AMD Update 17: Dame Judi Dench Has Macular Degeneration

Over the weekend, several articles appeared in the British press and also here in the States, about Dame Judi Dench announcing that she has macular degeneration – dry in one eye and wet in the other – and that she was going blind, although she was receiving treatment for the wet AMD in the hopes of preserving some of her sight in that eye.

I considered writing about this, but couldn’t find the right words – then I read what my friend Steve Rose of the Foundation Fighting Blindness had written on his blog, Eye on the Cure – and realized that he had the story just right.

So, with his permission, here is what he wrote:

Truly Grand Dame

Dr. Stephen Rose

Chief Research Officer

Foundation Fighting Blindness

Feb 20, 2012 05:30 pm

She's best-known, these days, as "M," director of the British Secret Service, in the last half-dozen James Bond films. But at 77, actress Judi Dench didn't earn the title Dame Commander of the Order of the British Empire solely for turning the notion of "Bond girl" on its head. In fact, she earned that title back in 1988, after delivering what was already a career-and-a-half's worth of stage and film performances, in everything from Shakespeare to the musical Cabaret. Since then, she's worked non-stop, playing, among other notable roles, Queens Elizabeth (Shakespeare in Love) and Victoria (Mrs. Brown) on film and starring in a long-running BBC hit comedy, As Time Goes By.

So it was with sadness that this past weekend I read the wire reports that Dame Judi has age-related macular degeneration, otherwise known as AMD. She reportedly can't read scripts anymore, nor can she see clearly the faces of fellow actors and, more important, family and friends.

That sadness, however, is mixed with hope. And those of you acquainted with the Foundation probably know why.

AMD is a retinal degenerative disease that affects the macula - the part of the retina that allows us to see fine detail. Worldwide, AMD is the most common cause of blindness in those 50 and older. More than 1.6 million in England are affected, and roughly 10 million people in the United States either have AMD or are at risk for developing it.

It's no surprise that Dame Judi mentioned, in an interview, that her mother had AMD, seeing as Foundation-funded researchers discovered that genetics appears to be a major factor in more than half of AMD cases.

Dame Judi also mentioned having both kinds of AMD - wet and dry - one in each eye. Dry AMD, which accounts for 90 percent of all cases, is caused by the accumulation of protein- and fat-containing "drusen," or waste deposits. It's true that drusen can become apparent with age and not cause vision loss, and it usually takes many years for a person to lose vision to dry AMD. People with dry AMD don't usually experience a total loss of central vision, but they do lose significant ability to read, drive and do work that requires seeing fine detail (like Dame Judi). And they are at greater risk for developing the more severe wet form.

Wet AMD is the one which causes more vision loss. It's "wet" because abnormal blood vessels grow beneath the macula, leaking blood and fluid and doing damage to photoreceptor cells. Wet AMD often progresses rapidly and can cause substantial loss of central vision.

So, why am I hopeful? Well, Ms. Dench did mention she's getting injections, and that they may be helping stop the vision loss. Although the article didn't go into detail, there are now a few treatments available to people with wet AMD - Lucentis and, more recently, a drug called Eylea, are FDA-approved here in the United States, and some ophthalmologists are using Lucentis' cousin, Avastin - developed to treat colon cancer - off label. All these were made possible by Foundation-funded studies supplying research leading to their development. Essentially, these treatments dry up those blood vessels, halting vision loss and, in some cases, even restoring some vision for people with wet AMD.

One last detail that's not surprising, considering Dame Judi's longevity in a career usually not kind to women of certain ages: her pluck. She says she has every intent to continue working, as people can read her scripts and directors can make accommodations for her on film. At the Foundation, and at AMD Alliance International, of which we're a member, we have seen that same kind of determination in many people with AMD, including those I spoke with a couple weeks ago during a seminar in Florida. These are resourceful, optimistic and determined people who continue to inspire us in our search for treatments and cures for all retinal diseases.

Dame Judi was quoted as saying she has no plans to retire soon. We, at the Foundation, certainly hope not, and we look forward to many more great performances.