Curcumin acts to regress macular drusen volume in dry AMD

Abstract

Purpose : Age-related macular degeneration (AMD) is characterized by a progressive accumulation of yellow deposits, drusen, that damage the macula. Drusen volume is a known useful marker for predicting late stage AMD. The purpose of this study is to evaluate the effects of oral curcumin on drusen size in dry AMD.

Methods : 20 AMD patients were recruited from Zaparackas and Knepper, Ltd after IRB approval and written consent. Each subject voluntarily took oral curcumin (1330mg BID) for 6 months. The cohort was divided into group 1a (n=14) and 1b (n=6). Both groups had retinal images taken at 0, 2, 4, and 6 months using a Heidelberg Spectralis OCT. Group 1a had OCT retinal images taken at 6 months prior to baseline to act as an internal control. Using 7 B-scans centered over the fovea, each druse was outlined, measured and recorded by macular region (fovea, parafovea, and perifovea), and size: small (<63µm), medium (63-124µm), and large (>125µm). Volume measurements were taken and compared over time. Using a staging system modified from Seddon et al, each subject was classified based on ocular examination and imaging. Based on this system, 19 were intermediate, and 1 was advanced. Three endpoints were analyzed: 1) Total drusen volume change; 2) A total drusen volume threshold of 0.03mm³ for increased risk in developing late-stage AMD; and 3) Change in staging.

Results : Mean drusen volume (mm³) significantly decreased in 11 subjects (0.110±0.106 - 0.055±0.060, p=0.004), remained stable in 3 (0.265±0.127 - 0.260±0.168, p=0.18), and increased in 4 subjects (0.112±0.219 - 0.154±0.206, p=0.04). Mean foveal volume was significantly decreased (-14.0%, p<0.0001) in the cohort at 6 months. Notably, 1 subject’s staging decreased from intermediate to early AMD. Drusen volume in 1 subject decreased below the threshold risk volume of 0.03mm³ and 2 subjects exhibited an increase in total drusen volume above 0.03mm³.

Conclusions : Oral curcumin decreased drusen volume in 11 subjects. The drusen volume increased in the 6 months prior to the start of the curcumin study, showing the progressive nature of the disease; however, the responders’ drusen volume returned to baseline. The results indicate the use of oral curcumin could be beneficial to some patients with the dry form of AMD.

This is a 2020 ARVO Annual Meeting abstract.

 

Figure 1: (A) Average total drusen volume response over time. (B) Overall drusen volume response in cohort 1a.