Prof Robyn Guymer AM
Age-related macular degeneration (AMD) is a multi- factorial disease and is a leading cause of vision loss in our elderly communities. The initiating patho- genic mechanisms that lead to loss of vision are not completely understood, yet the early disease is char- acterized by the deposition of debris, where the accumulation of by-products exceeds the normal clearance capacity of the retina. Understanding the underlying mechanisms by which debris accumu- lates in AMD is critical for understanding disease pathways and ultimately developing novel treat- ment targets for early AMD.
We have been investigating a novel hypothesis for the pathogenesis of AMD where we argue that a functional deﬁcit in immune cell phagocytosis is a major contributor to the accumulated debris, trigger- ing events that lead to irreversible damage and vision loss. We have also been investigating, in both animal and human studies, the possibility that sub- threshold nanosecond laser, speciﬁcally using the retinal rejuvenation therapy (2RT) laser, designed and manufactured in Australia, might trigger a series of events that could lead to reduced debris accumulation. Finally, we have deﬁned early fea- tures, as seen on optical coherence tomography (OCT), that signify the earliest point where there is loss of RPE and photoreceptors in AMD. These signs, that deﬁne a stage called, nascent geographic atrophy (nGA), provide a biomarker that can be used as an early disease endpoint, enabling earlier stage intervention studies in AMD. Using a com- bined atrophic endpoint, incorporating these early signs of atrophy, we were able to conduct the world ﬁrst randomized trial of 2RT laser in intermediate AMD to determine its safety and efﬁcacy in slower progression of vision-threatening late-stage AMD. In the 2018 Norman McAlister Gregg lecture I will discuss this research which furthers our understand- ing of AMD.
Brief Curriculum Vitae:
Robyn Guymer is Professor of Ophthalmology at Melbourne University and a deputy director of the Centre for Eye Research Australia. She is also a senior retinal specialist at the Royal Victorian Eye and Ear Hospital. She is a clinician scientist who leads a team of 20 researchers primarily investigat- ing age-related macular degeneration (AMD).
She has investigated genetic and environmental risk factors for AMD, predictors of response to treat- ments for late AMD, as well as being a principal investigator in many industry-sponsored trials. She is on several pharmaceutical advisory boards and is part of the Mactel consortium, the Beckman/Ryan AMD initiative (USA) and the International Classiﬁ- cation of Atrophy (CAM) group. She is currently investigating new strategies for treating early stages of AMD with a nanosecond laser and is working to identify novel imaging and functional biomarkers and surrogate endpoints to improve the feasibility of conducting early intervention trials. She is a mem- ber of the Macular Society and an inaugural fellow of the Australian Academy of Health and Medical Sciences. Professor Guymer was awarded the NHMRC’s 2016 Elizabeth Blackburn Fellowship for the top-ranked female research fellowship in clinical medicine.