Driving Research to New Treatments for AMD

BY MARY-RUSSELL ROBERSON

A Donor Takes the Wheel with his Leadership and Support

Decades ago, Tom Cabaniss watched as age-related macular degeneration (AMD) robbed his newly retired father of his independence. His father became legally blind in both eyes within a year and had to give up driving—a significant blow to a man who worked with and loved cars.  
 
“I saw him completely lose control of everything he worked for,” Cabaniss says. “It’s very difficult to adjust to losing your sight when you’re 60 years old. I dreaded that. I dreaded that for me.” 
 
Last year, Cabaniss himself was diagnosed with AMD, but his experience is markedly different than his father’s, due to new treatments available at Duke Eye Center. His vision, while not perfect, has improved since he was first diagnosed and he is still able to drive and enjoy cars—which is important to him since he’s a car aficionado like his dad. In place of dread, he now feels gratitude. “I’m very lucky,” he says. 
 
The Role of Family History  
 
AMD can damage or destroy a person’s central vision, leaving peripheral vision relatively unaffected, but still making it difficult or impossible to read, drive, or perform daily activities. Risk factors for AMD include age, race (white people are at higher risk), smoking, obesity, cardiovascular disease, and having a near relative with the disease. For some people, like Cabaniss’ father, AMD progresses rapidly, while others maintain good vision indefinitely.  
 
The disease typically begins when deposits build up beneath the central retina, an area called the macula. This stage is called “dry” macular degeneration. Sometimes, the disease progresses to “wet” macular degeneration, in which new blood vessels form and bleed or leak fluid under and into the retina, causing people to experience a large cloud or blind spot in the center of their vision.  
 
Cabaniss’ mother developed dry AMD about fifteen years after her husband became legally blind. Her disease progressed very slowly. Because both his parents had AMD, Cabaniss says, “I lived in fear of getting it. I was worried about myself and my daughter.” 
 
A Growing Relationship with Duke Eye Center 
 
In the late 1990s, soon after his mother was diagnosed with AMD, Cabaniss drove from his home in Charlotte to Chase City in southern Virginia, picked up his parents, and took them to Duke Eye Center to be evaluated by Eric Postel, MD, professor of ophthalmology and a retinal specialist. That was the beginning of a decades-long relationship that continues today.  
 
Cabaniss brought his mother to regular appointments with Postel, and eventually became a patient himself. When the two first met, Postel was studying the relationship between genetics and AMD, which Cabaniss found intensely interesting. Over the years, they racked up a lot of time discussing AMD, heredity, risk factors and prognosis.  
 
“I developed a relationship with Dr. Postel and I started giving Duke Eye Center a little money for his research,” Cabaniss says. 
 
Cabaniss’ mother participated in Postel’s genetic study, which identified a gene variant that increases the risk for developing AMD. The results of the study were published by Postel and colleagues in Science in 2005. 
 
“It was an important publication,” Postel says, “and it was a step toward better therapies. [By participating in the study,] Tom’s mother played a key role.” 
 
Better Therapies Emerge 
 
In late 2019, Cabaniss noticed what he describes as a cloud in his left eye. Postel confirmed that he had wet AMD and immediately started Cabaniss on injection therapy. The cloud dissipated, and the only vision problem that remains is a slight distortion.  
 
Postel explains that the treatment doesn’t cure AMD, but limits the vision damage that can occur. “The injections have done what they are supposed to do, and his vision is better,” Postel says. (The drugs are injected into the eye, but the eye is numbed ahead of time, and Cabaniss says it’s not a painful procedure.) 
 
The new treatments can be effective for AMD by slowing the formation of leaky blood vessels in the eye. There are several different drugs in this class that the Duke Eye Center uses for AMD, and Postel says more treatments are in the pipeline. “It’s a rapidly changing field,” he says. “We have treatments now that we didn’t have 20 years ago, and 20 years from now—or even five—we’ll have much better treatments.”  
 

“We have treatments now that we didn’t have 20 years ago, and 20 years from now—or even five—we’ll have much better treatments.”  

Eric Postel, MD

 
Participating on the Leadership Council 
 
About 10 years ago, Postel recommended Cabaniss for a spot on the Duke Eye Center Leadership Council, and he has served ever since. Members of the Leadership Council meet regularly to hear about research and planning at Duke Eye Center and to offer their insight as community leaders.  
 
“Tom’s a lawyer,” Postel says, “and he brings a very thoughtful and direct approach. He is interested in looking under the hood and figuring out what makes things work and how they run and, if they are rough at idle, how we’re going to get it to work right.”  
 
Cabaniss, who now lives in Raleigh and is an attorney with McGuireWoods LLP, says, “There are lots of amazing things going on at Duke Eye Center, and it’s really interesting to be on the Leadership Council and hear about them.” Because of his own experiences, he enjoys staying on top of the current research, and he’s grateful for the care he has received there. 
 
“I‘m a big fan of Duke Eye Center,” he says. “Absolutely.”