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Our Stories

Dr. Shelley Boyd to open Canada’s first dry age-related macular degeneration clinic at St. Michael’s

Toronto, April 15, 2014

By Leslie Shepherd

Dr. Shelley Boyd tests her new confocal scanning laser ophthalmoscopy
Dr. Shelley Boyd tests her new confocal scanning laser ophthalmoscopy that will allow her to provide high resolution, topographic images of the retina, the light-sensitive part of the eye where age-related macular degeneration exists. (Photo by Katie Cooper)

Age-related macular degeneration is the leading cause of irreversible blindness in the Western world. Yet there is no treatment or cure for the 85 per cent of people who suffer from the “dry” form of the disease. Every clinical trial in the world has failed to bring new treatments.

The wet form of age-related macular degeneration, or AMD, is characterized by the growth of abnormal blood vessels in the macula, the part of the retina which is responsible for detailed central vision. The dry form is characterized by the presence of yellow deposits called drusen in the macula that may distort vision as they grow in size and number, as well as by the loss of delicate retinal tissue.

The American Academy of Ophthalmology calls dry AMD a “time bomb of vision loss.” An estimated 1 million Canadians have advanced or high-risk dry AMD, and those numbers are growing as the population ages. Vision loss accounts for the highest direct cost to the Canadian health care system, approximately $16 billion a year, more than cancer, for example.

Dr. Shelley Boyd, an ophthalmologist and retinal specialist at St. Michael’s Hospital, was instrumental in developing what has become the standard of care for the “wet” form of the disease. Dr. Boyd worked with Novartis in 2002-04 to develop Lucentis, a drug injected into the eye every four to six weeks for people with wet AMD. Dr. Boyd noted that Lucentis went from being a good idea in the lab to the standard of treatment in clinics very quickly, making it “one of the most successful knowledge translation stories you will ever hear.”

Her hope is to do the same for the dry version of AMD. This spring Dr. Boyd will open the first dedicated high-risk dry AMD clinic in Canada. She recently acquired an imaging device known as a confocal scanning laser ophthalmoscope that will allow her to provide high-resolution, topographic images of the macula . With this device she can better evaluate a patient’s risk of disease progression and describe the various subtypes of the disease. This knowledge significantly helps with clinical trial design, ensuring that patients at the highest risk levels are enrolled, reducing the time and number of patients necessary to show a drug effect.

Much of the work in her new clinic for dry AMD will be to assess who is at risk of having their disease progress so they can be monitored more closely and potentially take part in clinical trials. The clinic will also integrate with the St. Michael’s smoking cessation programs, since people who smoke have a three times higher risk of going blind. She also hopes to offer nutrition counseling, since diet and vitamins are also known to influence the disease.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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