Month: March 2013

The Fall 2010 issue of AER Journal: Research and Practice in Visual Impairment and Blindness focuses on concerns related to services for adults who are deaf-blind. In addition to advocacy and leadership, the journal discusses communication, travel, and aging.

Six deaf-blind young adults traveled to Washington, DC, last year to develop leadership and advocacy skills and to put a face on the issues affecting persons who are deaf-blind. They were participants in a one-week course to build and apply their skills in meetings with Senators, members of Congress, and the President of the United States. Following this experience, the participants evaluated and discussed their perceptions of the benefits of the program to help shape its future direction.

George, an 18-year-old from Florida who graduated from high school with honors, is blind and uses hearing aids for moderate hearing loss. Crystal, a 24-year-old college graduate from Texas, was born with vision and hearing loss. She uses a combination of speech and sign language and works with a guide dog. These two young people and four others studied how best to present their messages and how to handle any situations that might arise. For instance, how should they respond if a Senator were to address the interpreter rather than the advocate?

The program participants reviewed and advocated for four legislative topics regarding deaf-blindness: the need for Support Service Providers, support for state technical assistance projects, inclusion in the 21st Century Telecommunications and Video Description Act, and increased support for the Helen Keller National Center.

The participants also turned their focus inward, evaluating their training and experiences to identify the most important aspects. They considered access to information on policy issues, knowledgeable mentors who understand deaf-blindness, and opportunities to practice advocacy skills while engaging with elected officials to be the most effective parts of the program. Their input will help improve the program in the future.

As a result of their experiences, the six program participants also expressed awareness of their ability to bring about change in a national context for other people who are deaf-blind. All have plans to become involved in mentoring other young adults who are deaf-blind to encourage participation in policy efforts.

Although deaf-blindness creates barriers to communication, these young men and women benefited from a positive experience. Several participants have continued advocacy efforts on state and local levels, while some have pursued international experiences. They have maintained contact with one another and others involved in the course. Some participants also plan to share their experiences at national conferences.

Source: Allen Press Publishing Services

Scientists have shown that through an eye exam, doctors can identify infants who are most likely to benefit from early treatment for a potentially blinding eye condition called retinopathy of prematurity (ROP), resulting in better vision for many children.

These long-term results of the Early Treatment for Retinopathy of Prematurity (ETROP) study confirm that the visual benefit of early treatment for selected infants continues through 6 years of age. The research, published April 12 online in Archives of Ophthalmology, was supported by the National Eye Institute (NEI), part of the National Institutes of Health.

“This study has set the standard of care for infants with ROP by showing that early treatment of selected high-risk premature babies has positive longer-term results on vision,” said NEI Director Paul A. Sieving, M.D., Ph.D.

An estimated 15,000 premature infants born each year in the United States are affected by some degree of ROP. At-risk infants generally are born before 31 weeks of the mother’s pregnancy and weigh 2.75 pounds or less.

This disease, which usually develops in both eyes, is one of the most common causes of vision loss in children. About 90 percent of infants with ROP have a mild form that does not require treatment, but those who have a more severe form can develop lifelong visual impairment, and possibly blindness.

During pregnancy, the blood vessels of the eye gradually grow to supply oxygen and essential nutrients to the light-sensitive retina. If a baby is born prematurely, growth of the blood vessels may stop before they reach the edge of the retina. In these newborns, abnormal, fragile blood vessels and retinal tissue may develop at the edges of the normal tissue. The abnormal vessels can bleed, resulting in scars that pull on the retina. The main cause of visual impairment and blindness in ROP is retinal detachment. Laser therapy or cryotherapy, using freezing temperatures, are the most effective treatments to slow or stop the growth of abnormal blood vessels.

“The long-term study has given clinicians evidence that infants with ROP should be treated with different strategies based on an infant’s risk for a severe form of the disease, which can be determined through an exam at the bedside,” said study chair William V. Good, M.D., of Smith-Kettlewell Eye Research Institute in San Francisco.

Previously, doctors treated infants with ROP when they estimated their risk for retinal detachment to be 50 percent, a strategy developed through the NEI-supported Cryotherapy for Retinopathy of Prematurity study. Although this was a major finding, many infants still went on to develop severe eye disease. Therefore, the first phase of the ETROP study aimed to discover if doctors could identify infants at a higher risk for progression of the disease and intervene early to improve their vision.

In 2003, the ETROP study found that early treatment – upon diagnosis as higher risk for severe ROP – improved the vision and retinal health of certain infants after nine months. These infants had dilated or twisted blood vessels in the retina and substantial growth of new blood vessels, classified as Type 1 disease. Eyes with Type 2 ROP, or a more moderate amount of new blood vessel growth, did not benefit from early treatment. Doctors could predict which infants were more likely to benefit from early treatment by identifying certain eye characteristics, such as the appearance and location of the blood vessels.

The current study followed the same 370 children through 6 years of age, when researchers checked their vision and examined the development of their eyes. The nine-month study recommendations were confirmed through 6 years. Type 1 eyes benefitted from early treatment, and Type 2 eyes had similar results with either early treatment or treatment at the standard time. Seventy-five percent of the early-treated Type 1 eyes were spared legal blindness, compared with 67 percent of Type 1 eyes that received treatment at the standard time. Of the Type 2 eyes that were carefully monitored for disease progression through the standard protocol, more than half improved without treatment.

“Unfortunately, not all eyes selected for early treatment do well,” said Robert J. Hardy, Ph.D., director of the ETROP study coordinating center and professor of biostatistics at the University of Texas School of Public Health in Houston. “Additional research is needed to identify still better methods for the prevention and treatment of severe ROP.”

Source:
National Eye Institute
NIH/National Eye Institute

Regeneron Pharmaceuticals, Inc. (Nasdaq: REGN) announced that the U.S. Food and Drug Administration (FDA) has accepted for review the Company’s Biologics License Application (BLA) for VEGF Trap-Eye for the treatment of the neovascular form of age-related macular degeneration (wet AMD). The FDA also granted the Company’s request for priority review of its BLA. A Priority Review designation is given to drugs that offer major advances in treatment, or provide a treatment where no adequate therapy exists. Under priority review, the target date for an FDA decision on the VEGF Trap-Eye BLA is August 20, 2011.

“We are very pleased that the FDA has chosen to grant priority review to VEGF Trap-Eye. We look forward to working closely with the FDA to achieve our goal of bringing a new treatment option that offers a major advance to patients with age-related macular degeneration,” said Leonard S. Schleifer, M.D., Ph.D., President and Chief Executive Officer of Regeneron.

About VEGF Trap-Eye

Vascular Endothelial Growth Factor (VEGF) is a naturally occurring protein in the body. Its normal role in a healthy organism is to trigger formation of new blood vessels (angiogenesis) supporting the growth of the body’s tissues and organs. However, in certain diseases, such as diabetes, it is also associated with the growth of abnormal new blood vessels in the eye, which exhibit vascular permeability and lead to edema. VEGF Trap-Eye is a fusion protein consisting of portions of human VEGF receptors 1 and 2 extracellular domains fused to the Fc portion of human IgG1. VEGF Trap-Eye binds all forms of VEGF-A, along with the related Placental Growth Factor (PlGF). VEGF Trap-Eye is a specific and highly potent blocker of these growth factors. VEGF Trap-Eye is specially purified and contains iso-osmotic buffer concentrations, allowing for injection into the eye.

Regeneron and Bayer HealthCare are collaborating on the development of VEGF Trap-Eye for the treatment of wet AMD, central retinal vein occlusion, diabetic macular edema, myopic choroidal neovascularisation, and other eye diseases and disorders. Bayer HealthCare intends to submit a regulatory application outside of the United States in the first half of 2011. If approved by regulatory authorities, Bayer HealthCare will market VEGF Trap-Eye outside the United States, where the companies will share equally in profits from any future sales of VEGF Trap-Eye. Regeneron maintains exclusive rights to VEGF Trap-Eye in the United States.

Source: Regeneron Pharmaceuticals, Inc

Dr. Marc Maurer, President of the National Federation of the Blind, the nation’s oldest and largest organization of blind people, will testify before the Subcommittee on Domestic and International Monetary Policy, Trade, and Technology of the House Committee on Financial Services, regarding the issue of paper currency identifiable by the blind.

On May 20, 2008, the U.S. Court of Appeals for the District of Columbia Circuit upheld a ruling that could force a redesign of U.S. paper currency so that blind people can distinguish denominations by touch.

Dr. Marc Maurer said: “I appreciate the opportunity to share the considered opinion of the National Federation of the Blind regarding paper currency. We represent the largest group of blind people in the United States, and each year we gather to consider important matters affecting the blind. We strongly disagree with the federal court ruling because the premise of the ruling is that the blind of America are being unlawfully made victims of discrimination because we lack “meaningful access” to paper money, which is patently untrue. Hundreds of thousands of blind people use paper money every day without difficulty. Identifying items by touch (including currency) is convenient, but not essential to the ability of blind people to participate fully in society. For a court to say that if we cannot identify it by touch, we can’t use it is a fiction and a dangerous one. Millions of items that cannot be identified by touch must be managed by the blind in business, industry, and education every day; if the public comes to believe the myth that we cannot manage those items, then we will be denied the equality and opportunity we seek. If the paper money of the United States is to be changed, then the National Federation of the Blind must be consulted about what changes are to be made.”

About the National Federation of the Blind

With more than 50,000 members, the National Federation of the Blind is the largest and most influential membership organization of blind people in the United States. The NFB improves blind people’s lives through advocacy, education, research, technology, and programs encouraging independence and self-confidence. It is the leading force in the blindness field today and the voice of the nation’s blind. In January 2004 the NFB opened the National Federation of the Blind Jernigan Institute, the first research and training center in the United States for the blind led by the blind.

National Federation of the Blind

CIBA Vision, the eye care unit of Novartis, has reached a final global patent litigation settlement agreement with CooperVision, Inc. (NYSE: COO) that resolves all current patent infringement lawsuits between the two companies.

CIBA Vision has licensed its so called “Nicolson” patents to CooperVision. This will enable both companies to move forward in bringing forth new and improved innovations to meet the needs of eye care professionals and consumers. The Nicolson patents cover high-oxygen-transmissible contact lenses, including CIBA Vision’s O2OPTIX™, AIR OPTIX™ and NIGHT & DAY® silicone hydrogel contact lenses.

In exchange, CooperVision will pay CIBA Vision a royalty on US net sales of its Biofinity® contact lenses until 2014 and on net sales outside of the US until 2016. CIBA Vision also has licensed two patent families from CooperVision related to contact lens designs. Further terms of the agreement are confidential.

This follows a settlement of patent litigation, also involving the Nicolson patents, between CIBA Vision and Bausch & Lomb, reached in 2004, when CIBA Vision and Bausch & Lomb cross-licensed rights to their silicone hydrogel contact lens technologies. As part of the agreement, Bausch & Lomb agreed to pay CIBA Vision a royalty on net US sales of its PureVision™ brand contact lenses until 2014 and on net sales outside the US until 2016.

About CIBA Vision

With worldwide headquarters near Atlanta, CIBA Vision is a global leader in research, development and manufacturing of optical products and services, including contact lenses and lens care products. CIBA Vision products are available in more than 70 countries. For more information, visit the CIBA Vision web site at cibavision.

CIBA Vision is the eye care unit of Novartis, a world leader in offering medicines to protect health, cure disease and improve well-being. In 2006, the Group’s businesses achieved net sales of USD 37.0 billion and net income of USD 7.2 billion. Approximately USD 5.4 billion was invested in R&D. Headquartered in Basel, Switzerland, Novartis Group companies employ approximately 100,000 associates and operate in over 140 countries around the world. For more information, please visit novartis.

Disclaimer

The foregoing release contains forward-looking statements which can be identified by the use of terminology such as “will”, or similar expressions, or by express or implied discussions regarding the development of potential future products, or potential future revenue from royalties or from such potential future products. Such forward-looking statements reflect the current views of the Company regarding future events, and involve known and unknown risks, uncertainties and other factors that may cause actual results to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that will be successful in developing any such potential future products or in bringing them to market, or that CIBA Vision will earn any particular levels of revenue from royalties or from such potential future products. In particular, management’s expectations could be affected by, among other things, unexpected regulatory actions or delays or government regulation generally; unexpected difficulties in developing new products; competition in general; uncertainties as to sales by Cooper Vision of its products; and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those anticipated, believed, estimated or expected. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.

CIBA Vision

Retina Implant AG, a leading developer of subretinal implants for the visually impaired, announced that they will partner with the Wills Eye Institute in Philadelphia as the lead U.S. clinical trial investigator site. This partnership marks the first time Retina Implant’s subretinal implant technology will be utilized in studies by patients who suffer from retinitis pigmentosa in North America.

“The results of the subretinal approach in Europe demonstrate the great potential this implant has to impact dramatically the quality of life for our patients here in the United States,” said Dr. Julia A. Haller, ophthalmologist-in-chief, Wills Eye Institute. “Patients involved in previous clinical trials have achieved extraordinary success in their ability to regain useful vision. It is this life-changing success we hope to replicate with our own patients as Wills becomes the first institution in the U.S. to offer Retina Implant’s technology.”

Retina Implant’s subretinal implant technology has been in clinical trials for more than six years in Germany and plans to expand its second human clinical trial into the U.K. this summer. The results of their first human clinical trial proved to be superior to any other company in the retinal implant industry. Moreover, results of Retina Implant’s first human clinical trial were published in the prestigious peer-reviewed journal Proceedings of the Royal Society B last November. The results showed placement of the implant below the retina, in the macular region, provided optimum visual results allowing patients to recognize foreign objects and to read letters to form words.

“We are honored to work with one of the foremost eye care centers in the world to bring our product to the United States,” said Dr. Walter-G. Wrobel, president and CEO, Retina Implant AG. Reinhard Rubow, executive vice president and CFO, Retina Implant AG adds: “It is our hope that by offering patients in America with this technology that we, with the Wills Eye Institute, will be able to change the lives of those who are currently living in darkness.”

Wills Eye Institute was established in 1832 as the nation’s first eye care hospital and is recognized as a world-leader in the field of ophthalmology. Wills Eye has been ranked as one of the nation’s top three ophthalmology centers by the annual U.S. News & World Report survey since its inception in 1990, and provides a full-range of primary and sub-specialty eye care. Wills Eye is the only center in North America that will conduct this evaluation of artificial vision.

“Wills Eye Institute has a strong tradition of innovation and discovery, providing people who suffer from eye disorders with cutting-edge technology that can assist them in living the best possible life,” said Joseph P. Bilson, executive director, Wills Eye Institute. “We’re excited to be working with Retina Implant and continue our tradition by bringing this technological advance to people in the United States who have lost their vision due to retinitis pigmentosa.”

Source:

Wills Eye Institute

Retina Implant AG

In May of 2009,
StemCell Pharma, Inc. (SCPI) will organize an international
commission for the examination of Edi Leanca, a Romanian boy born
blind and diagnosed with Leber’s Congenital Amaurosis (LCA), the most
severe form of Retinitis Pigmentosa (RP), who regained his sight
after receiving stem cell implants. The technique used on Edi Leanca
is a proprietary technique owned by SCPI. The examination will take
place in Bucharest, Romania by a commission made up of retinal
experts with representatives from Romania, the European community,
Russia and the USA. A report will be issued regarding their
examination.

You may find the entire story of Edi Leanca on the SCPI website
stemcellpharmainc.

SCPI is a privately held Nevada corporation formed in May of 2005. It
owns the worldwide rights to two inventions (patents pending) namely:

1. An Amniotic Membrane Stem Cell Telomerase Enhanced Implant and…
2. “The Transsclera Technology for Delivery of Stem Cells plus
Enhancing Factors”

The first invention deals with a proprietary technique, whereby
using telomerase modulators, the number of multiplications of the stem
cells can be manipulated either by keeping them at normal rate or if
needed to increase their multiplication by extending the telomerase
lengths.

The second invention “The Transsclera Technology,” uses the SCPI
formulations (stem cells plus enhancing factors) applied on the
sclera (the white of the eye) where through a proprietary technique,
the formulations cross rapidly the retina layers, landing on the
retinal pigment epithelium (RPE) and the photoreceptors layers. It
is postulated that the stem cells would next, through a process of
differentiation become cones and rods, eventually clean the area of
damaged or dead photoreceptors, construct a new photoreceptor layer
and restore a certain degree of vision.

Based upon this technology, SCPI had developed blue prints that would
allow through setting up, licensing or joint venture (JV) agreements
to set up new stem cell clinics or with existing stem cell clinics
abroad.

Another project this time in the US would involve setting up an
experimental stem cell clinic authorized in Nevada. This project if
and when approved won’t be the first one successfully concluded. In
July of 1977, the Governor of Nevada Mike O’Callaghan signed the bill
H.R. 54 authorizing the manufacturing and marketing in Nevada of
Gerovital H3, GH3, the Romanian anti-aging drug brought to the US by
Dr. Sapse. Gerovital H3 is now used all over the US.

SCPI has also available two stem cell treatments in injectable form
containing formulations intended for retinal diseases and for the
treatment of aging and diseases associated with aging.

These products are intended for clinical trials FDA type, in the US
or abroad, and when or if approved for marketing, they would become
available to patients via medical prescriptions issued by treating
physicians. (Dr. Sapse President of StemCell Pharma, Inc. had
received US patents for the treatment of Alzheimer’s and depression
in an aging population.)

StemCell Pharma, Inc.

Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness in Americans older than 50, affecting more than two million people.

The American Academy of Ophthalmology wants to remind people that although AMD is incurable, there are new treatments that can usually recover lost vision and prevent further vision loss from the disease.

The Academy encourages those older than 50 to see an ophthalmologist for a comprehensive, dilated eye examination every one to two years to ensure that AMD and other vision-threatening conditions are detected and treated early.

“The key in treating AMD is catching it early; early detection is the best defense against losing your vision,” said Academy clinical correspondent Lylas G. Mogk, MD, chair of the Academy’s Vision Rehabilitation Committee. “Research continues, and I think we’ll see increasingly effective AMD treatments becoming available in the near future.”

What is AMD?

AMD, progressive and usually painless, affects the macula, a small, specialized area of the retina, located at the back of the eye and responsible for central vision. AMD causes central vision to blur, but leaves peripheral vision intact.

There are two types of AMD: dry and wet. Approximately 90 percent of people with AMD have the dry form, in which aging changes in the macula results in gradual vision loss.

Although only 10 percent of people with AMD have the wet form, it generally progresses much quicker than the dry form. Wet AMD is characterized by the growth of abnormal retinal blood vessels that leak blood or fluid, causing rapid and severe central vision loss.

Reducing AMD Risk

“The most important risk factors for AMD include smoking, high blood pressure and diet,” said Dr. Mogk. ” Recommendations for reducing the risk of developing AMD include not smoking; eating a heart-healthy diet rich in fish, fruit and green leafy vegetables; avoiding foods with trans fats; exercising and controlling your blood pressure and weight.”

Other risk reducers include:

— The National Eye Institute’s (NEI) Age-Related Eye Disease Study found that high levels of antioxidants and zinc can reduce the risk of vision loss by about 25 percent in patients with “intermediate” AMD in one or both eyes and those with “advanced” AMD in only one eye. (Smokers and ex-smokers should not use beta carotene because studies have shown an association with lung cancer and beta carotene in smokers.) A new study will evaluate the effects of lutein and omega-3 fatty acids.

— Anti-Vascular Endothelial Growth Factor (VEGF) drugs inhibit the development of unwanted blood vessels that cause wet AMD, and these agents help prevent further visual loss and even improve vision. At the current time, these are injected directly into the eye. Two drugs have already been approved by the FDA, Macugen and Lucentis, and the makers of several others are looking to gain FDA approval.

— Conventional laser therapy and photodynamic therapy are also treatments for wet AMD and have been approved by the FDA based on studies by the National Eye Institute (NEI).

About the American Academy of Ophthalmology

The American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons Eye M.D.s with more than 27,000 members worldwide. Eye health care is provided by the three “O’s” opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy’s Web site at aao/

American Academy of Ophthalmology (AAO)
655 Beach St. P.O. Box 7424
San Francisco, CA 94120-7424
United States
aao/

View drug information on Lucentis; Macugen; Photodynamic Therapy.

This month’s Ophthalmology, the journal of the American Academy of Ophthalmology, reports on the use of bevacizumab (Avastin) to benefit diabetic patients with macular edema as well as people who develop cystoid macular edema after cataract surgery. Bevacizumab is also used to treat some cancers. A third study describes methods that could make cataract surgery safer for diabetic retinopathy (DR) patients. DR is the major threat to vision in working-age people, a health issue that will only intensify if cases triple by 2050 as predicted.

New Treatment Succeeds after Laser Fails in Diabetic Patients; Treatment also Controls Cystoid Macular Edema after Cataract Surgery
DR damages the light-sensitive retina at the back of the eye, the area that transmits images to the optic nerve. In type 2 diabetes patients, retinopathy cfm vision loss most often results from macular edema (DME), swelling and thickening of the macula in the retina’s center. Laser treatment is usually able to reduce vision loss, but widespread, diffuse DME (DDME) is often resistant to laser and other standard treatments.

Treating DMME with bevacizumab (Avastin), an anti-vascular endothelial growth factor (anti-VEGF) medication that inhibits abnormal blood vessels, was studied in115 patients (139 eyes) by the Pan-American Collaborative Retina Study Group, led by J. Fernando Arevalo, MD, of the Caracas Central Ophthalmologic Clinic, Venezuela. Within one month of the initial intravitreal bevacizumab (IVB) injections, improvement could be detected. By the end of the 24 month follow-up period vision had improved in 51.8 percent of eyes, and 97.1 percent of eyes were either stable or improved. No serious adverse effects occurred.

The Pan-American Collaborative Retina Study Group also reviewed the use of bevacizumab in patients with post-cataract surgery cystoid macular edema (CME) who had not responded to standard treatment. Twenty to 30 percent of all cataract surgery patients develop CME, in which the macula swells as fluid-filled cysts form. Usually the condition resolves without treatment and causes no permanent vision loss, but in a small percentage of patients vision remains worse than 20/40 and treatment is needed. Standard treatments include steroids, non-steroidal anti-inflammatories (NSAIDs), other medications, or surgery.

The researchers reviewed the records of 31 patients (36 eyes) who were treated with at least one IVB injection and followed for 12 months between 2005 and 2007. At the study’s outset the mean best-corrected visual acuity was 20/200, and at 12 months the mean was 20/80. Most eyes (72.2 percent) improved and the rest remained stable (27.8 percent). Macular thickness also decreased in most eyes. Patients who received two or more injections were significantly more likely to improve. No adverse systemic or vision side effects or outcomes were reported.

“Large, randomized controlled clinical trials are needed to confirm IVB’s efficacy and safety in treating these conditions,” Dr. Arevalo said. “The results for DMME are very promising and suggest that combining anti-VEGF treatment with laser therapy may prove useful.” He added, “Also, once further study is completed, unresolved CME post-cataract surgery should be considered for inclusion as an indication for use of IVB.”

Extra Precautions Needed with Cataract Surgery for DR Patients

Before 1996, diabetic patients often experienced rapid retinopathy progression following cataract surgery. In the past decade the less-invasive phacoemulsification method has reduced cataract surgery complications in general, but the impact on diabetic retinopathy has been unclear. A clinic-based cohort study (2004 to 2006) led by Jie Jin Wang, MMed, PhD, at the Centre for Vision Research, University of Sydney, Australia, followed 169 diabetic patients aged 65 years and older for 12 months post-cataract surgery. Forty-five of these patients had surgery in just one eye.

Overall, DR developed or progressed in about one-third of operated eyes compared with about one-fifth of non-operated eyes. In the 45 patients for whom fellow eye comparisons were made, DR progressed in 35.6 percent of operated eyes versus 20 percent of non-operated eyes. Research on older cataract surgery methods had reported DR progression in 37 to 38 percent of eyes within 12 to 18 months of surgery; phacoemulsification is somewhat less likely to stimulate DR progression, the new study suggests. Dr. Wang cautions that patients who need cataract surgery may simply be at greater risk for DR progression, because both conditions are related to poor control of diabetes. Cataract may be a marker for greater DR severity or increased risk of progression.

“Although our results should not argue against cataract surgery in older people with diabetes, clinicians need to recognize the DR risk, treat active DR preoperatively-for example, use laser treatment to control macular edema and other active DR-and closely monitor diabetes and DR after cataract surgery,” Dr. Wang said.

Eds: Full texts of the studies are available from the Academy’s media relations department.

Source
American Academy of Ophthalmology

View drug information on Avastin.

Scientists at the Schepens Eye Research Institute, an affiliate of Harvard Medical School, have identified a key mechanism for successfully transplanting tissue into the adult central nervous system. The study found that a molecule known as MMP-2 (which is induced by stem cells) has the ability to break down barriers on the outer surface of a damaged retina and allow healthy donor cells to integrate and wire themselves into remaining recipient tissue. The finding, reported in the Journal of Neuroscience, holds great promise not only for patients with retinal disease, but for those suffering from spinal cord injuries and neurodegenerative disorders such as Parkinson’s and Alzheimer’s Diseases.

“This is a very significant finding,” says Dr. Michael Young, associate scientist at the Schepens Eye Research Institute and principal investigator of the study. “We believe that it will ultimately make retinal transplantation and restoration of vision a possibility.” He adds that transplantation of donor photoreceptors (in whole retina transplants) may prove to be more beneficial than transplanting stem cells alone, as these retinal transplants contain a complete organized supply of cells necessary for proper vision.

The regenerative capacity of central nervous system tissue in adult mammals, including human begins, is extremely limited. This is partly due to the formation of barriers, known as “glial” scars, which are triggered by the body to protect the injured retina or other nerve tissue from further damage. This dense scar tissue throws up a blockade to foreign cells, including transplants meant to heal and regenerate. This is what has made previous attempts to transplant whole donor retinas so difficult, according to Young.

On the other hand, in recent years, stem cells have been shown to overcome these physical barriers, easily penetrating the scar and integrating into the injured tissue. For instance, in studies published several years ago, Young and his colleagues demonstrated this special stem-cell talent in damaged mouse retinas. In those studies cells injected into injured retinas quickly integrated into the existing retinal tissue.

Intrigued by this phenomenon, Young and his team believed that if they could identify and harness the key molecules used by stem cells to gain access into the injured retina, they could potentially improve the success of non-stem cell transplants. Based on this idea, the team conducted a series of experiments.

In their initial experiments, the team compared the chemicals that were generated when stem cells were injected into damaged retinas and those produced when they attempted to transplant whole retina tissue into the eyes of mice with degenerated retinas. They found – in the stem cell injected retinas – an increase in the amount of and the level of activity of the molecule MMP-2 in host tissue. They concluded that this molecule dissolved the scar on the outer surface of the retina. There was no increase in MMP-2 when they attempted whole-retina transplants.

The team went on to transplant a layer of stem cells between the degenerating mice retinas and healthy donor tissue (whole retina). They found that MMP-2 induced removal of the scar barrier and allowed healthy donor cells (of the whole retina) to make new connections with the damaged retinas in the mice.

“These are very powerful results,” says Young. “We are convinced that the increase of this molecule is a major key to creating a permissive environment for central nervous system regeneration.”

The team is now investigating therapeutic approaches that would eliminate the need for stem cells. This would involve the use of just the MMP-2 molecule, which is already available in the pharmaceutical market, to foster a receptive transplant environment in the eye, and, in other CNS tissues.

Other scientists involved in the study include: Yiqin Zhang, Henry J. Klassen, Budd A. Tucker, and Maria-Thereza R. Perez.

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

Contact: Patti Jacobs

Schepens Eye Research Institute