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Macular Degeneration News
Radiation & Anti-VEGF Injections for Wet Macular Degeneration Therapy
American Academy of Ophthalmology-November 2007-Jeffrey Heier, M.D. reported on one year results of a multicenter clinical trial to evaluate the safety and efficacy of using beta radiation combined with Avastin Injections to treat wet macular Degeneration. At one year it appears that the combined therapy may provide more sustainable resultsfor certain patients. Additional followup and data collection are required to evaluate the long term results on visual acuity.
Smoking and Macular Degeneration
Archives of Ophthalmology: August 2007-Current and past smokers appear to be a considerably higher risk for developing Age Related Macular Degeneration according to a study published in the August 2007 Archives of Ophthalmology. Researchers presented the results of a study that demonstrated that curretn smokers were four times as likely to develop ARMD and past smokers were three times as likely to develop geographic atrophy than patients who had never smoked.
Primary Avastin Treatment Superior vs. Secondary Therapy:
Retina July/August 2007-Researchers presented the results of a study to compare the results of using Avastin alone as primary treatment for Macular Degeneration as compared to using Avastin injections after patients had been had first treated with Macugen. The patients treated with Avastin as a primary treatment demonstrated significantly better results after their treatment.
Vitamin Therapy for Age Related Macular Degeneration Improves Quality of Life
Ophthalmology: July 2007-Many studies have suggested that vitamins and supplements may offer a benefit to those suffering from ARMD. A recent study reported in the July 2007 journal Ophthalmology evaluated the cost effectiveness of vitamin therapy for ARMD and found that the overall quality of life was improved and the development of visual impairment was reduced in the better seeing eye.
Statin Cholesterol Medication and Macular Degeneration
American Journal of Ophthalmology: July 2007-While it was hoped that the use of statin medications, commonly prescribed to lower cholesterol, would provide some benefit in the progression of Age Related Macular Degeneration, the Beaver Dam Study has found that statins are not associated with either a slowing or progression of ARMD which is in agreement with other early studies including the Rotterdam Study and the Blue Mountains Study. The researchers did conclude that larger, long-term studies are needed to examine the association of statin use and the incidence of late ARMD.
Cost Effectivity of Lucentis Injections vs. Avastin Injections
British Journal of Ophthalmology: May 2007-Lucentis and Avastin are anti-VEGF drugs used to inhibit the formation of neovascularization. Both are used as intravitreal injections to treat macular degeneration. The San Francisco based firm Genentech markets both drugs. However, British researchers have found that Lucentis costs 50 times more than Avastin without producing even a 2.5 times improvement in effect which researchers say would justify the cost. There is some controversy among Ophthalmologists because Lucentis has undergone specific clinical studies and received FDA approval to treat Macular Degeneration whereas Avastin is being used “off label” to treat Macular Degeneration.
Macular Degeneration Prevention with Beta Carotene Diet Supplements
Archives of Ophthalmology: March 2007-A specific formulation of dietary supplement has been reported in the AREDS Study to help moderate the onset and severity of Macular Degeneration. A 12-year long term Harvard study published in the Archives of Ophthalmology indicated that another formulation of dietary supplement containing only Beta Carotene was not effective in preventing Macular Degeneration.
OXiGENE, Waltham, Massachusetts Press Release: February 2007-OXiGENE reported that early results of clinical trials involving an experimental drug called Combretastatin A4 Phosphate (CA4P) administered through intravenous injection for patients with myopic macular degeneration demonstrated a halt in the progression of vision loss.
Genetic and Lifestyle Risk Factors for Macular Degeneration
Archives of Ophthalmology: March 2007-Harvard Medical School researchers at Brigham and Women’s Hospital has shown that individuals with certain common genetic mutations are 50 times more likely to develop Age Related Macular Degeneration than people who have normal copies of the same genes. Further, the chance of developing Age Related Macular Degeneration increase incrementally when lifestyle-related factors of smoking and obesity were added into the genetic equation. The genetic mutations associated with macular degeneration are common in Caucasian populations. The genetic risk factors were not affected in either a negative or positive way by other lifestyle choices including regular aspirin use, fruit consumption, fatty acid ratios, or use of alcohol.
Diabetic Retinopathy News
Diabetic Retinopathy May Predict Stroke Risk
Stroke: March 2007-Researchers at the University of Melbourne in Australia reported in the journal Stroke, that patients with diabetic retinopathy appear to have an increased risk of developing a stroke. They identified that the same factors causing damage to blood vessels in the Retina and causing diabetic retinopathy, also can be associated with an increased risk of stroke suggesting that patients with diabetic retinopathy also should be carefully monitored for the possibility of developing strokes.
Nepafenac Eye Drops Could Reduce Diabetic Eye Damage
Diabetes: February 2007-A non steroidal anti-inflammatory eye drop commonly used after cataract surgery called Nepafenac has been reported in the journal Diabetes to reduce microvascular damage in the retina of rats that is similar to the damage found in diabetic retinopathy. Researchers are hopeful that this could offer a benefit to patients with diabetes.
Lucentis and Diabetic Retinopathy
American Journal of Ophthalmology: December 2006-Researchers from the Johns Hopkins University-Wilmer Eye Institute reported results indicating the Lucentis Injections are useful as a treatment for diabetic retinopathy based on the findings in a small clinical trial in which there was significant visual improvement in people with early stages of the diabetic retinopathy that received Lucentis Injections. In particular, those patients with thickening of their Macula experienced dramatic improvement within a week after treatment, which actually continued to improve with repeated therapeutic injections. Similar results have been reported with Avastin Injections.
Avastin and Diabetic Retinopathy
American Journal of Ophthalmology: October 2006-Research reported in the American Journal of Ophthalmology, indicates that Avastin Injections eliminated neovascularization, or abnormal blood vessel growth, that was associated with vision loss in patients with proliferative diabetic retinopathy. Proliferative diabetic retinopathy can lead to vitreous hemorrhage and retinal detachment so achieving regression of the new blood vessel growth is a highly positive finding.
Avandia, Avandamet & Avandaryl May Cause Diabetic Macular Edema
U.S. Food and Drug Administration Warning Letter-January 2006-The FDA warned patients, physicians and GlaxoSmithKline the manufacturer of the compound rosiglitazone, contained in Avandia, Avandamet and Avandaryl, that these drugs used to treat diabetes could cause or worsen swelling of the retina in the Macula or diabetic macular edema. additional labeling about the risk of potential development of internal eye swelling known as diabetic macular edema. Symptoms of diabetic macular edema include blurry vision, decreased ability to adapt to the dark, and decreased color sensitivity.
Diabetes and Dry Eyes
American Journal of Ophthalmology: March 2005-A study reported in the American Journal of Ophthalmology indicated that patients with diabetes are more likely to have dry eye symptoms suggesting that inadequate blood sugar control in diabetic patients appears to be associated with development of dry eye. The study found that 20.6 percent of diabetic patients needed lubricating eye drops, compared with 13.8 percent of non-diabetic patients. This increased even further among those patients with poor blood sugar control.
Corticosteroid Injections for Diabetic Retinopathy
British Journal of Ophthalmology: March 2005-Researchers at the University of Heidelberg reported that the intravitreal injection of the corticosteroid Triamcinolone Acetonide effected significant improvement in patients with retinal swelling or diabetic macular edema. More than two thirds of those patients treated achieved an improvement of two or more lines of Snellin Visual Acuity and the effects lasted for as long as seven months after treatment. This suggests an important role of therapeutic injections of the anti-inflammatory drug Triamcinolone Acetonide in treating diabetic retinopathy.
Glaucoma News
Availability of Glaucoma Treatment for Older Americans
Association for Research in Vision and Ophthalmology: May 2007-Glaucoma researcher Joshua D. Stein, M.D, of Duke University School of Medicine reported that almost one third of older Americans diagnosed with glaucoma do not receive treatment, predisposing them to serious progressive vision loss and ultimately blindness. This issue needs to become part of the agenda for health care policy agencies and insurance companies in order to reverse the trend of glaucoma continuing to be a leading cause of blindness in older populations.
Risk of Auto Accidents and Falling with Glaucoma
Investigative Ophthalmology and Visual Sciences: March 2007-A study conducted at Dalhousie University found that patients with glaucoma were approximately six times more likely to have auto accidents than a control group-and they were likely to be at fault when involved in an accident. Further, they found that patients with glaucoma were three times more likely to experience a fall than a control group.
Glaucoma Risk from Weight Lifting
Archives of Ophthalmology: September 2006-Brazilian researchers reported that certain weight lifting maneuvers such as bench presses can temporarily boost intraocular pressure (IOP) and increase the risks associated with glaucoma. Further patients diagnosed with “normal tension” should be questioned and warned about possible involvement with exercises that involve weight lifting.
Glaucoma and Cataracts with On Line Steroid Purchase
The Lancet: August 2006-According to a report in the British medical journal The Lancet, a woman who illegally purchased oral steroids on-line now has serious vision problems as a side effect, including glaucoma and cataracts.
"The on-line availability of controlled and uncontrolled drug therapies needs to be carefully monitored," stated British ophthalmologists Philip Severn, M.D., and Scott Fraser, M.D. of Sunderland Eye Infirmary. In addition they warn of other risks with illegally purchasing drugs on-line, including risks that the substances are fake or could interact with other medications.
Glaucoma Screening and Diabetes
Ophthalmology: July 2006-Louis Pasquale, M.D., Co-Director of the Massachusetts Eye and Ear Infirmary Glaucoma Service reiterated the need for careful evaluation of Type 2 diabetic patients for glaucoma. Even after excluding lifestyle factors such as alcohol use and exercise, researchers still found a significant relationship between presence of Type 2 diabetes and development of glaucoma. "While obesity fuels the Type 2 diabetes epidemic, it appears that factors unrelated to obesity contribute to the positive association between Type 2 diabetes and glaucoma," reported Dr. Pasquale. This further reinforces the need for all Type 2 diabetics to be screened for glaucoma on a regular basis.
Selective Laser Trabeculoplasty (SLT) as Primary Treatment for Glaucoma
Journal of the American College of Surgeons: January 2005-Results of a large scale clinical study has identified that Selective Laser Trabeculoplasty, a type of laser treatment for glaucoma, is becoming useful as a primary treatment for glaucoma instead of eye drops. Eye drops for glaucoma are quite effective, however due to high costs, side effects and a lack of patient compliance SLT may offer a good alternative for initial treatment.
Cataract News
FDA Approves Crystalens HD (TM) 4th Generation Accommodating Lens Implant-Jume 200
Bausch & Lomb received approval from the Food and Drug Administration (FDA) to market the Crystalens HD™ in the United States. Crystalens accommodating intraocular lens (IOL) was first approved by the FDA in November 2003. The Crystalens HD is the fourth generation of the only FDA approved accommodating lens.The surface of the Crystalens HD (TM) has been shaped to enhance the depth of focus with a proprietary optical modification. The enhanced optic provides an increased depth of focus which is designed to improve near vision without compromising intermediate or distance vision. The HD lens does this without inducing increased undesirable dysphotopsia or night vision symptoms.
Aspheric Lens Implants & Contrast Sensitivity
Journal of Cataract & Refractive Surgery: August 2007-A Canadian researcher reported that by carefully measuring and targeting the amount of spherical aberration to be corrected through an Aspheric Intraocular Lens Implants after cataract surgery, it is possible to improve the overall contrast sensivity achieved. Contrast sensitivity improvements are generally regarded as a way to improve vision in dim illumination and poor lighting conditions such as for night driving.
Delaying Cataract Surgery
Canadian Medical Association Journal: April 2007-People who undergo cataract surgery within six weeks of booking their procedure have better visual outcomes, as well as increased quality of life and fewer adverse events such as falling, says research reported in the April 24 issue of the Canadian Medical Association Journal. People who waited six months or longer for their cataract surgery experienced more adverse events.
Cholesterol Drugs Decrease Risk of Cataracts and Macular Degeneration
American Journal of Ophthalmology: April 2007-The class of cholesterol lowering medications called “statins” have been found to reduce risks of developing both cataracts and advanced age-related macular degeneration. Researchers found that statins slowed the development of cataracts by 50%.
ReStor® Aspheric Lens Implant FDA Approved: February 2007
The U.S. Food and Drug Administration recently approved a new aspheric version of Alcon's AcrySof ReStor Intraocular Lens (IOL) for cataract surgery. The lens, known as the AcrySof ReStor apodized diffractive aspheric IOL, addresses presbyopia by providing different zones enabling vision correction at near to far distances. An Alcon Laboratories statement says the newly approved aspheric optics design is the only one currently available in the U.S. in a presbyopia correcting lens implant.
Researchers previously have produced evidence that aspheric lenses, which are somewhat flattened at the periphery, may help offset aberrations in the eye that can cause vision problems such as reduced night vision and contrast sensitivity.
Medicare Allows Astigmatism Correcting Lens Implants for Cataract Surgery
Centers for Medicare and Medicaid Services: February 2007 Medicare recipients are now able to choose an astigmatism-correcting Intraocular Lens for cataract surgery. While the ruling allows Medicare coverage for basic cataract surgery, patients must pay out-of-pocket for any extra features such as for astigmatism correction. In the past, astigmatism-correcting lens implants were not covered at all.
Common Prostate Drug Can Cause Problems With Cataract Surgery
American Academy of Ophthalmology: August 2006 – A number of medical associations including the American Academy of Ophthalmology, the American Society of Cataract & Refractive and the American Urological Association have warned patients that the common prostrate drug, Flomax, and similar medications known as alpha-blockers may cause problems during cataract surgery. If you are taking Flomax and plan on having cataract surgery it is important that you alert your cataract surgeon before you have your surgery.
Flomax, commonly used to treat an enlarged prostate, and other alpha-blockers such as Hytrin, Cardura and Uroxatral can cause abnormal movement of muscles controlling the opening and closing of the iris and thus can interfere with pupil dilation, creating a condition known as intraoperative floppy iris syndrome.Your cataract surgeon will take extra precautions including additional eye drops if you are taking these medications in order to prevent unexpected complications during cataract surgery.
Asthma Drugs May Be Linked to Cataracts
European Respiratory Journal: July 2006 - Researchers at McGill University Health Centre found that people older than 65 using daily doses of inhaled corticosteroids to reduce risk of attacks of asthma or chronic obstructive pulmonary disease (COPD) increase their risk of developing cataracts by 24%. For that reason older people with asthma who use cortisone-based medications in their inhalers might consider asking their physicians about reducing dosages to avoid cataracts or their progression.
"New Technology" Designation Awarded to Tecnis Intraocular Lens
Centers for Medicare and Medicaid Services: March 2006 -The Centers for Medicare and Medicaid Services (CMS) announced that the "new technology" designation for the Tecnis Intraocular Lens, used to replace the eye's natural lens during cataract surgery, was effective in late February 2006. Because the lens incorporates an aspheric design, it corrections higher order aberrations and thus is helpful in increasing glare under certain lighting conditions by enhancing contrast especially at night and low light conditions.
Fruits and Vegetables May Protect Against Cataracts
American Journal of Clinical Nutrition: July 2005- Researcher William Christen of Harvard Medical School and Brigham and Women's Hospital investigated the effects of dietary intake of fruits and vegetables on the occurrence of cataracts. When the study began, none of the patients had cataracts. By the end of the study, those who had eaten the most fruit and vegetables were 10% to 15% less likely to have cataracts than the other patients.
Medicare Allows Presbyopia Correcting Lens Implants for Cataract Surgery
Centers for Medicare and Medicaid Services: May 2005-The Centers for Medicare and Medicaid Services (CMS) have ruled that Medicare beneficiaries may choose Intraocular Lenses (IOLs) that correct presbyopia for an additional fee as part of their Medicare-covered cataract surgery. These newer IOLs correct vision at more than one distance and offer the possibility of little or no dependency on reading glasses. Before the ruling, Medicare patients were limited to receiving the traditional monofocal distance-vision IOLs that don't correct near vision.
ReZoom™ Multifocal Lens Implant FDA Approved: April 2005
The ReZoom Multifocal Intraocular Lens is designed to distribute light over five optical zones to provide distance, intermediate, and near vision for cataract patients. The idea is to reduce the need for spectacles, including reading glasses, after cataract surgery.
AcrySof ReSTOR® Lens Implant FDA: March 2005
The AcrySof Lens Implant, a type of artificial lens or intraocular lens implant that can restore vision at near, intermediate, and distance ranges following cataract surgery received U.S. Food and Drug Administration approval. The clinical studies supporting the approval showed that 80 percent of patients who received the AcrySof ReSTOR lens did not use glasses for any activities after cataract surgery. The AcrySof ReSTOR lens provides different ranges of vision based on a lens configuration that enables specific distribution of light in response to how wide or small the eye's pupil might be. Most current intraocular lenses used for cataract surgery are able to restore vision only in limited distance ranges, which means patients often must use eyeglasses or other corrective lenses following surgery.
LASIK Surgery & Laser Vision Correction News
LASEK Safe with Controlled Diabetes
European Society of Cataract & Refractive Surgery Meeting: Stockholm September 2007-According to data presented at the ESCRS in Stockholm Sweden, Diabetic patients who wish to have Laser Eye Surgery for Laser Vision Correction of nearsightedness can have LASEK safely, although they should expect to have longer epithelial healing times. Refractive results were good for myopic patients, however a significant number experienced epithelial healing times of greater than 4 days possibly increasing discomfort and slowing overall visual revcovery. Patients with evidence of Diabetic Retinopathy should not be treated.
Same Visual Outcome from Blade Free All Laser LASIK & Conventional LASIK
Ophthalmology: August 2007-In a recent prospective LASIK study to compare the results of using a conventional microkeratome vs. a femptosecond laser (Intralase), researchers found that there was no clinically significant difference in high-contrast visual acuity, manifest refractive error, contrast sensitivity or Intraocular forward light scatter throughout the six-month followup.
Femptosecond Laser Flap Does Not Improve Dry Eye After LASIK
Journal of Cataract and Refractive Surgery: July 2007-Manufacturers of femtosecond lasers used to create flaps for LASIK surgery have made numerous claims regarding the clinical benefits of laser flaps. The most common LASIK side effect is temporary dry eye. Researchers reported on the use of the femptosecond laser to create flaps in various hinge positions in order to evaluate whether dry eye was reduced after LASIK. The results demonstrated a significant increase in dry eye, consistent with LASIK surgery regardless of using the femptosecond laser and regardless of hinge position.
LASIK and Air Force Vision Requirements
Associated Press: June 2007-Up until recently, the Air Force and other United States military services did not permit the use of LASIK for Laser Vision Correction for those involved in certain high contact or specialized positions such as pilots due to environmental condition concerns or safety concerns during combat. This policy will soon change at the Air Force Academy in Colorado Springs where cadets will not only be permitted to have LASIK prior to their enrollment and still be able to meet the vision requirements, but will actually be able to have LASIK at the Air Force Academy eye clinic.
Epi-LASIK Safety and Efficacy
Ophthalmology: June 2007-According to a study published is the June 2007 issue of Ophthalmology, Epi-LASIK can provide a safe and effective alternative to LASIK. Epi-LASIK is a type of Corneal Laser Eye Surgery in which rather than creating flap of tissue through the corneal stroma-which is a thicker flap-one is created by simply delaminating the corneal epithelium into a flap and replacing it after the application of the laser to achieve the desired correction. This is one potentially useful procedure option for those who have thinner corneas.
Visual Symptoms and Aberrations After LASIK
Journal of Refractive Surgery: March 2007- Investigators reported that LASIK patients who experience unusual symptoms such as halos, glare, double vision and blurry vision are typically found to have high order aberrations when evaluated with wavefront analysis. In addition these patients are likely to have reduced overall visual acuity and contrast sensitivity.
Keratitis Eye Inflammation and LASIK
Journal of Cataract and Refractive Surgery: March 2007-Researchers at the Moran Eye Center of the University of Utah reported that the overall incidence of corneal inflammation after LASIK surgery approximates 3% of all LASIK Eye Surgery performed at their institution. The actual eye surface inflammation, called non infectious keratitis or diffuse lamellar keratitis is a well known LASIK complication that is a risk of LASIK surgery believed to be related to sterilization procedures for instruments. Diffuse Lamellar Keratitis is easily managed clinically with steroid eye drops and sometimes lifting the flap and rinsing the surface of the cornea so it is free of debris.
LASIK and Acne Medication Accutane
Journal of the American Academy of Dermatology: January 2006- LASIK patients should avoid the widely prescribed acne medication Accutane as it induces dry eye and may cause difficulties with healing and vision. Those patients with acne patients should stop using Accutane at least six months before undergoing LASIK surgery and for six months after the LASIK procedure, to give the front surface of the eye sufficient time to heal and establish a normal and healthy tear film.
Other Eye Care News
Multiple Sclerosis Treatment Tysabri Reduces Vision Loss
Neurology: April 2007-Researchers at the University of Pennsylvania reported that vision loss related to multiple sclerosis is significantly reduced in people treated with the drug Tysabri. Multiple sclerosis or MS can cause Optic Neuritis, which is an inflammation and damages the fibers in the optic nerve, responsible for transmitting signals to the brain. In people diagnosed with MS and who took Tysabri, vision loss was reduced by as much as 47%.
Dry Eye and Quality of Life for Older Americans
American Journal of Ophthalmology: March 2007- Investigators from the Schepens Eye Research Institute of Harvard Medical School said about 4.8 million older U.S. residents have dry eye, which creates symptoms such as eye irritation and vision disturbances. Their investigation indicates that dry eye may be overlooked as a major health issue among older U.S. populations and found that the condition affects 7.8% of women and 4.7% of men aged 50 and older. Reading, computer use, and driving are among daily activities that can be significantly impacted by dry eye.
Interferon for Hepatitis C Patients May Cause Vision Problems
Investigative Ophthalmology and Visual Sciences: March 2007-Patients with Hepatitis undergoing treatment with Interferon (IFN) may retinopathy, which involves possible bleeding and other damage to the retina. Retinopathy was detected in some patients after only two weeks of Interferon treatments. Researchers reported that retinopathy symptoms subsided in all but nine patients after Interferon treatments were concluded.
Viagra, Cialis, Levitra and Vision
British Journal of Ophthalmology: January 2006 -Impotence drugs such as Viagra, Cialis, and Levitra could cause optic nerve damage and sudden blindness in older men with vascular problems such as high blood pressure or a history of heart attacks. Researchers recommend that patients using drugs such as Viagra should be warned of the risk of developing impaired blood flow to the optic nerve, which can cause sudden blindness.
Patients who previously had experienced heart attacks were 10 times more likely to develop a condition called non-arteritic anterior ischemic optic neuropathy (NAION), causing reduced blood flow damaging the eye's optic nerve, if they had taken drugs for impotence.
Other previous research indicated that older people generally are more likely to have NAION, particularly if they have high cholesterol, high blood pressure, a history of smoking, heart disease, and diabetes. This same group also is more likely to experience impotence, and therefore to take medication for it.
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