of complicity here? BIRD Well I hope not. We have all suffered from the press misrepresenting what we say and I've had this dilemma all my life as to whether I talk to the press or not. But in the early days when people with retinitis pigmentosa were going to Moscow to be cured we were told not to talk to the press. Then finally we did talk to the press and the headline was "London ophthalmologists at war with Russians" which was absolutely not what we'd said. And so totally misrepresented and the reporter said it was the page editor who put that headline on, it wasn't his fault. WHITE No one every takes responsibility for the headlines. Who told you not to talk to the press? BIRD The local people at Moorfield's told us initially we shouldn't talk to the press because that was publicity and somehow that was wrong. WHITE Has the attitude changed to that? BIRD Oh it has changed. And what I felt was that we could not let these reports go into the public without any kind of reply, that seemed totally wrong. WHITE But how much is it also driven to some extent by the need for research funds? After all these need money and publicity produces that money doesn't it, if your local board thinks that you're doing a good job or the university thinks you're doing a good job you're more likely to get your funds aren't you. BIRD Well private funds certainly depend to some extent on publicity and one has to accept that. Whether funding from the research boards such as MRC and Wellcome are helped by publicity, I'm not sure... WHITE That's the Medical Research Council. BIRD Yes Medical Research Council and the Wellcome Trust, whether publicity affects them very much I'm not sure but it must even help them to some extent, that is to show that they're doing a good job. WHITE Let me just get it clear, there are two forms of AMD aren't there? BIRD Well often we hear the terms Wet AMD and Dry AMD. But I prefer to talk about early and late Age Related Macular Disease. In early disease there's a build up of debris at the back of the eye but the vision may be normal or at least people have very few problems, such as difficulty seeing in bright lights and prolonged after images. The ability to read is virtually unimpaired at this stage. There's then late disease which is divided into two - geographic atrophy in which the retina dies away, which is known as dry and caroidal neovascularisation where abnormal blood vessels grow at the back of the eye and destroy the retina and that is often known as wet. WHITE So what can we treat most effectively and what does not lend itself very well to treatment at the moment? BIRD It has been known for quite a long time that laser applied to the back of the eye will cause the debris to disappear. But unfortunately the laser treatment causes a reaction which negates any benefit from the clearing of the debris. The new form of laser treatment is one in which the damage is vastly less and it is thought that it would cause clearance of debris but there may not be the complications we saw with conventional laser. It should be emphasised, however, that this has not been proved as being of overall benefit, so it's something that's still in the stage of development. WHITE And what's the timescale on this because on with those headlines you can see why people will immediately have huge hopes of what can be available? BIRD Clinical trials are very time consuming and from the beginning of a trial it may be three, four or even five years before there is a clear difference between those who have been treated and those who have not. WHITE So we are talking about quite a long time? BIRD We're talking about quite a long time before it's proven beyond doubt that it is of benefit. WHITE Can I just ask you to sum up perhaps where we stand on the drug treatments, which are the treatments which perhaps most people who are listening to this who have a definable form of AMD are receiving? BIRD The drugs that are being mostly used at the moment are for the so-called wet form and these are all drugs called anti-VEGF. VEGF is a diffusible agent that induces blood vessel growth. And if VEGF is removed from the eye the blood vessels die down and stop the destructive process. And that has been stunningly successful in the treatment of caroidal new vessels which is the most common form of blind - the complications of AMD in this country. It has the disadvantage that it needs to be injected into the eye and injected once a month for a period. Clearly that's difficult for patients to attend hospital once a month and it's been quite a challenge for the profession to generate this new treatment. Ophthalmic units have worked very hard to be able to deliver this treatment to large numbers of people and on the whole it's been successful. There's a lot of research now looking for other anti-VEGF agents, that may be drops taken by mouth or with longer acting agents, such that we don't have to inject once a month. WHITE So can you sum up your advice to sufferers in a nutshell because we've got various forms of AMD and various forms of treatment, what's the advice that you could safely give to anyone with the problem? BIRD Well I think firstly the major message is that a lot of people are working very hard to resolve the problem. And what I think is very encouraging is many pharmaceutical companies are now helping in identifying new forms of treatment, better forms of treatment and treatment delivery and I think that is very encouraging. People with Age Related Maculopathy, in the early stage of good vision, there is nothing definitive as yet except that they clearly shouldn't smoke, particularly if there's a family history of Age Related Macular Disease because that clearly increases the risk. The situation is changing day by day, at least month by month, so they should not give up hope. WHITE That's Professor Alan Bird who's honorary consultant at Moorfield's Eye Hospital in London. Back to the You and Yours homepage The 成人论坛 is not responsible for external websites |
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