Month: April 2013

Otsuka Pharmaceutical Co., Ltd. announced it has applied for regulatory approval in Japan to manufacture and market Mucosta® (rebamipide) ophthalmic suspension for treatment of dry eye. Dry eye is a chronic condition of the corneal and conjunctival epithelia resulting from a range of factors, and involves subjective symptoms including ocular discomfort and visual disturbance.

By its novel mechanism of action to promote the production of mucin in the ocular surface (both the cornea and the conjunctiva), Mucosta ophthalmic suspension stabilizes the tear film and has demonstrated effectiveness in dry eye treatment. In a clinical trial conducted in Japan, it was confirmed that in addition to the improvement in corneal-conjunctival damage in patients with dry eye, Mucosta ophthalmic suspension also showed improvements in subjective symptoms.

Dry eye is one of the most common problems treated by ophthalmologists. It is thought that in people with dry eye, the amount of mucin in the tear decreases, resulting in instability in the aqueous layer covering the mucin layer, leading to damages to the corneal and conjunctival epithelia. Additionally, people with dry eye suffer from unpleasant sensory symptoms such as “dryness, ” “gritty/sandy sensation,” and “eye pain,” as well as subjective symptoms relating to vision, including “difficulty seeing” and “blurred vision.” Such symptoms vary considerably in degree but often interfere with dry eye sufferers’ daily lives.

Rebamipide, the active ingredient in Mucosta ophthalmic suspension, was discovered by Otsuka Pharmaceutical and first launched as Mucosta Tablets in 1990 in Japan as an anti-gastric ulcer agent. In 1994, a supplemental indication for the treatment of gastric mucosal lesions (erosion, bleeding, reddening, edema) stemming from gastritis (acute gastritis, acute exacerbation of chronic gastritis) was approved. While exploring the potential of this compound, Otsuka Pharmaceutical focused on the mucin-increasing mechanism of Rebamipide, and Mocosta ophthalmic suspension was developed as a novel dry eye treatment that acts on the decreased amount of mucin in the tear, resulting in dry eye.

Based on its corporate philosophy of “Otsuka-people creating new products for better health worldwide,” Otsuka Pharmaceutical Co., Ltd. is dedicated to contributing to the health of people around the world.

Source: Otsuka Pharmaceutical Co., Ltd

In June, Army Reserve Officer and University of Houston College of Optometry (UHCO) alumnus Dr. Ben Uhl learned he was shipping off to care for the eyes of American and NATO soldiers, sailors, airmen and marines in Afghanistan. As he made his way through the war-torn country, Uhl soon realized that he was not the only Houston Cougar serving in this capacity.

Upon arriving in Afghanistan, Uhl synced up with three additional UHCO graduates providing eye care to the troops. Fellow graduates Drs. David Miller, Danny Elizando and Kerry Phelan also are stationed in Afghanistan, solely responsible for the eye care of the more than 90,000 troops stationed in the country. The services they are providing have proven especially valuable considering that recent data has shown eye injuries account for roughly 10 percent of all battlefield wounds.

“We’re a critical wartime specialty shortage, so they need us,” said Uhl. “There are certain military occupational specialties that the Army doesn’t have enough of, and optometry is one of them.”

Uhl is currently stationed at Kandahar Airfield, a NATO facility, and tasked with setting up a new clinic. NATO and American troops, locals and detainees all will benefit from the treatment provided by clinic staff. Uhl will be deployed for 400 days, but the clinic will likely remain even after the American military operations are complete.

Not long into his deployment, Uhl began to cross paths with his Cougar connections. In July, he met up with Miller in Kabul and learned that UHCO class of 2007 graduate Phelan also was stationed in Afghanistan. Elizando rounds out the group of alumni, having graduated from UHCO in 1979. Elizando subsequently went to medical school and later became an ophthalmologist.

“Uhl, Miller, Elizando and Phelan are great role models for our students and the UH community,” said Earl Smith, UHCO dean. “All of us here at UHCO wish them success with their missions and a safe return home.”

Prior to his current deployment, Uhl served four years in the Army, including Operations Enduring Freedom and Iraqi Freedom. He returned to the United States after his tours and entered optometry school at UHCO. By 2008, he graduated with honors and continued to serve as a reservist. Shortly thereafter, Uhl’s passion for eye care and serving his country would lead him to Afghanistan, and beyond the mountains of Panama, where he treated more than 1,000 Panamanians in only 10 days. When not deployed, Uhl practices at Plymouth County Eye Care in Le Mars, Iowa, and Sergeant Bluff Eye Care in Sergeant Bluff, Iowa.

Source:

University of Houston

UH College of Optometry

Researchers at the University of Washington (UW) have reported for the first time that mammals can be stimulated to regrow inner nerve cells in their damaged retinas. Located in the back of the eye, the retina’s role in vision is to convert light into nerve impulses to the brain.

The findings on retina self-repair in mammals will be published this week in the Early Edition of the Proceedings of the National Academy of Sciences. Other scientists have shown before that certain retina nerve cells from mice can proliferate in a laboratory dish. Today’s report gives evidence that retina cells can be encouraged to regenerate in living mice.

The UW researchers in the laboratory of Dr. Tom Reh, professor of biological structure, studied a particular retinal cell called the M??ller glia.

“This type of cell exists in all the retinas of all vertebrates,” Reh said, “so the cellular source for regeneration is present in the human retina.” He added that further studies of the potential of these cells to regenerate and of methods to re-generate them may lead to new treatments for vision loss from retina-damaging diseases, like macular degeneration.

The researchers pointed out the remarkable ability of cold-blooded vertebrates like fish to regenerate their retinas after damage. Birds, which are warm-blooded, have some limited ability to regenerate retinal nerve cells after exposure to nerve toxins. Fish can generate all types of retinal nerve cells, the researcher said, but chicks produce only a few types of retinal nerve cell replacements, and few, if any, receptors for detecting light.

M??ller glia cells generally stop dividing after a baby’s eyes pass a certain developmental stage. In both fish and birds, the researchers explained, damage to retinal cells prompts the specialized M??ller glia cells to start dividing again and to increase their options by becoming a more general type of cell called a progenitor cell. These progenitor cells can then turn into any of several types of specialized nerve cells.

Compared to birds, the scientist said, mammals have an even more limited M??ller glia cell response to injury. In an injured mouse or rat retina, the cells may react and become larger, but few start dividing again.

Because the M??ller glia cells appeared to have the potential to regrow but won’t do so spontaneously after an injury, several groups of researchers have tried to stimulate them to grow in lab dishes and in lab animals by injecting cell growth factors or factors that re-activate certain genes that were silenced after embryonic development. These studies showed that the M??ller glia cells could be artificially stimulated to start dividing again, and some began to show light-detecting receptors. However, these studies, the researchers noted, weren’t able to detect any regenerated inner retina nerve cells, except when the M??ller glia cells were genetically modified with genes that specifically promote the formation of amacrine cells, which act as intermediaries in transmitting nerve signals.

“This was puzzling,” Reh said, “because in chicks amacrine cells are the primary retinal cells that are regenerated after injury.” To resolve the discrepancy between what was detected in chicks and not detected in rodents, the Reh laboratory conducted a systematic analysis of the response to injury in the mouse retina, and the effects of specific growth factor stimulation on the proliferation of M??ller glia cells.

The researchers injected a substance into the retina to eliminate ganglion cells (a type of nerve cell found near the surface of the retina) and amacrine cells. Then by injecting the eye with epidermal growth factor (EGF), fibroblast growth factor 1 (FGF1) or a combination of FGF1 and insulin, they were able to stimulate the M??ller glia cells to re-start their dividing engines and begin to proliferate across the retina.

The proliferating M??ller glia cells first transformed into unspecialized cells. The researchers were able to detect this transformation by checking for chemical markers that indicate progenitor cells. Soon some of these general cells changed into amacrine cells. The researchers detected their presence by checking for chemicals produced only by amacrine cells.

Many of the progenitor cells arising from the dividing M??ller glia cells, the researchers observed, died within the first week after their production. However, those that managed to turn into amacrine cells survived for at least 30 days.

“It’s not clear why this occurs,” the researchers wrote, “but some speculate that nerve cells have to make stable connections with other cells to survive.”

In addition to Reh, the authors of the research findings, “Stimulation of Neural Regeneration in the Mouse Retina,” were Mike O. Karl, Susan Hayes, Branden Nelson, Kristine Tan, and Brian Buckingham, all of the UW Department of Biological Structure. The research was supported by postdoctoral fellowships from the German Research Foundation, ProRetina Travel Grants, National Research Service Awards, and a National Eye Institute grant from the National Institutes of Health.

Source: Leila Gray

University of Washington

Cataract surgery and AMD; Eye of the beholder; ‘Normal’ visual decline

Does cataract surgery increase the risk of vision loss in people with age-related macular degeneration (AMD)? How do people read faces to judge age or fatigue? Which has a larger impact on the “normal” decline of visual function as we age, genetic or environmental factors? These questions are explored in the February issue of Ophthalmology, the journal of the American Academy of Ophthalmology.

Age-Related Eye Disease Study (AREDS) Examines Macular Degeneration Risk Related to Cataract Surgery

Age-related macular degeneration (AMD) and cataract are leading causes of visual impairment in the United States. Both are related to aging, and they share other risk factors, but it has been unclear whether a direct causal link might be involved. Several large epidemiological studies had raised concern that cataract surgery might accelerate AMD progress and threaten vision. To address this concern, Emily Y. Chew, MD, of the National Eye Institute, and colleagues analyzed data for a cohort of participants in the Age-Related Eye Disease Study (AREDS). This cohort is the only large prospective study in which the severity of AMD was documented before and after cataract surgery and which included more than five years of in-depth participant follow-up.

AMD causes changes in the retina, the light-sensitive tissue that focuses images at the back of the eye, and severe AMD leads to loss of central vision. Cataract is cloudiness or opacity in the eye’s lens that interferes with the clear focus of images on the retina.

AREDS researchers concluded there was little evidence that cataract surgery had a negative effect on progression to advanced AMD. “These data may provide some reassurance to patients with AMD who are considering cataract surgery,” Dr. Chew said.

The primary purpose of the AREDS multicenter controlled randomized clinical trial was to assess whether antioxidant and mineral supplements affect progress to advanced AMD and development of cataracts. The cohort study included 4,577 participants (8,050 eyes) aged 55 through 81 at enrollment; it compared the risk of advanced AMD in patients who had cataracts removed versus the risk for those who did not have the surgery. All participants took either antioxidant/mineral supplements or placebos. Study eyes were examined every six months over five or more years. One analysis compared AMD progression in matched pairs of eyes, where one eye had cataract surgery after baseline but before developing advanced AMD, and the paired eye did not have cataract surgery. Matched pairs were determined based on similar risk factors for AMD, assigned antioxidant or placebo treatment, baseline AMD category, person’s age, and other factors. Results of the matched pair analysis and of two other standard analytical models revealed no consistent pattern of accelerated AMD progression after cataract surgery.

Several factors may explain the divergent conclusions reached by AREDS and the earlier studies. The most likely cause would be that earlier studies had unintended biases or confounding variables. Also, techniques of cataract surgery and lens replacement have changed over time, and AREDS participant surgeries were performed more recently than those tracked in the combined-population studies. A significant number of subjects in earlier studies did not have lens replacement after cataract extraction, while AREDS participants were likely to have had ultraviolet-B light blocking lenses inserted, which may have protected their maculae and decreased AMD risk.

Old or Tired? How People Read and Rate Faces

A recent study led by Peter A. D. Rubin, MD, of the University of Tennessee Health Science Center, used eye-tracking methodology to determine how signs of age or fatigue are assessed. Based on their experiences with patients, the researchers hypothesized that the eye area would be especially important. Social psychology research confirms that an attractive appearance enhances everything from a person’s self-esteem to job prospects, and Dr. Rubin’s group wanted to learn which facial features are key to a youthful, lively appearance. They assumed this information would be useful to people considering plastic surgery.

Forty-seven young adults (15 males, 32 females) were recruited from student populations in the Boston area; all passed vision screening tests. In each of two sessions a participant viewed photo images of 48 older individuals on a computer monitor equipped with a camera that analyzed infrared reflection from the eye’s pupil and cornea to determine duration and direction of the gaze. This device, located in the Brandeis University Emotion Laboratory of Derek Issacowitz, PhD, allowed Dr. Rubin’s group to quantitatively measure gaze patterns related to subjective judgments about age and fatigue. The images showed individuals’ faces in neutral expressions, photographed under standardized conditions; the faces were divided into “LookZones” for data analysis. After viewing the image for five seconds, the participant clicked a selection on a rating scale. Age was assessed in the first session and tiredness in the second.

In rating age, participants most often looked at the eye region (46%), the nose (19.2%), the forehead (13.3%), and the region between the eyebrows (10.6%). The eye region was also most frequently selected in rating fatigue (44.7%), followed by the nose (18%), forehead (13.7%) and area between the brows (12.3%). Participants also looked longest at the eye region in both assessment sessions, concentrating on the brow and lower lids. Since the eye region represents just 21% of the area of the face, clearly this area is disproportionately important to such judgments. Overall, results indicated a strong relationship between the way facial regions were used in assessments of age and of fatigue. Because static rather than video images were used, the study did not determine whether attention would be drawn toward the mouth during speech. The researchers note that people from age groups other than young adult might assess facial features differently than this study’s participant group.

“Our results raise the possibility that aesthetic surgery to the eye region may be an efficient, effective intervention to enhance an individual’s attractiveness by reducing how old or tired one appears,” Dr. Rubin said. “Apparently, beauty is not only in the eye of the beholder, but also in the eye of the beholdee,” he quipped. American Society of Plastic Surgery 2007 statistics list eyelid surgery as the fourth most common procedure performed in the United States. Dr. Rubin’s next study will rate age and fatigue perceptions using images of patients before and after cosmetic surgery.

Visual Decline as We Age: Genetics or Environment?

Vision worsens for most of us as we age, even in the absence of eye diseases such as glaucoma or AMD. Elders who have good visual acuity (20/25 vision or better) may have trouble driving at night or adjusting when they move between indoor and outdoor light. Some declines are optic, such as presbyopia, reduced flexibility of the eye’s lens, which causes poorer near vision for many people after age 40. Other declines are neuronal, related to the eye’s ability to send images to the brain. Since crucial functions like reading and memory depend on vision, it is important to understand how “normal” aging occurs and discover what can be done to delay or prevent reduced function. In the first investigation of heredity’s impact on neuronal visual decline, Ruth E. Hogg, PhD, of the University of Melbourne, Australia, and her colleagues used a classic twin study to explore genetic and environmental factors.

Study participants were a cohort of the AMD twin study by the University of Melbourne Centre for Eye Research, comprised of eighty-four twins (42 pairs, 21 identical and 21fraternal) between the ages of 57 and 75 who met study criteria for visual acuity and absence of eye disease. In each person the eye with the best visual acuity (or the right eye if acuity was equal in both eyes) was tested for adaptation to light level changes, for color detection, and for detection of gray tone gradations between image and background, termed contrast sensitivity. Taken together, these tests assess key visual functions needed in daily life. When test results showed that a visual ability declined at about the same age in identical twins, the trait was assumed to be under genetic control, and when the decline occurred at different ages, environmental factors were considered dominant. Results for identical twins and fraternal (non-identical) were compared, and when concordance between scores was higher for identical than for fraternal pairs, genetics was assumed to be the controlling factor.

Genetic factors appear to be strong determinants of sharp visual acuity and color discrimination, functions performed by cone cells pathways in the eye’s retina, the tissue at the back of the eye that converts light into electronic images for relay to the brain. Genetic factors were not strongly correlated with night vision and the ability to adapt to light level changes, which are performed by retinal rod cells, implying that environmental influences are important to those functions. Autopsies and other studies have found that substantially more rod than cone cells are lost as eyes age. The flow of nutrients across the retinal membrane appears to be more important for rod cell than for cone cell function, and it is here that environmental factors – such as smoking, deficient nutrition, excessive sunlight exposure, and inflammation – may influence visual decline. Rod cell deterioration is accepted as a component of both general visual decline and age-related diseases like AMD, the most common cause of visual disability in elders.

“Our results support clinical and research efforts now underway to slow or stop age-related vision decline by modifying lifestyle factors and/or using specific medications,” says Dr. Hogg.

About the American Academy of Ophthalmology

AAO 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/

Source: Mary Wade

American Academy of Ophthalmology

Studies from the May 2005 issue of Ophthalmology, the clinical journal of the American Academy of Ophthalmology, are now
available. These include:

— How Can We Insure That Neuro-ophthalmology Will Survive?

— Management of the Patient with Suspected Temporal Arteritis: A Decision-Analytic Approach

— The Diagnostic Yield of the Evaluation for Isolated Unexplained Optic Atrophy

— Diabetes and Hypertension in Isolated Sixth Nerve Palsy: A Population-Based Study

— Initial Evaluation of Subcutaneous Daclizumab Treatments for Noninfectious Uveitis: A Multicenter Noncomparative
Interventional Case Series

— Risk Factors for Mortality in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy

— Pathological Findings in Eyes with the Ganciclovir Implant

— 14-Year Incidence, Progression, and Visual Morbidity of Age-Related Maculopathy: The Copenhagen City Eye Study

— Hyperglycemia, Blood Pressure, and the 9-Year Incidence of Diabetic Retinopathy: The Barbados Eye Studies

— Vitreous Levels of Vascular Endothelial Growth Factor and Intercellular Adhesion Molecule 1 Are Related to
Diabetic Macular Edema

— Outcomes of 140 Consecutive Cases of 25-Gauge Transconjunctival Surgery for Posterior Segment Disease

— Fundus Autofluorescence and Central Serous Chorioretinopathy

— Ruthenium Brachytherapy for Uveal Melanoma, 1979-2003: Survival and Functional Outcomes in the Swedish Population

— Grouped Congenital Hypertrophy of the Retinal Pigment Epithelium Follows Developmental Patterns of Pigmentary
Mosaicism

— Fundus Perimetry with the Micro Perimeter 1 in Normals: Comparison to Conventional Threshold Perimetry

— Discrimination of Glaucomatous Optic Neuropathy by Digital Stereoscopic Analysis

— Does Adjunctive Glaucoma Therapy Affect Adherence to the Initial Primary Therapy?

— Safety and Efficacy of Phacoemulsification Compared with Manual Small-Incision Cataract Surgery by a Randomized
Controlled Clinical Trial: 6-Week Results

— Anterior Vitreous Tapping to Manage Positive Vitreous Pressure during Triple Procedures

— Role of Hyaluronidase in Diplopia after Peribulbar Anesthesia for Cataract Surgery

— Detection of Virulence Factors in a Corneal Isolate of Klebsiella pneumoniae

— Incidence of Herpes Simplex Virus Keratitis in France

— Intraoperative Mitomycin C and Amniotic Membrane Transplantation for Fornix Reconstruction in Severe Cicatricial
Ocular Surface Diseases

— Correlation of Corneal Complications with Eyelid Cicatricial Pathologies in Patients with Stevens-Johnson Syndrome
and Toxic Epidermal Necrolysis Syndrome

— Intralesional Triamcinolone Acetonide Injection for Primary and Recurrent Chalazia: Is It Really Effective?

— Paradoxical Use of Frontalis Muscle and the Possible Role of Botulinum A Toxin in Permanent Motor Relearning

— Simultaneous Orbital Decompression and Correction of Upper Eyelid Retraction versus Staged Procedures in
Thyroid-Related Orbitopathy

— Combined Rectus Muscle Transposition with Posterior Fixation Sutures for the Treatment of Double-Elevator Palsy

— Full Vertical Rectus Muscle Transposition Combined with Medial Posterior Fixation Sutures for Patients with
Adduction Deficiency

To receive a copy of these studies, please contact the media relations unit at the American Academy of Ophthalmology at (415)
561-8534, mediaaao.

The American Academy of Opthalmology is the world’s largest association of eye physicians and surgeons–Eye M.D.s–with more
than 27,000 members.

Contact: Media Relations
mediaaao
415-561-8534
American Academy of Ophthalmology
aao

Although both adults and children are subject to the effects of ultraviolet (UV) radiation, younger eyes are more susceptible to exposure to the sun’s harmful rays. Eye care professionals note that glasses with a UV-blocking coating and sunglasses do not offer complete protection, and advise parents also to consider UV-blocking contact lenses for children who need vision correction to fill in some of the eye health gaps left by these more traditional means.

Compared to their parents, children have larger pupils (allowing more light into their eyes), clearer lenses, and are outside without eye protection much more frequently and for longer periods than most adults. It is estimated that 80 percent of lifetime exposure to UV occurs by age 18 and that children’s annual dose of UV radiation is three times that of adults.

“Short-term damage to the eyes is hard to notice, but over the long-term the sun can cause irreversible harm to all structures of the eye and surrounding tissue that are left unprotected or under-protected,” says Christine W. Sindt, OD, FAAO, Assistant Professor of Clinical Ophthalmology, University of Iowa. “The effects of UV radiation are cumulative over a person’s lifetime, so exposure may contribute to the development of various ocular disorders including age-related cataract.”

“These conditions may not manifest for years at which point the damage is already done and it is too late to reverse the effects of the sun,” adds Dr.Sindt. “That’s why it is important to get maximum protection beginning in childhood. The greatest measure of UV protection can be achieved with a combination of UV-absorbing sunglasses, a wide brimmed hat, and UV-blocking contact lenses.”

Why Sunglasses Alone Are Not Enough

While most sunglasses can help block UV rays that enter through the lenses, most frame styles do not prevent unfiltered rays from reaching the eyes from the sides, top, and/or bottom of the glasses. “Because of this, some sunglasses block as little as 50 percent of all UV radiation from reaching the eyes,” explains Dr. Sindt. Similarly, hats with brims offer no protection from UV rays reflected up from surfaces such as pavement, sand and water.

Added Protection for Contact Lens Wearers

UV-blocking contact lenses offer unique protection against the direct and reflected rays that pass through the cornea into the eye, and are not blocked by sunglasses or hats. “This provides contact lens wearers with an important added measure of protection,” says Dr.Sindt.

However, not all contact lenses offer UV protection, and, of those that do, not all provide similar absorption levels. Among contact lens brands, only ACUVUE® ADVANCE™, ACUVUE® ADVANCE™ for ASTIGMATISM, and ACUVUE® OASYS™ Contact Lens brands carry the Seal of Acceptance for Ultraviolet Absorbing Contact Lenses from the American Optometric Association’s Commission on Ophthalmic Standards. The lenses are the only ones to offer the highest level of UV-blocking??�* available, blocking more than 90 percent of UVA rays and 99 percent of UVB rays that reach the lens. On average, contact lenses without UV blocking block approximately 10 percent of UV-A radiation and 30 percent of UV-B radiation.

Although UV-blocking contact lenses provide important added protection for patients, they should not be viewed as a stand-alone solution. “Contact lenses should always be worn in conjunction with high-quality UV-blocking sunglasses and a wide-brimmed hat,” says Dr.Sindt.

Can children wear contacts?

There is no minimum age requirement for contact lenses. According to the recently conducted Contact Lens In Pediatrics (CLIP) study, the first clinical investigation to compare children under 12 years of age and teens using silicone hydrogel contact lenses, researchers report that children as young as eight years old who need refractive error correction are as capable as teenagers at wearing and caring for soft contact lenses.

“Contact lenses often provide a more convenient mode of correction for young wearers,” says Dr.Sindt. “Contacts that provide protection from UV-radiation offer a value-added benefit that can help keep eyes vital and healthy.”

ACUVUE® ADVANCE™ Brand Contact Lenses with HYDRACLEAR™, ACUVUE ADVANCE™ for ASTIGMATISM and ACUVUE® OASYS™ Brand Contact Lenses with HYDRACLEAR™ PLUS are indicated for daily wear vision correction. ACUVUE® OASYS™ may also be worn for up to six consecutive nights/seven days of extended wear as recommended by an eye care professional. Contact lenses should not be worn for longer periods than recommended by an eye care professional. As with all contact lenses, eye problems, including corneal ulcers, can develop. Some wearers may also experience mild irritation, itching or discomfort. Lenses should not be worn if the wearer has an eye infection or experiences eye discomfort, excessive tearing, vision changes, redness or other eye problems. If these conditions occur, the wearer should contact their eye care professional. Consult the patient information guide available from your doctor for complete information. For further information visit acuvue.

About Johnson & Johnson Vision Care Inc.

The VISTAKON division of Johnson & Johnson Vision Care, Inc., specializes in disposable contact lenses which it markets under such brand names as ACUVUE®, ACUVUE® ADVANCE™ with HYDRACLEAR™, ACUVUE® ADVANCE™ for ASTIGMATISM, ACUVUE® OASYS™ with HYDRACLEAR™ PLUS, ACUVUE® and ACUVUE® 2; 1-DAY ACUVUE®; 1-DAY ACUVUE® MOIST™, ACUVUE® BIFOCAL; ACUVUE® TORIC, and ACUVUE® 2 COLOURS™.

ACUVUE®, ACUVUE® ADVANCE™, HYDRACLEAR™, ACUVUE® OASYS™, ACUVUE® 2 COLOURS™, and VISTAKON® are trademarks of Johnson & Johnson Vision Care, Inc.

Helps protect against transmission of harmful UV radiation to the cornea and into the eye.

WARNING: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE: Long term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-Blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-Blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information.

Researchers presented study results that indicate that subconjunctivally delivered insulin ameliorates degenerative and inflammatory responses in diabetic rat retinas at the Association for Research in Vision and Ophthalmology (ARVO) 2007 Annual Meeting in Fort Lauderdale, Fla.

Regular human insulin in doses ranging from 0.01U to 1U was injected subconjunctivally in control and 1 month diabetic male Sprague Dawley (SD) rats. The biological effects of subconjunctival insulin on the retina were analyzed using immunoblotting, kinase assays and immunohistochemical analysis. Additionally, insulin-loaded hydrogels were designed for subconjunctival implantation to provide low levels of insulin to the retina for prolonged periods. The hydrogels were engineered to be thermoresponsive and hydrolytically degradable, and their pharmacokinetic and pharmacodynamic properties were studied in vitro and in vivo using R28 cells in culture and SD rats respectively.

Lead researcher Ravi S.J. Singh, MD, of the Pennsylvania State College of Medicine in Hershey, Penn., reports that low dose periocular delivery of insulin to the retina of diabetic rats does not alter blood glucose levels and may treat early diabetic retinopathy.

Established in 1928, ARVO is a membership organization of more than 11,700 eye and vision researchers from over 70 countries. The Association encourages and assists its members and others in research, training, publication and dissemination of knowledge in vision and ophthalmology. ARVO’s headquarters are located in Rockville, Md. For more information, logon to arvo/.

Contact: Karen Colson

Association for Research in Vision and Ophthalmology

Eye Health Month is off to an exciting start, with the recent announcement by MUHC researcher Dr. Robert Koenekoop and his colleagues of a breakthrough discovery in the genetics of childhood blindness. The new study identified the gene most often responsible for LCA (Leber Congenital Amaurosis), the commonest form of congenital blindness. “This discovery represents a significant advance in the fight against this debilitating condition.” says Dr. Koenekoop, Director of the McGill Ocular Genetics Centre at the MUHC and Associate Professor in Ophthalmology, Human Genetics at McGill University. He is also principal co-investigator of this study with Dr. Anneke den Hollander, and Dr. Frans Cremers from The University of Nijmegen in the Netherlands.

LCA causes blindness from birth or during the first few months of life. About 600 patients with LCA are currently being diagnosed and managed at the McGill Ocular Genetics Center of the MUHC, directed by Dr. Koenekoop. The disorder affects 1 in 30,000 newborns, and is currently incurable. “This is about to change, however,” says Dr. Koenekoop. “Our discovery has major implications for improved screening. It also opens avenues for treatment of LCA.”

Discovery of the CEP290 gene and a single mutation found in 20 percent of LCA patients will significantly speed up the genetic testing process for blind children. From a therapeutic viewpoint, this discovery adds another pathway for possible therapeutic manipulation and paves the way for a human gene replacement trial of a related LCA gene (RPE65) in early 2007. If this trial is successful, gene replacement therapy may not be far off.

Prior to Dr. Koenekoop’s discovery, LCA had been linked to mutations in eight genes. Together, these mutations account for about 45 percent of cases. By studying members of a Quebec family affected by LCA, Dr. Koenekoop’s team, which includes research associate and molecular biologist Dr. Irma Lopez, was able to identify a mutation in a gene known as CEP290. This mutation was detected in 21 percent of unrelated cases – making it one of the most common causes of LCA yet identified. The team’s research, which was funded by the Foundation Fighting Blindness Canada, was published in the September 2006 issue of The American Journal of Human Genetics.

“The Foundation Fighting Blindness is dedicated to funding the best research in Canada and Dr. Koenekoop’s new gene discovery proves that,” says Sharon Colle, National Executive Director. “We believe that childhood blindness is intolerable and that cures really are in sight.” The MUHC, in collaboration with Dr. Anneke den Hollander and Dr. Frans Cremers from the University of Nijmegen, will continue research into LCA, conducting functional studies of the CEP290 gene and screening more patients for CEP290 mutations.

Quebec is the perfect place to study genetic diseases like LCA. Quebec’s population of approximately 6 million is known as a “founder population” because it can be traced back to a small number (approximately 250) of forefathers. This small gene pool provides the ideal population for the study of genetic disease. “Genetic diseases like LCA are more common in founder populations,” says Dr. Koenekoop. “Our patients are enthusiastic about participating in these studies. They realize this research may ultimately lead to improved diagnosis, treatments and cures.”

The Montreal Children’s Hospital is the pediatric teaching hospital of the McGill University Health Centre (MUHC). The institution is a leader in the care and treatment of sick infants, children, and adolescents from across Quebec. The Montreal Children’s Hospital provides a high level and broad scope of health care services, and provides ultra specialized care in many fields including: cardiology and cardiac surgery; neurology and neurosurgery, traumatology; genetic research; psychiatry and child development and musculoskeletal conditions, including orthopedics and rheumatology. Fully bilingual and multicultural, the institution respectfully serves an increasingly diverse community in more than 50 languages. thechildren/

The McGill University Health Centre is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at McGill University–the Montreal Children’s, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge.

Contact: Ian Popple

McGill University

As the smoking ban comes into force in England a survey published recently by the Royal National Institute of Blind People (RNIB) reveals that just 30 per cent of people in the UK know that smoking can cause blindness.

The UK’s 13 million smokers are at least twice as likely as non-smokers to lose their sight in later life yet most people are not even aware of this extra reason to give up.

The link between smoking and AMD (age-related macular degeneration) is as robust as the link between smoking and lung cancer, yet few people know this or have even heard of AMD5. AMD is the UK’s leading cause of sight loss – there are around 500,000 people in the UK with the condition – and an estimated 54,000 people have the condition as a result of smoking.

Barbara McLaughlan, RNIB Campaigns Manager, said: “Smoking is the only proven cause of AMD that people can do anything about yet our research shows that only a small percentage know this. With the smoking ban now in force in England this gives everyone trying to quit another very strong incentive.

“RNIB is calling on the Government to introduce specific warnings on cigarette packets and to fund a major public awareness campaign on the dangers of smoking to your eyesight.”

The benefits of quitting smoking are very real. Studies have shown that people who stopped smoking 20 years ago have a similar risk of developing AMD as non-smokers do and the risk starts to decrease after ten years of not smoking5.

— Every day another 100 people in the UK will start to lose their sight. There are around two million people in the UK with sight problems. RNIB is the leading charity working in the UK offering practical support, advice and information for anyone with sight difficulties. If you, or someone you know, has a sight problem RNIB can help. Call the RNIB Helpline on 0845 766 9999 or visit w www.rnib .

— TNS OnLineBus survey commissioned by RNIB asking the question: Did you know that smoking can cause blindness?

— Smoking and Age-Related Macular Degeneration: A Review of Association, Thornton J, Edwards R, Mitchell P, Harrison R, Buchan I, Kelly SP, published in Eye 07/09/2005

— Kelly SP, Thornton J, Lyratzopolous G, et al: Smoking and blindness, British Medical Journal 2004; 328: 537- 8

— AMD Campaign Report 2005 (UK), Awareness of Age-related Macular Degeneration and Associated Risk Factors, Barbara McLaughan, 07/09/2005.

Royal National Institute of Blind People

A research team at the Institut de recherches cliniques de Montreal (IRCM), funded by the Foundation Fighting Blindness – Canada and the Canadian Institutes of Health Research (CIHR), discovered a novel mechanism that regulates how neural stem cells of the retina generate the appropriate cell type at the right time during normal development. These findings, published in the renowned journal Neuron, could influence the development of future cell replacement therapies for genetic eye diseases that cause blindness.

In their report, the scientists show that a gene called Ikaros is expressed in the most immature retinal stem cells in the mouse, which are “competent” to generate all seven different cell types that compose the retina. But this gene is not expressed in the “older” stem cells, which are more restricted in their differentiation potential and produce only the late-born neurons. “By studying the retina of a mouse in which the Ikaros gene was inactivated, we found that the generation of early-born retinal cell types was impaired, whereas the generation of the late-born retinal cell types was not affected,” explained Dr. Michel Cayouette who led the study. In contrast, forcing the expression of Ikaros in older retinal stem cells, which have normally turned off its expression, was sufficient to give back the competence to these cells to generate early-born neurons. Overall, these results indicate that the expression of Ikaros in retinal stem cells is both necessary and sufficient to confer the competence to generate early-born retinal neurons.

The identification of adult retinal stem cells in recent years has opened up the possibility that such cells could one day be used to replace damaged or lost cells in various retinal diseases such as glaucoma, macular degeneration or retinitis pigmentosa. For such approaches to be effective, however, it is crucial that stem cells generate only the appropriate cell type for a particular condition. This study suggests that it may be possible to manipulate the competence of retinal stem cells so that they only generate retinal cells associated to a particular temporal stage. “For example, added Dr. Cayouette, inactivating Ikaros could favor the production of later-born neurons such as photoreceptors, which are lost progressively in retinal degenerative diseases.” Future studies will be required to assess the usefulness of this approach for potential cell replacement therapies.

Reference: Jimmy Elliott, Christine Jolicoeur, Vasanth Ramamurthy, and Michel Cayouette. (2008) Ikaros confers early temporal competence to mouse retinal progenitor cells. Neuron Volume 60 October 9, 2008, 26-39.

Dr. Michel Cayouette is Director of the Cellular Neurobiology Research Unit at the IRCM. Dr. Cayouette is also Associate Researcher at the Universit?� de Montr?�al. This research is supported by grants from the Foundation Fighting Blindness – Canada and the Canadian Institutes of Health Research (CIHR).

Established in 1967, the IRCM (ircm.qc/) now has 37 research units specialized in areas as diversified as systems biology, immunity and viral infections, cardiovascular and metabolic diseases, cancer, medicinal chemistry, clinical research and ethical reflection. It has a staff of more than 450. The IRCM is an independent institution, affiliated to Universit?� de Montr?�al. It has built over the years a close collaboration with McGill University.

Information:
Michel Cayouette, PhD
Director of the Cellular Neurobiology Research Unit
ircm.qc/microsites/

cayouette/en

Source: Lucette Th?�riault

Institut de recherches cliniques de Montreal