EYE experts in Southampton have discovered that liver transplant patients have a greater risk of sight loss.

The unexpected revelation by a team at Southampton General Hospital, found that 65 per cent of transplant patients had some form of age-related macular degeneration (AMD) – the leading cause of blindness in the elderly.

Now eye consultant Professor Andrew Lotery is calling for the introduction of regular eye tests for all liver transplant recipients in a bid to save their sight.

They also discovered that treating AMD directly through the eye and not through the blood will prove much more successful.

During the pioneering threeyear project, they studied 223 Western European patients, 55 years and over, who had undergone liver transplants at least five years ago, to find out more about the relationship between the complex eye condition and liver transplantation.

Scientists already knew that a mutation which causes a gene in the liver – called complement factor H (CFH) – to produce abnormal proteins is more common in AMD sufferers, possibly causing more inflammation in the eye.

The researchers wanted to find out if receiving a new liver without the fault had any effect on the development of AMD and inflammation in the eye to determine if treatment for the condition given systemically, for example intravenously, could be more effective than directly into the eye.

They examined mutations in the CFH gene in recipients’ blood and in donor tissue, and found AMD was associated with the CFH gene mutation in the recipients’ original liver – receiving a liver with or without it had no effect on the development of the disease.

As levels of inflammation in the eyes caused by the CFH gene remained unchanged in patients with AMD after a liver transplant, Prof Lotery said the findings imply CFH protein produced in the eye and not in the liver is responsible for the development of AMD and means therapies directed into the eye are more likely to be successful.

Prof Lotery said: “This study has provided us with some invaluable insights into this complex eye disease.

“As a result of this project, in which we were primarily looking at whether or not fault-free genes could affect development of AMD, we have discovered liver transplant patients have a high incidence of AMD and that was unexpected.

“However, with this knowledge, we now know much more emphasis should be placed on the eye health of liver transplant patients and that should involve regular and ongoing optician monitoring and prompt referral to ophthalmologists if AMD is detected.

“At present, very large sums of money are being spent on clinical trials of intravenous treatments to try to treat complement gene mutations linked to AMD, yet our evidence suggests these may prove futile and that efforts need to be focused on direct treatments administered through the eye.”

The research was part funded by the Gift of Sight charity. To make a donation call 023 8059 9073.