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A Truly Grand Dame

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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, Dame Judi 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.

Dame Judi Dench in Shakespeare in Love:

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.

9 Responses to 'A Truly Grand Dame'

  1. Mac Euler says:

    My favorite Judi Dench movie was “Iris” in which she played a woman struggling with Alzheimer’s disease. Jim Broadbent played her partner (husband?), and they were wonderful together. (He is also great in Iron lady.) Kate Winslet was in it, as well.

    I think a lesson we can take away from this is that with any sudden change in vision, see an eye doctor immediately. That is definitely the case with wet AMD. Treatments like Lucentis and Avastin have a good chance of working if they are administered right away.

  2. Maria Pointer says:

    Let’s hope that other eye diseases benefit from stem cell research and genetic testing, B.E.S.T. has not received much help and it has afflicted my family for three generations! Countless careers and lifestyles stopped in our tracks with nowhere to go. I have an Aunt who uses crude methods of seeing, and has no independence left. Something I’m not looking forward to. One should just hope they get the disease with the research money or cures.

    • EyeOnTheCure says:

      Hi Maria, thanks for posting and sharing your story with us. One day we hope to have a cure for Best disease. As you noted, more awareness around this disease is certainly needed.

    • EyeOnTheCure says:

      Maria, to provide you with more information on where the Foundation is at with Best disease research:

      Foundation-funded researchers at the University of Pennsylvania have had some good initial success in canine studies of gene therapy for Best disease. Those studies continue, and we are focused on moving the approach into a clinical trial.

      There are now clinical trials of stem cell treatments underway for Stargardt disease and dry age-related macular degeneration. While I can’t say at this point whether these may be beneficial someday for people with Best disease, I think there is some hope that they would be, because dry AMD, Stargardt disease, and Best are all conditions that affect the macula. We are also funding a number of other stem cell lab projects – at the University of Wisconsin and the University of Washington, for example — that may have applicability to Best disease.

  3. Jan says:

    I am in the same situation as Ms. Dench. I have one wet and one dry. Diagnosed at 48 years old. Twelve years later, I still see out of the ‘dry’ eye. The injections have helped delay the progression in the “wet” eye, but they do not PREVENT the growth of vision loss. I’ve had 33 injections and I’ve lost almost all vision in the “wet” eye. Only light comes through now. I’m praying for a cure and hoping this Ms. Dench’s unfortunate circumstances helps others realize what the disease is. So many people are unaware.

    • EyeOnTheCure says:

      Thanks for posting and sharing your story Jan. We also hope that the announcement has and will continue to bring awareness to the international community about this disease.

  4. Hey! I’m at work surfing around your blog from my new apple iphone! Just wanted to say I love reading your blog and look forward to all your posts! Carry on the fantastic work!

  5. Wonderful post. I appreciate your attention to this topic and I learned a lot

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