Month: February 2013

Many people find their eyesight deteriorates as they get older, which can make it difficult to read the small print on medicine labels. This in turn can make it harder to manage your medicines, leading to medicine mix ups and subsequent health problems.

The latest issue of MedicinesTalk, published by NPS, includes tips for identifying and storing medicines, and sourcing accurate information to help make life easier for people with eyesight problems.

“Vision deterioration can occur slowly, so its immediate effects on everyday life may not be evident. Blurred or impaired vision can however make it difficult to identify medicines and read small print so it’s important people know how to manage their medicines safely,” said NPS CEO, Dr Lynn Weekes.

Checking your medicines in a place with good lighting and using a magnifying glass to read the medicine label can help prevent accidental mix ups.

Being organised can help make things less confusing. Keep all your medicines in one place and group the same medicines together with an elastic band or using a colour-coding system.

Your pharmacist can also help you to manage your medicines. Ask them to give you the same brand of medicine each time so that the shape and size of the packaging won’t change. They can also print the medicine information leaflet in larger font so it’s easier to read.

Pharmacists can also help with medication organisers, or dose administration aids, which are daily or weekly pill boxes that store each dose of your medicine in a separate compartment that is clearly labelled according to the day or time it should be taken. There are a number of different organisers available so make sure you buy one that is easy to use, is large enough to store all your medicines and where you can clearly read the labels,

“If you have trouble reading medicine labels, ask your pharmacist about a blister pack medication organiser. These are weekly medication organisers prepared by your pharmacist and store each dose of your medicines in an individual blister or bubble. There is usually a small charge but they are useful for people who are struggling to manage their medicines,” Dr Weekes said.

There are also devices now available to help people with little or no vision identify items like groceries, clothing and medicines. These include small barcode scanners and audio labellers, which can store a voice recording of your medicine which is read out when you point the device at its container. Ask a friend or relative to help you purchase these online from Vision Australia.

Source:

NPS

Lissamine green sounds like the latest cleaning sensation being hawked on television and probably not something you would want to get in your eyes.

But a few properly placed drops can reveal staining patterns that are key to diagnosing dry eye syndrome earlier than other methods, providing doctors more options for treating the potentially sight-stealing disease, new research at UT Southwestern Medical Center confirms.

Lissamine green is an eye-drop stain used by ophthalmologists to detect damaged cells on the eye’s surface, flagging them green under special lighting.

“What this research showed is that the degree and pattern of staining was a good, objective indicator of the severity of the tear deficiency,” said Dr. James McCulley, chairman of ophthalmology at UT Southwestern and one of the world’s leading experts on dry eyes.

Dry eye syndrome is one of the most common eye ailments. According to various estimates, it affects 10 percent to 30 percent of the world’s population, including 10 million to 14 million Americans — mostly older women. Symptoms include eyes that burn or sting, blurred vision, frequent blinking, light sensitivity or a sandy or gritty feeling like something is in the eye.

In a study appearing in the journal Eye and Contact Lens, Dr. McCulley and his colleagues found that the severity of the dry eye condition in patients correlates with where the stain patterns show up. Researchers identified three basic patterns that indicated progressively dangerous conditions:

* The least-severe condition is indicated by stains limited to the whites of the eyes between the lids toward the nose. This so-called nasal staining doesn’t necessarily predict dry eye: it might be caused by environmental factors, such as pollution.

* The second level appears as stains in the white of the eye between the lids, but toward the ear. “That is fairly diagnostic of a tear deficiency,” Dr. McCulley said.

* The third and most severe level occurs when the stain also appears on the cornea.

“That’s when things really get serious,” said Dr. McCulley, the study’s senior author. “If the dry eye is significantly affecting the cornea, it deteriorates vision and adds a major risk factor for a person developing a bad infection.”

Stains in the cornea indicate a break in the surface cells. Most bacteria require such a break in order to penetrate the eye, where the bacteria can cause an ulcer.

“When the surface is healthy, we’re protected against the vast majority of bacteria. But if there’s a compromise of the surface, then bacteria can invade,” said Dr. McCulley, who said the investigation was inspired by his many years observing staining patterns in the patients he treated.

Researchers examined the stain patterns in 22 patients with varying degrees of dry eyes and 11 patients without ocular disease, who served as control subjects. The research not only revealed the progressive pattern, but also underscored the value of using lissamine green stain over the more commonly used fluorescein stain, which doesn’t easily identify damage until it is more progressed.

“If an ophthalmologist uses the most commonly used stain, which is fluorescein, they’re going to miss the first two stages of the development of dry eye and consequently miss a lot of diagnoses,” said Dr. McCulley, director of the Theodore and Mary Beasley Laboratory for Ocular Surface Research and the Jean H. & John T. Walter Jr. Center for Research in Age-Related Macular Degeneration.

Earlier diagnosis is crucial in giving doctors more treatment options and preventing the disease from getting worse. Dry eye syndrome can also signal other conditions such as lupus or rheumatoid arthritis, further underscoring the importance of early diagnosis.

“The more severe stage is not only more problematic in affecting vision, but it is more difficult to treat and reverse,” Dr. McCulley said. “So it’s very important to diagnose at the mild stages because it can become a self perpetuating disease if not effectively treated.”

Other researchers involved in the study were Dr. Igor Butovich, assistant professor of ophthalmology, Dr. Eduardo Uchiyama, technical staff associate and lead author of the paper, and Dr. Joel Aronowicz, technical staff associate.

The study was funded by grants from the National Institutes of Health and Research to Prevent Blindness.

Dr. James McCulley — utsouthwestern.edu/findfac/professional/0,2356,14755,00.html

Source Russell Rian

UT Southwestern Medical Center

Strobe-like eyewear designed to train the vision of athletes may have positive effects in some cases, according to tests run by a team of Duke University psychologists who specialize in visual perception.

The eyewear has lenses that alternate between clear and opaque states, producing a strobe experience. Nearly 500 people participated in more than 1,200 training sessions and had their visual abilities tested before and after they wore the eyewear. They completed visual-motor tasks, such as catching and throwing a ball, as well as computer-based tests.

Once the eyewear is removed, the theory goes, the brain’s visual processing has been trained to see the ball’s path more clearly. The Duke psychologists found subjects experienced some improvements in noticing brief stimuli and detecting small changes in motion after training with the eyewear.

Anecdotally, some athletes who trained with the eyewear also report that the ball seems to have slowed down when they view it with regular vision afterwards, said Stephen Mitroff, an assistant professor of psychology and neuroscience at Duke who led the research.

The strobe eyewear has lenses that alternate between clear and opaque states at eight different rates, with a constant 100 milliseconds (one-tenth of a second) of clear vision between each opaque phase. At their most rapid flashing rate, the eyewear becomes opaque for 67 milliseconds, six times per second. At the slowest rate, they are opaque for 900 milliseconds, or 90 percent of each second.

Participants included Duke athletes in varsity football, men’s basketball and men’s and women’s soccer, as well as students in club teams for ultimate Frisbee, volleyball and juggling, and other undergraduates.

Half of the participants trained with the strobe eyewear and the other half trained with control eyewear that was identical, but with clear lenses. All completed computer tasks that measured visual sensitivity and attention before and after training with the eyewear. The experiments were designed to evaluate whether those who wore the strobe eyewear would improve more after the training than those who wore the control eyewear, said postdoctoral researcher Gregory Appelbaum.

The research was funded by Nike, which developed the eyewear and is marketing it as Nike Vapor Strobe. The Duke team presented its findings May 6 in a poster session at the Vision Sciences Society in Naples, Fla.

Because this was a preliminary study, the researchers were unsure what measures would give them the clearest results. They tried several different lengths of exposure to the eyewear, different strobe rates and many physical and computer-based tasks. They found performance improvements in some tests, but not in all of them.

The Duke team measured slight improvements in some tests after only two 25-minute training sessions, and in both elite athletes and non-athletes. In other cases, they found no changes.

“Our results varied, but stroboscopic training does seem to enhance vision and attention,” Mitroff said. “Not every test we tried showed differences, but several showed significant improvements.”

For example, after training with the eyewear, participants were more sensitive to small amounts of motion. They also were better able to pick up visual details that were only available for about one-tenth of a second. Preliminary data also suggest a possible improvement at a dribbling skills test with the varsity soccer players.

The results show the eyewear does affect vision performance, but there is still much more to learn, said Mitroff, whose main body of research concerns the ability to see hidden objects in displays, such as security scans or radiological films. More research is needed to figure out how little or how much exposure to the eyewear has an effect, how long that effect may last and which skills are affected most.

“There are still many open questions,” Mitroff said. “We don’t know how long these effects last. We don’t know much training is needed, and we don’t yet have the whole picture on what is being trained.”

Despite the lingering questions, Mitroff said the eyewear may be a great tool for looking at how the brain adapts to changing conditions and how visual cognition works.

Source:
Karl Leif Bates
Duke University

A scientist at Schepens Eye Research Institute (SERI) found that increasing the contrast of details of certain sizes was of special importance in making television watching more enjoyable for the visually impaired. The study, published in the current (November/December) issue of Ophthalmic and Physiological Optics (OPO), provides information that will aid in the development of an electronic device to help millions suffering eye diseases. People who may benefit from such a device include those suffering from macular degeneration, diabetic retinopathy and other causes of low vision.

“Most of us take seeing the television for granted,” says Dr. Eli Peli, principal investigator of the study, senior scientist at SERI and a professor at Harvard Medical School. “But for the visually impaired, it is very difficult. This is a source of great frustration and discouragement since so much news and entertainment come from tuning into the ‘tube’.”

As a low vision rehabilitation expert, Peli sees hundreds of patients suffering from vision impairments caused by diseases such as age-related macular degeneration (AMD), diabetic retinopathy and other diseases that impair the central vision. AMD destroys the tiny central part of the retina called the macula. This makes activities such as reading, driving, and watching television extremely difficult. Peli, an electrical engineer and an optometrist by training, has devoted his career to creating and evaluating new technologies to help low-vision patients regain their ability to do these tasks.

The goal of the current OPO study was to determine if people with impaired vision benefited from an individually tuned contrast enhancement of their TV.

Peli and his colleagues used an image-processing device developed for them by DigiVision Inc. that allows them to manipulate, in real time, the contrast of different sized details (or edges) in the video screen to their individual liking. “This is a very flexible device but also quite expensive and complex, and thus could not be brought to market easily,” says Peli. Using this device and similar approaches, Peli and his team learned that certain details in an image that are too small will not be visible to someone with central vision loss even with the highest contrast. They also learned –through patients’ responses– that the large details in an image were fully visible–even to visually impaired persons–without modification. “What we were interested in were the image details that could not be seen until we increased their contrast,” says Peli.

The current study had two parts. In the first part, 46 subjects with central vision loss were shown a series of still images and asked to find — by moving a computer mouse on the table–a setting where the image was most visible. Moving the mouse in one direction changed the size of the detail to be enhanced. Movements in the other direction changed the amount of contrast enhancement applied to those details. . Peli and his colleagues found that the patients did have individual preferences. Each patient repeatedly selected a preferred size and a specific level of contrast enhancement. They also found that patients who selected smaller details to be enhanced selected less contrast enhancement. In the second part of the study, 20 of these patients were asked to watch a video from PBS programming and to rank the quality of the moving images every 10 seconds by moving a mouse up and down on a table in front of them. Every 10 seconds, the processing of the video changed, ranging from un-enhanced, to purposely blurred, to enhanced according to the subject’s individual preference. Additionally some images were viewed at enhancement levels arbitrarily set to 4 different levels: smaller details enhanced with higher and with lowers contrast than the individual selection and larger details also at higher and at lower contrast.

Peli and his team found that patients did like the images that reflected their own individual settings for contrast and details better than the un-enhanced video. However, personal preferences were only slightly higher for those individual settings than for the arbitrarily enhanced images.

According to Peli, these results mean that enhancement levels could be selected that will be acceptable to most people, simplifying the type of device needed. Peli envisions a small box that could be attached to any television and would offer only a few enhancement settings, making it less expansive and less complicated to use. Belkin, an international technology company, has recently released a video enhancement cable product, RazorVision, which enhances video for normal sighted TV viewers. *DigiVision, the company that developed the Belkin device and holds a patent pending on the technology, is interested in creating another version of the product for visually impaired viewers based on results from this and other image studies by Peli and his colleagues, *(DigiVision, Inc. was awarded a “Connect 2005 Most Innovative New Product Award” for their “Video Enhancement Cable.” Connect is a San Diego organization which has recognized innovative new products in the San Diego region for the last 18 years.)

Though not part of the study results, Peli says that people with normal sight who have been exposed to these enhanced videos do not see them as interfering with their enjoyment of viewing. “In fact, they usually don’t seem to be aware that the image has been enhanced,” he says. “This means that the visually impaired and their family and friends with normal sight could enjoy watching television together.

To view a split screen image that compares an enhanced and an un-enhanced image, CLICK HERE.

Schepens Eye Research Institute is a major affiliate of Harvard Medical School and the largest independent eye research institute in the world.

Patti Jacobs
pjacobs12comcast
Schepens Eye Research Institute
eri.harvard.edu

The General Optical Council recently gave its formal support to transferring responsibility for hearings to a new Independent Adjudication Body at the earliest opportunity. The new body will be set up as a result of recommendations in the Government’s White Paper on professional regulation, and could take on fitness to practise cases from 2010. The GOC has already separated its role in investigation and prosecution from adjudication by creating an independent hearings panel. The move is in line with best practice to ensure that registrants’ human rights are protected and that all parties can continue to expect fair, impartial treatment. In the longer term, shared adjudication should mean more consistent FTP decisions across the healthcare professions.

Council voices concerns about European legislation

The GOC today highlighted key areas of concern about proposed new legislation giving European professionals rights to ‘temporary’ and ‘occasional’ registration in the UK. The European Qualifications Directive would allow qualified European practitioners the right to practise as optometrists and dispensing opticians in the UK without going through the process of full registration. Members voiced concerns that patient safety would be compromised if temporary and occasional registrants were not subject to CET requirements, or did not have adequate insurance. Concerns were also expressed that less information would be available on the register about such individuals than was the case for full registrants. The Council agreed that these issues should be raised in the GOC response to the current consultation.

GOC to tender for consumer complaints service

At its meeting today, the General Optical Council agreed to re-issue an invitation to tender for a consumer complaints mediation service. The tender process was postponed in November last year pending a Department of Health consultation on the introduction of a single complaints process across health and social care. In the interim, a 12-month contract extension was agreed with the current providers, OCCS. The consultation has now been issued and was not felt to have an impact on these arrangements. Therefore, Council agreed to re-issue the tender document with a view to awarding a new three-year contract.

New framework for optical competencies

The General Optical Council will consult on a new unified competency framework for optics in the UK. The proposed framework takes on board best practice from Australia and the work of the World Council of Optometry. Competencies would be expressed in ‘units’, ‘elements’, ‘performance criteria’ and ‘indicators’. The new framework will mean that competencies shared by optometrists and dispensing opticians will be stated in the same terms, and that there is a clear understanding of the meaning of key terms, such as ‘ability’, ‘knowledge’ and ‘understanding’. The content of the competencies will be the subject of a second consultation, planned for 2008.

Spotlight on opticians’ continuing education success

GOC Chairman Rosie Varley put the spotlight on the professions’ achievements in the first cycle of statutory continuing education and training (CET) at today’s meeting of Council. Fewer than two per cent of registrants failed to meet minimum requirements. All categories of registrants demonstrated their commitment to maintaining standards, with a large number earning well beyond the minimum required number of points. The contribution of Deputy Registrar Dian Taylor, the cooperation and support of CET providers and optical bodies, and the work of Vantage Technologies were all recognised as contributing to the scheme’s success. Council members commented on the uneven uptake of CET across competency areas, expressing concerns in particular about the amount of CET in low vision. The need to consider the balance of ‘modalities’ – particularly between distance learning and face to face events – was also discussed. These will be amongst the issues reviewed as part of planning the future development of the scheme.

New arrangements for entry to the pre-reg period (PRP)

The General Optical Council today agreed new arrangements for entry to the pre-registration period for students who do not achieve the required standard for automatic progression. Students who fail to achieve a 2(ii) degree are currently required to sit the Professional Qualifying Exam (PQE) part one. There is a low success rate in this examination. In the new system, students will have the opportunity to re-enter the final year of the degree programme as a special student, and will progress to the PRP if they gain an average pass mark of 50 per cent in final exams. Deputy Registrar and Director of Education, Dian Taylor, stressed that the new arrangements would not reduce the standards required for entry to the PRP, but should provide better support for students to improve their results.

General Optical Council
Registered office: 41 Harley Street, London, W1G 8DJ

Role for the serotonin transporter in platelet aggregation

New data, generated by Randy Blakely and colleagues, at Vanderbilt University, Nashville, have established a role for constitutive expression of the protein SERT (the serotonin transporter) in platelet aggregation, a key event in blood clotting. In the study, SERT expression and function were shown to have a role in the aggregation of both mouse and human platelets. Mechanistically, SERT was found to interact directly with the beta-3 component of a protein known as integrin alpha-IIb/beta-3, and this led to increased SERT expression on the surface of the platelet and thereby increased SERT function. Alterations in SERT distribution in platelets was linked to polymorphisms in the beta-3 gene. The interaction of the genes that make beta-3 and SERT has been of substantial clinical interest as they have been implicated in cardiovascular disease and autism. The authors therefore suggested that the demonstration that SERT interacts with integrin beta-3 provides a possible mechanistic basis for these recent genetic associations. In addition, as SERT is the target for the most widely prescribed class of antidepressants (SSRIs), the authors suggest that these data might help explain the recognized comorbidities between cardiovascular disease and depression.

TITLE: Interactions between integrin alpha-IIb/beta-3 and the serotonin transporter regulate serotonin transport and platelet aggregation in mice and humans

AUTHOR CONTACT:
Randy D. Blakely
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Seeing clearly how genetic mutations cause loss of sight

Retinitis pigmentosa (RP) is a hereditary disease that often results in complete loss of sight as a result of the progressive degeneration of the retina of the eye. Mutations in many different genes are known to cause RP, one of which is PRPF31. New data generated by Carlo Rivolta and colleagues at the University of Lausanne, Switzerland, have provided insight into the effect of several different RP-causing PRPF31 mutations.

The information in genes is translated into protein via an mRNA intermediate. In the study, six different PRPF31 mutations that cause RP were found to generate substantially less mRNA, and therefore dramatically lower amounts of protein, than nonmutated PRPF31. Surprisingly, although blocking a process known as nonsense-mediated mRNA decay, which destroys certain forms of mRNA that would not correctly translate the information in a gene into protein, increased the amount of mRNA generated from the mutated PRPF31, no increase in mutant protein was observed. The authors therefore suggested that most PRPF31 mutations are effectively nonfunctional because surveillance mechanisms destroy any mRNA generated from the mutated genes, and therefore that PRPF31 mutations mediate their RP-causing effect by decreasing the amount of PRPF31 protein present in a cell.

TITLE: Premature termination codons in PRPF31 cause retinitis pigmentosa via haploinsufficiency due to nonsense-mediated mRNA decay

AUTHOR CONTACT:
Carlo Rivolta
University of Lausanne, Lausanne, Switzerland.

Why muscle wasting diseases may not require stem cell treatment after all

Muscle wasting, also known as muscle atrophy, can be caused by inactivity, injury, disease, aging, and medication. Many studies have shown that muscle atrophy is accompanied by death of the DNA-containing myonuclei of muscle fibers, which would mean that recovery from muscle atrophy would require replenishment from muscle stem cells. In a new study, Jo Bruusgaard and Kristian Gundersen at the University of Oslo, Norway, used time-lapse microscopy of mouse muscle fibers and myonuclei during atrophy to investigate this process. When mice were subjected to muscle atrophy by various methods, physical evidence of wasting was apparent by significantly decreased muscle fiber areas. However, myonuclei death was not observed in any case during the 28 days of monitoring. The authors concluded therefore that intervention efforts to reverse muscle atrophy should not focus on muscle stem cells.

TITLE: In vivo time-lapse microscopy reveals no loss of murine myonuclei during weeks of muscle atrophy

AUTHOR CONTACT:
Kristian Gundersen
University of Oslo, Oslo, Norway.

Learning more about why people with Bardet-Biedl syndrome are obese

Bardet-Biedl syndrome (BBS) is a genetic disorder characterized by many features, including obesity and an increased risk of heart disease. Although BBS is a rare disorder, because it is characterized by problems faced by an increasing number of individuals who do not have BBS, much effort is being invested in determining the genes that are mutated in individuals with BBS and how these contribute to obesity and increased risk of heart disease. New data generated by Kamal Rahmouni and colleagues at the University of Iowa Carver College of Medicine, Iowa City, have indicated that sensitivity to the hormone leptin, which suppresses appetite and increases energy expenditure by activating leptin receptors on specific nerves in the brain, is lost in three mouse models of BBS.

In the study, administration of leptin to mice lacking Bbs2, Bbs4, or Bbs6 (proteins made by three of the twelve genes so far identified as being mutated in individuals with BBS) was found to have little effect on body weight and food intake. Further analysis indicated that this resistance to the effects of leptin as an appetite suppressor was associated with a defect in nerves in the brain known as proopiomelanocortin neurons. Although all three strains of mice were resistant to the effects of leptin as an appetite suppressor, only Bbs2-/- mice were resistant to the effects of leptin on arterial blood pressure. As such, Bbs2-/-” mice had normal blood pressure, whereas Bbs4-/- mice and Bbs6-/- mice had elevated blood pressure. These data have provided insight into why individuals who have BBS as a result of different genetic mutations might exhibit different clinical symptoms.

TITLE: Leptin resistance contributes to obesity and hypertension in mouse models of Bardet-Biedel syndrome

AUTHOR CONTACT:
Kamal Rahmouni
University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.

Eradicating established tumors in mice

Although an immune response mediated by T cells is mounted toward a tumor, over time the tumor adapts and can escape control by the immune response. Similar problems are an obstacle to T cell-based immunotherapeutic approaches to treating individuals with cancer. Loss of the target of the T cells is one mechanism by which tumors escape immune control. A new study by Bin Zhang and colleagues, at the University of Chicago, has characterized immune pathways that can eradicate established tumors in mice, including variants of the tumor that had lost the target of the antitumor T cells (so called antigen-loss-variants; ALVs). Specifically, in this model, the production of the soluble factors IFN-gamma and TNF by antitumor cytotoxic T cells was required for tumor eradication. For these soluble factors to mediate their antitumor effects both bone marrow and stromal cells had to express IFN-gamma and TNF receptors. These data led the authors to suggest that IFN-gamma and TNF acted on tumor stroma to effect bystander killing of ALVs, and they hope that this insight will aid in the development of effective strategies to eliminate established cancers.

TITLE: IFN-gamma – and TNF-dependent bystander eradication of antigen-loss variants in established mouse cancers

AUTHOR CONTACT:
Bin Zhang
University of Texas Health Science Center, San Antonio, Texas, USA.

Learning from a new model for potassium-induced muscle weakness

HyperKPP is a genetic muscle disorder that causes muscle weakness in response to resting after strenuous exercise and to eating potassium-rich foods, among other things. To better understand the mechanisms underlying HyperKPP, Lawrence Hayward and colleagues at the University of Massachusetts Medical School in Worcester, generated a mouse model of the disease by introducing a genetic mutation that causes HyperKPP into the corresponding mouse gene. These mice developed problems similar to individuals with HyperKPP, including abnormally slow muscle relaxation, muscle weakness following potassium exposure at levels typical in human muscle fibers during exercise, and slow recovery from muscle fatigue. The authors therefore hope that this mouse model of HyperKPP may help researchers better understand the human disease and develop better therapies for it and related disorders.

TITLE: Targeted mutation of mouse skeletal muscle sodium channel produces myotonia and potassium-sensitive weakness

AUTHOR CONTACT:
Lawrence J. Hayward
University of Massachusetts Medical School, Worcester, Massachusetts, USA.

Contact: Karen Honey

Journal of Clinical Investigation

ISTA Pharmaceuticals,
Inc. (Nasdaq: ISTA), today announced positive results from the preliminary
analysis of the Company’s Phase IIb clinical study of ecabet sodium, which
is being developed as a treatment for dry eye syndrome. Patients in the
ecabet sodium group achieved a strong trend in the objective sign of blink
rate. In addition, patients in the ecabet sodium group reported a strong
trend in the Ocular Symptom Disease Index (OSDI) and a positive trend in
the subjective assessment of patients’ most bothersome symptom. Strong and
positive trends are used to confirm observations from previous clinical
ecabet sodium studies and to serve as indicators of potential efficacy
endpoints in Phase III studies. While ISTA’s Phase IIb study was not
powered to show statistical significance, ecabet sodium did achieve
statistical significance in the OSDI assessment. There were no reports of
serious ocular adverse events compared with placebo. Further analyses of
the Phase IIb study results are ongoing.

“We are very encouraged by the Phase IIb study’s preliminary results,
as they support our belief that ecabet has the ability to treat signs and
symptoms of dry eye syndrome,” stated Vicente Anido, Jr., Ph.D., President
and Chief Executive Officer of ISTA. “Our key objectives for this study
were to validate our protocol and to screen out non-responders. We were
successful in doing both. In addition, we showed positive trending in one
sign and one symptom, plus achieved statistical significance in a second
symptom, all in a single study. Ecabet sodium may provide advantages over
other dry eye products and product candidates, as we believe the drug not
only improves the quality of tears by enhancing mucin production, but may
increase the quantity of tears produced. Although not a predetermined
endpoint in this study, 14 percent of patients in the treatment group
reported increases in the quantity of tears produced, as compared to only
1.8 percent in the placebo group. We are continuing our analyses of both of
our Phase II clinical studies to identify the signs and symptoms to
evaluate in Phase III testing. Upon completion of the analyses, we will
request a meeting with the Food and Drug Administration to discuss its
recommended clinical path in order to bring this novel treatment to
patients suffering from dry eye syndrome. At this time, we anticipate
beginning Phase III studies in 2008.”

A total of 112 patients were assigned randomly to receive either ecabet
sodium or placebo four times a day for 90 days. There were four primary
efficacy endpoints: two objective signs (blink rate and corneal staining)
and two subjective symptoms (the patient’s most bothersome symptom and the
patient’s response to the Ocular Surface Disease Index (OSDI)). Patients
were evaluated in a controlled adverse environment (“dry eye chamber”)
twice during the study, once on Day 1 and once on Day 91. The objective
signs were measured pre- and post-exposure to the dry eye chamber on Day
91. The subjective symptoms were measured following exposure to the dry eye
chamber on both Day 1 and Day 91. To date, the FDA has considered
improvement, as measured in Phase III studies, in one sign and one symptom
to be acceptable for approval of a prescription dry eye product.

ISTA will host a conference call with a simultaneous webcast tomorrow,
Friday, June 1, 2007, at 11:00 AM Eastern Time to discuss today’s
announcement regarding the ecabet sodium Phase IIb study preliminary
results and other recent product and commercial developments.

About Ecabet Sodium

ISTA acquired U.S. rights to ecabet sodium for the treatment of dry eye
syndrome from Senju Pharmaceuticals Co., Ltd., in November of 2004. Ecabet
sodium is already marketed in Japan as an oral agent for gastric ulcers and
gastritis by Tanabe Seiyaku Co., Ltd as an originator of ecabet sodium.

Ecabet sodium represents a new class of molecules that increase the
quantity of mucin produced by conjunctival goblet cells and corneal
epithelia. Mucin is a glycoprotein component of tear film that lubricates
while retarding moisture loss from tear evaporation.

About ISTA

ISTA Pharmaceuticals is an ophthalmic pharmaceutical company. ISTA’s
products and product candidates addressing the $3.2 billion U.S.
prescription ophthalmic industry include therapies for inflammation, ocular
pain, glaucoma, allergy, dry eye, and vitreous hemorrhage. The Company
currently markets three products and is developing a strong product
pipeline to fuel future growth and market share. The Company’s product
development and commercialization strategy is to launch a new product every
12 to 18 months, thereby continuing its growth to become the leading niche
ophthalmic pharmaceutical company in the U.S. For additional information
regarding ISTA, please visit ISTA Pharmaceuticals’ website at
istavision.

Statements contained in this press release that refer to future events
or other non-historical matters are forward-looking statements. For
example, and without limiting the foregoing, statements in this press
release related to the prospects and timing of further development of
ecabet sodium (including but not limited to statements that ISTA will
complete its analysis and confirm its preliminary Phase IIb findings, meet
with the FDA, and initiate a Phase III study with respect to ecabet sodium
during 2008), the potential of ecabet sodium to treat dry eye syndrome and
its potential advantages over other currently marketed dry eye products,
ISTA’s statements about potential future objective endpoints for Phase III
studies and ISTA’s goals of bringing a new product to market every 12 to 18
months and becoming the leading niche ophthalmic pharmaceutical company in
the U.S. are forward-looking statements. Except as required by law, ISTA
disclaims any intent or obligation to update any forward-looking
statements. Such statements are based on ISTA’s expectations as of the date
of this press release and are subject to risks and uncertainties that could
cause actual results to differ materially. Important factors that could
cause actual results to differ from current expectations include, among
others: the risk that full analysis of the Phase IIb data or further
testing of ecabet sodium, will not reflect the preliminary Phase IIb
results, or support any or all of the conclusions provided in this press
release; delays, risks and uncertainties related to ISTA’s ecabet sodium
development program (including the difficulty of predicting the timing or
outcome of ISTA’s product development efforts and the FDA or other
governmental agency approval or actions); uncertainties and risks regarding
market acceptance of ISTA’s approved products and the impact of competitive
products and pricing; risks and uncertainties related to successful
compliance with FDA and/or other governmental regulations applicable to
ISTA’s facilities, products, and/or business; uncertainties and risks
related to the scope, validity, and enforceability of patents related to
ISTA’s products and technologies and the impact of patents and other
intellectual property rights held by third parties, and such risks and
uncertainties as detailed from time to time in ISTA’s public filings with
the U.S. Securities and Exchange Commission, including but not limited to
ISTA’s Annual Report on Form 10-K for the year ended December 31, 2006, and
ISTA’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2007.

ISTA Pharmaceuticals, Inc.
istavision