Month: July 2014

Females under the age of 75 years whose blood levels of vitamin D are high appear to have a reduced risk of developing AMD (Age-Related Macular Degeneration), researchers from the University of Buffalo, New York, wrote in Archives of Ophthalmology.

Macular degeneration is when the patients start losing their central vision – objects directly in front of them are harder to see, making such tasks as reading, writing, recognizing faces and driving much more difficult. The macular, or macula lutea is an oval-shaped yellow spot close to the center of the retina, in the eye. Macular degeneration, caused by damage to the retina, mainly affects elderly individuals. It is the main cause of partial-blindness among patients over the age of 50 years. Even though central vision is affected, because the patient still has peripheral vision, other activities in daily life are usually still possible to do.

The authors wrote:

“Age-related macular degeneration (AMD), a chronic, late-onset disease that results in degeneration of the macula, is the leading cause of adult irreversible vision loss in developed countries. Age-related macular degeneration affects approximately 9 percent (8.5 million) of Americans aged 40 years and older.”

Amy E. Millen, Ph.D., and team set out to find out whether serum 25(OH)D blood levels were linked to age-related macular degeneration risk. They gathered data on 1,313 females who had participated in the Carotenoids in Age-Related Eye Disease Study, part of the Women’s Health Initiative Observational Study.

The authors wrote:

“Serum 25(OH)D is the preferred biomarker for vitamin D status, as it reflects vitamin D exposure from both oral sources and sunlight.”

After making adjustments for several AMD risk factors, they could not identify any significant link between vitamin D levels and early or advanced AMD.

Among 968 females aged less than 75 years whose serum 25(OH)D was high, the risk of developing early AMD was significantly lower, the researchers observed. However, among the 319 older females with higher serum 25(OH)D, there was a very slight increase in AMD risk.

The women under 75 with the highest vitamin D levels were found to have a 59% lower risk of developing early AMD compared to those with the lowest levels.

The authors wrote that milk, fish, fortified margarine and fortified cereals were among the top food sources of vitamin D. They found no link between self-reported direct sunlight exposure and AMD risk.

The researchers concluded:

“This is the second study to present an association between AMD status and 25(OH)D, and our data support the previous observation that vitamin D status may potentially protect against development of AMD. More studies are needed to verify this association prospectively as well as to better understand the potential interaction between vitamin D status and genetic and lifestyle factors with respect to risk of early AMD.”

“Vitamin D Status and Early Age-Related Macular Degeneration in Postmenopausal Women”
Amy E. Millen, PhD; Rick Voland, PhD; Sherie A. Sondel, MS; Niyati Parekh, PhD; Ronald L. Horst, PhD; Robert B. Wallace, MD; Gregory S. Hageman, PhD; Rick Chappell, PhD; Barbara A. Blodi, MD; Michael L. Klein, MD; Karen M. Gehrs, MD; Gloria E. Sarto, MD, PhD; Julie A. Mares, PhD; for the CAREDS Study Group
Arch Ophthalmol. 2011;129(4):481-489. doi:10.1001/archophthalmol.2011.48

Prevalence of cataracts causing significant visual problems appears high among older U.S. Hispanics who also often encounter barriers to access to care, according to a study in the September issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Although cataract is the leading cause of visual impairment in the Hispanic community, there has been little research on the prevalence of cataract, cataract surgery or factors that may affect whether Hispanic individuals are able to obtain cataract surgery, according to background information in the article.

Aimee Teo Broman, M.A., of the Johns Hopkins School of Medicine, Baltimore, and colleagues conducted a survey of visual impairment and blindness of Hispanic individuals 40 years or older living in southern Arizona between April 1997 and September 1999. Individuals completed a questionnaire, in either English or Spanish, to determine their history of visual problems and eye care as well as their socio-economic status, medical history and preferred language, country of birth and other questions relating to adapting to U.S. culture. Participants’ visual acuity was then assessed.

Of the 4,774 people who participated in the interview and examination, 2.8 percent (135) had visually significant cataract and 5.1 percent (244) had undergone bilateral cataract surgery. The researchers found two factors were important in determining whether individuals received cataract surgery: whether they spoke English and whether they had medical insurance.

“Our data suggest that even after adjusting for high rates of diabetes mellitus, U.S. Hispanic individuals are at a greater risk of having a visually impairing cataract than either African American or white individuals,” the authors report. “Cataract is the leading cause of visual impairment in this population and is associated with lower levels of self-reported quality of life; however, a significant percentage of those who likely need cataract removal have never obtained surgery in the population.”

“In summary, visually significant cataract appears to be high among U.S. Hispanic individuals of Mexican descent, as evidenced by rate of cataract and rate of surgery,” the authors conclude. “Language and financial barriers in this population impede access to surgery. Further work to remove these barriers and provide sight restoration is warranted among Hispanic individuals living in the United States.”

Editor’s Note: This project was supported by a grant from the National Eye Institute, Bethesda, Md. and a Research to Prevent Blindness Challenge grant, New York, N.Y.

John Lazarou
JAMA and Archives Journals
jamamedia

Results of clinical research on new presbyopia treatments now available in Europe – and possibly available soon in the United States – were reported in today’s Scientific Program of the 2010 Joint Meeting of the American Academy of Ophthalmology (AAO) and Middle East-Africa Council of Ophthalmology (MEACO). The AAO-MEACO meeting is the world’s largest, most comprehensive ophthalmic education conference and is in session October 16 through 19 at McCormick Place, Chicago.

Presbyopia is Inevitable, but Blurry Vision is Not

From age 40 onward our eyes’ lenses gradually lose the ability to focus on close-up objects, a condition called presbyopia. By our 50s or 60s, almost everyone experiences blurry near vision, although distance vision often remains good. More than 60 million people in the United States are presbyotic, as are more than 400 million worldwide. Reading glasses are one solution, but many people are interested in glasses-free vision correction. Options now available include a form of LASIK that improves near vision in one eye, called monovision, and intraocular lenses (IOLs) that replace the eyes’ natural lenses. Within a few years, several new presbyopia treatments described in today’s Scientific Program will likely be available in the U.S.

A Corneal Lens Implant with Built-In Vision Correction

Ioannis G. Pallikaris, MD, University Hospital of Crete, Greece, reported on a new type of micro-lens, the Flexivue, that was implanted in the corneas of 15 patients, who were followed for 12 months post-surgery. In a procedure lasting about 10 minutes, an extremely thin lens was inserted into the cornea (the clear outer structure) of the patient’s non-dominant eye through a tiny pocket made with a highly precise femtosecond laser. The specific vision-correcting prescription for each patient was incorporated in the outer area of the lens. After lens insertion, the pocket self-sealed and held the lens in place. On average, treated eye near vision improved from 20/100 to 20/25 without glasses, and distance vision decreased from 20/20 to 20/40. Vision remained stable in both eyes post-surgery in all patients through the follow-up period.

“This corneal lens implant appears to be a safe, effective way to correct presbyopia in people aged 45 to 60,” said Dr. Pallikaris. “Ninety-eight percent of patients were satisfied with their vision; 69 percent reported ‘excellent’ and 30 percent ‘good’ near vision in our survey. Ninety-two percent said they no longer used glasses.”

He said there were no surgery-related complications, but about 15 percent of patients reported glare and/or halos around lights, and some had reduced contrast sensitivity. Distance vision in the implanted eye is less influenced and remains better than it would be when a LASIK monovision procedure corrects for near vision; Dr. Pallikaris called this advantage “smart monovision.” Another key advantage is that, unlike LASIK and related refractive surgical procedures, the effects of corneal lens implants can be reversed by lens removal. Dr. Pallikaris was one of the pioneers of LASIK in the early 1990s.

He stressed that proper patient selection is crucial to Flexivue implant success: the candidate should have worn reading glasses for at least one year; patients would be disqualified if they have certain types of astigmatism, lens opacity (cataract) or several other conditions.

Financial disclosure: Dr. Pallikaris states that he is chair of the medical advisory board of Presbia, maker of Flexivue.

Corneal Inlay “Pinhole” Optics Sharpens Near Vision

Corneal inlays work by changing the eye’s depth of focus. Clinical trials are underway in the U.S., and the inlay is commercially available in Europe and Asia. Daniel S. Durrie, MD, reported on three years of clinical trial results for 153 patients implanted with either a 5- or 10-micron-thick AcuFocus lens. Both near and distance vision were slightly better in the 5-micron group. Both groups showed improvement in near vision, on average 20/25 in the 10 micron group and 20/20 in the 5 micron group. Distance vision was preserved in the implanted eye.

The procedure involves making a corneal flap as in LASIK, placing a small, donut-shaped inlay in the center of the cornea in the non-dominant eye, then replacing the flap. With the inlay’s small-aperture (“pinhole”) optics, peripheral light coming into the eye is blocked while central rays are unaffected, resulting in improved near vision. Distance vision is mostly unaffected, but patients may notice a slight difference when they compare their two eyes. Like corneal lenses, inlays’ effects can be reversed by removal.

“Results for AcuFocus have remained stable for three years of follow up, and we’ve seen dramatic improvements in corneal inlays in the past seven years of clinical study,” Dr. Durrie said.

Financial disclosure: Dr. Durrie states that he is a clinical investigator for AcuFocus.

Reshaping the Cornea without Breaking the Surface

Perhaps the most surprising cornea-based correction technique among the newcomers is INTRACOR. This technology applies femtosecond laser energy pulses inside the cornea, in the stromal cell layer just under the surface. Unlike LASIK and related surgeries, no tissue is removed. Instead, the pulses cause a biomechanical change in the cornea that shifts its center slightly forward. This improves near vision while maintaining distance vision. Small interior incisions may also be made to correct small degrees of near- or farsightedness. The procedure, done in the non-dominant eye, takes less than half a minute.

Mike P. Holzer, MD, University of Heidelberg, Germany, presented two-year follow-up data on INTRACOR presbyopia correction in 25 patients. Participants showed significant gains in near vision without glasses and maintained good distance vision. Patient satisfaction was high. INTRACOR has generated strong interest in Europe, Asia and South America and is gathering momentum in the U.S.

“The procedure is painless, and because no tissue is removed, the risk of infection is extremely low and the body does not need to mount a strong healing response,” Prof. Holzer said. “The cornea is not weakened, as it can be with other types of refractive surgery. Patients’ vision improved within hours of the procedure and remained stable over the follow-up period,” he added.

Financial disclosure: Prof. Holzer states that he receives consulting fees from Technolas Perfect Vision GmbH.

Source:

American Academy of Ophthalmology

Children of women with hypothyroidism an under active thyroid who had elevated thyroid stimulating hormone (TSH) in the first and second trimesters of pregnancy, had a significantly reduced ability to see visual contrasts, compared to women with hypothyroidism with normal TSH levels during the first two trimesters, and pregnant women with normal thyroid levels, according to a new study being presented on Thursday, Oct. 4, at the 78th Annual Meeting of the American Thyroid Association (ATA) in New York. Adequate contrast sensitivity is an important ability for reading, viewing information of low contrast such as maps, and visuospatial ability in general.

The study shows that visual processing problems among infants of women with hypothyroidism were directly correlated with the mothers’ high level of TSH. These findings suggest that thyroid hormone is critical in early pregnancy for normal development of visual processing abilities.

A previous study showed that infants born to women who had hypothyroidism diagnosed prior to or during pregnancy had reduced ability to see visual contrasts and that the severity of their deficit was related to how hypothyroid their mothers were during the pregnancy. This research was based on an electrophysiological task where children saw bars that swept from low to high levels of contrast at a slow speed.

Researchers in this study wanted to expand on the previous study to include higher speeds of stimulus presentation, since they are thought to invoke a structure in the brain that is sensitive to rapidly moving stimuli. As the presentation speed increased, so did the response of a specific cell type in the thalamus, which signals contrasts in brightness.

The study involved 36 six-month-old infants born to hypothyroid women treated with levothyroxine, who were diagnosed prior to or during their pregnancies, and 22 control infants.

“The study shows the importance of adequate thyroid hormone levels for women in the early stages of their pregnancy for the neurological development of the fetus,” said Joanne F. Rovet, M.D., lead author of the study and a Senior Scientist at The Hospital for Sick Children in Toronto and Professor of Pediatrics at University of Toronto. “Mothers with pre-existing hypothyroidism should be monitored closely during their pregnancy to ensure that their hormone levels are adequately adjusted.”

For more information on thyroid disease and pregnancy, visit thyroid.

The American Thyroid Association (ATA) is the lead organization in promoting thyroid health and understanding thyroid biology. The ATA values scientific inquiry, clinical excellence, public service, education, collaboration, and collegiality.

The 78th annual meeting of the ATA will be in New York City from October 3-7, 2007 at the Sheraton New York Hotel & Towers. All program information is available at thyroid.

A non-profit medical society founded in 1923, the ATA fulfills its mission through supporting excellence and innovation in research, clinical care, education, and public health. ATA members are physicians and scientists who work to enhance the understanding of thyroid physiology and pathophysiology, improve the diagnosis and treatment of thyroid diseases, and promote the education of physicians, patients, and the public about thyroid disorders.

Thyroid diseases are among the most common disorders of the endocrine system, affecting almost 13 million Americans alone. The ATA has extensive online information for patients on thyroid disease (in English and Spanish) serving the clinician as a resource for patients and the public who look for reliable information on the internet. To further benefit patients, the ATA Alliance for Patient Education was formed in 2002 to offer an exchange of information between the ATA and four patient groups: Thyroid Foundation of America, ThyCa: Thyroid Cancer Survivors, Inc.; the Light of Life Foundation, and the National Graves’ Disease Foundation. A public forum is held each year in conjunction with the ATA annual meeting.

Thyroid Research grants total over $200,000 annually to young investigators.

American Thyroid Association
6066 Leesburg Pike, Ste 550
Falls Church, VA 22041
United States
thyroid

Diabetes UK is concerned that more than half a million people with diabetes in England are still not been screened for retinopathy.

The latest Department of Health figures show that 26 per cent of people with diabetes aged 12 and over did not receive retinal screening in the period January 2008 to December 2008.

Simon O’Neill, Director of Care, Information and Advocacy Services at Diabetes UK, said: “Diabetes UK is concerned that half a million people with diabetes are still not having their eyes checked using a digital camera as part of a local retinal screening programme.

“The tragedy is that if retinopathy is identified early enough, treated properly and people are supported to manage their diabetes well, blindness can be prevented in 90 per cent of cases.

“PCTs need to ensure they are promoting and inviting all eligible people with diabetes for retinopathy screening, and provide a service that meets national quality standards as dictated by the National Screening Committee.

“In turn, we would urge people to make every effort to attend their appointment when invited. If they have problems attending they should talk to their healthcare team about what help and support is available.”

Source
Diabetes UK

Ectropion is a medical condition in which the eyelid, usually the lower lid, folds inward. The eyelashes constantly rub against the cornea, thus making the condition quite uncomfortable. Ectropion is usually caused by genetic factors and may be congenital. Trachoma infection may cause scarring of the inner eyelid, which may also cause ectropion. Trachoma is an infectious eye disease, and the leading cause of the world’s infectious blindness. Globally, 84 million people suffer from active infection and nearly 8 million people are visually impaired as a result of this disease. Globally this disease results in considerable disability.

According to Medilexicon’s medical dictionary:

Ectropion is an inversion or turning inward of a part or the infolding of the margin of an eyelid.

The condition is common and can affect anyone, but it most often occurs in older people. It can affect either eyelid or both at the same time.
What are the symptoms of Ectropion?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

Symptoms of ectropion include redness and pain around the eye, sensitivity to light and wind, sagging skin around the eye, excessive tearing and decreased vision especially if the cornea is damaged. The most common symptoms are watery eyes, dry/red/sore eyes and obvious infection.

First, watery eyes is the most common symptom in relation to tear ducts. The tear duct is a tiny tunnel in the eyelid that drains tears from the surface of the eye to the back of the nose. If the eyelid droops and turns outwards, the opening of the tear duct is pulled away from the surface of the eye, preventing the tears from draining properly, so they build up inside the drooping eyelid, often causing discomfort, redness and more watering.

Second, eyes can become dry, sore and red because the drooping lower eyelid prevents the eye from closing properly and old tears from draining away. Thus, the eye becomes exposed to the air and is not bathed in fresh tears.

Finally, if tears cannot properly drain, bacteria are not cleaned away from the surface of the eye. This makes the surface of the eye vulnerable to conjunctivitis, a condition that causes further redness and irritation with a build-up of mucous on the eye. Infection then leads to further watering, often with redness and swelling of the eyelids, which may become crusty.
What are the causes of Ectropion?
Causes of ectropion include congenital patterns, ageing, previous scarring and spasms. However, the most common cause of ectropion is the tissues of the eyelids becoming slack.

Previous scarring can also lead to ectropion. If the delicate skin around the eyes is wounded or burned, the body forms a scar in an attempt to heal the injury. This can draw in the skin and pull the eyelids out of their normal position.

Bell’s palsy may also be a cause. In Bell’s, the muscles of the face, including the muscles that control the eyelids, become paralyzed or weak. Bell’s palsy is usually temporary and most people make a full recovery within a few months without treatment.

Very rarely, ectropion can be present at birth, when the eyelids have not developed properly. This can happen in babies with Down’s syndrome.
Diagnosing Ectropion
Diagnosis is determined through visual observation by a general practitioner. A doctor will be able to diagnose the condition after an examination of the eyes and eyelids. Special tests are usually not necessary as the symptoms and signs of ectropion are quite distinctive.

One should see a doctor immediately if decreased vision, eye pain, sensitivity to light or rapidly increasing redness of the eye is present.
What are the treatment options for Ectropion?
Treatment is a simple surgery in which excess skin of the outer lids is removed. Prognosis is excellent if surgery is performed before the cornea is damaged. This tightens the tendon that holds the outer eyelid in place. This gives extra support and lift to the eyelid.

If ectropion is left untreated and is stopping the eye from closing properly, the eye may become progressively more uncomfortable. In rare cases, the cornea may become exposed and a corneal ulcer may occur.
Preventing Ectropion
Prevention of ectropion is nearly impossible as is caused by congenital patterns, ageing and/or previous scarring.

Sy Kraft (B.A.)

Researchers have shown that ranibizumab (Lucentis) eye injections, often in combination with laser treatment, result in better vision than laser treatment alone for diabetes-associated swelling of the retina.

Laser treatment alone has been the standard care for the past 25 years. But nearly 50 percent of patients who received this new treatment experienced substantial visual improvement after one year, compared with 28 percent who received the standard laser treatment. The study involved 52 clinical sites within the Diabetic Retinopathy Clinical Research Network (DRCR), supported by the National Eye Institute (NEI) and the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health.

“These results indicate a treatment breakthrough for saving the vision of people with diabetic macular edema,” said Neil M. Bressler, M.D., chair of the DRCR and chief of the Retina Division at the Wilmer Eye Institute, Johns Hopkins University, Md. “Eye injections of ranibizumab with prompt or deferred laser treatment should now be considered for patients with characteristics similar to those in this clinical trial.”

Diabetic retinopathy is the most common cause of vision loss in working-age Americans. This condition damages the small blood vessels in the eye’s light-sensitive retinal tissue. When these damaged blood vessels begin to leak fluid near the center of the retina, known as the macula, macular edema occurs. The macula provides detailed central vision used for activities such as reading, driving, and distinguishing faces. In macular edema the retinal tissue swells, which can lead to vision loss if left untreated.

Laser treatment of the retina has been the standard care for diabetic macular edema since an NEI-supported study in 1985 showed it to be beneficial. However, recent small short-term studies have revealed the visual benefits of eye injections of medications that block a chemical signal that stimulates blood vessel growth, known as vascular endothelial growth factor (VEGF). These studies have indicated that repeated doses of anti-VEGF medications, such as ranibizumab, may prevent blood vessels from leaking fluid and causing macular edema. The DRCR study, published online April 27 in Ophthalmology, confirms preliminary results and provides evidence of the treatment’s effectiveness in combination with laser therapy through at least one year of follow up.

“This comparative-effectiveness study demonstrated that a new treatment can protect and, in many cases, improve the vision of people with diabetic macular edema,” said NEI Director Paul A. Sieving, M.D., Ph.D.

The current study included a total of 854 eyes of 691 people, who had one or both eyes treated. Participants, who were on average in their early 60s, were diagnosed with type 1 or 2 diabetes and macular edema. They were randomly assigned to one of four study groups: sham injections plus prompt laser treatment within one week; ranibizumab injections plus prompt laser treatment; ranibizumab plus deferred laser treatment after six months or more; or injections of corticosteroid medication known as triamcinolone (Trivaris) plus prompt laser treatment.

Ranibizumab injections could be given as often as every four weeks, and triamcinolone injections or laser treatments could be given as often as every 16 weeks. In general, treatment was continued until a participant’s vision or retinal thickness returned to normal, or additional treatment did not improve vision or retinal swelling.

After one year, nearly 50 percent of eyes treated with ranibizumab and prompt or deferred laser treatment showed a substantial visual improvement. People could read at least two additional lines on an eye chart with the treated eye, or letters that were at least one-third smaller than they could read before the study treatment. Fewer than 5 percent of eyes in these groups experienced a visual loss of two or more lines. The results were similar whether patients received prompt or deferred laser treatment with the ranibizumab injections.

In contrast, about 30 percent of eyes that received laser treatment alone or triamcinolone plus laser showed a visual improvement of two or more lines on an eye chart, while 13 to 14 percent of eyes in these groups had a visual loss of two or more lines.

Although participants in all three injection groups had a greater decrease in retinal thickness after one year than with laser treatment alone, patients who received triamcinolone injections had greater complication rates. About 30 percent of people in the triamcinolone group developed high eye pressure that required medications, and about 60 percent developed cataracts that required surgery.

Few participants who received eye injections of ranibizumab had eye-related complications, such as an infection inside the eye likely caused by the injections, or worsening of a retinal detachment that existed prior to beginning treatment. The study found that eye injections of ranibizumab were not associated with any serious risks such as heart attack or stroke. DRCR researchers will continue to monitor the study participants for at least three years to obtain additional information about the safety and effectiveness of these macular edema treatments.

Source:
National Eye Institute
NIH/National Eye Institute

View drug information on Lucentis.

Rapid genetic testing for eye disease is becoming a reality, thanks to a technology developed at the University of Michigan Kellogg Eye Center. Scientists have created a first-of-its-kind test on a microchip array that will help physicians hone their diagnoses for patients with the blinding disease known as retinitis pigmentosa (RP). The screening technique has proven to be reliable and cost-effective.

In the September issue of Investigative Ophthalmology & Visual Science (IOVS), scientists at the U-M Department of Ophthalmology and Visual Sciences report on the arRP-I sequencing array, the first technology to screen simultaneously for mutations in multiple genes on a single platform.

This is a novel tool for scientists and physicians alike, says lead author and Kellogg scientist Radha Ayyagari, Ph.D. “For diseases that are associated with multiple genes, like RP, we now have a new and faster method for identifying the underlying genetic basis. This is also useful in analyzing complex patterns of inheritance and for understanding how causative genes might interact with each other.”

RP is a group of diseases, affecting one in every 3,500 individuals, in which retinal degeneration leads to blindness or severe vision loss.

Among the outward signs and symptoms are loss of peripheral vision, night blindness, and abnormal results from an electroretinogram (ERG), a test that measures the electrical activity and function of the retina. A patient with the autosomal recessive form of the disease (arRP) has inherited one gene from each parent, neither of whom is affected by RP.

It is nearly impossible to identify which form of the disease a patient has through a clinical examination alone, notes John R. Heckenlively, M.D., a specialist in inherited eye disease who also participated in the study.

“Identifying the precise genetic mutation responsible for an individual’s disease will allow us to provide a precise diagnosis, and this knowledge will also allow us to apply genetic therapies as they are developed,” he says.

Some clues to treatments are beginning to emerge in animal models, and scientists expect future therapies to be very specific to the type of RP.

“Perhaps one patient will benefit from dramatically limiting exposure to sun or artificial light, and another will use certain vitamins or supplements to stop progression of the disease,” says Heckenlively. “Obtaining a molecular diagnosis is going to be very important in helping to guide gene-based treatments for patients in the coming years,” he concludes.

Ayyagari’s study involved 70 individuals with a clinical diagnosis of arRP. Thirty-five had not been previously screened, and 35 others with known genetic mutations were screened to validate the results.

The arRP-I chip contained sequences, or genetic codes, of 11 genes that carry approximately 180 mutations associated with early-onset retinal degenerations. To date more than 30 genes have been identified for various forms of RP. Ayyagari notes that while the size of the chip currently limits the ability to array all known RP genes, larger platforms are likely to be available soon.

The arRP-I chips designed by the Kellogg research team produced 97.6 percent of the sequence analyzed with greater than 99 percent accuracy and reproducibility. The material cost of the arRP-I chip was 23 percent less that of current sequencing methods. That figure does not take into account the substantial savings in time and labor realized by analyzing multiple genes at once. These chips can detect both previously known and novel mutations.

Kellogg scientists and physicians expect that genetic technologies will grow dramatically in the next five years, particularly as additional space becomes available in the recently approved expansion to the Eye Center.

A proposed expansion of the U-M’s eye disease genetic testing and counseling center will allow Ayyagari and Heckenlively to screen large numbers of interested patients, provide counseling and education on the implications of genetic testing, and advance the pace of research toward targeted genetic therapies for RP and other inherited eye diseases.

In addition to Ayyagari and Heckenlively, the co-authors of this study include Md Nawajes A. Mandel, Tracy Burch, Lianchun Chen, Vidyullatha Vasireddy, all members of the U-M Department of Ophthalmology and Visual Sciences; Robert A. Koenekoop of McGill University Health Center; and Paul A. Sieving of the National Eye Institute.

The research was funded by the National Eye Institute, part of the National Institutes of Health, as well as the Foundation Fighting Blindness; Research to Prevent Blindness, Inc.; Fonds de la Recherche en Sante Quebec; and the University of Michigan.

Reference: Sequencing Arrays for Screening Multiple Genes Associated with Early-Onset Human Retinal Degenerations on a High-Throughput Platform, Investigative Ophthalmology and Visual Science. 2005; 46:3355-3362.

Betsy Nisbet
bsnisbetumich.edu
734-647-5586
University of Michigan Health System
med.umich.edu/prmc/media/relarch.cfm

A new report released by the American Optometric Association (AOA) identifies surprising new insights into the vision and eye health of infants across the U.S. The findings from last year’s InfantSEE® Weeks pilot program, a year-long, federally-funded public health initiative, revealed a higher-than-expected number of infants with undiagnosed and untreated vision and eye health problems.

During the 2009 InfantSEE® Weeks, more than 1,000 comprehensive eye and vision assessments were conducted in eight states. Data from the assessments showed that one-in-six infants exhibited an overall cause for concern requiring follow-up care from an eye care professional.

The data also revealed one-in-four premature or minority infants displayed higher rates of cause for concern than other infants assessed during the pilot project. Additionally, one-in-four infants had a cause for concern in households with annual incomes below $25,000, and one-in-three infants had a cause for concern in households with incomes less than $15,000.

InfantSEE® provides a one-time, comprehensive eye assessment to infants in their first year of life, typically between the ages of six and 12 months. These assessments are provided at no cost to all families, regardless of ability to pay or access to insurance coverage.

Because healthy eyes and vision are critical to normal development in infants and children, the AOA established the nationwide InfantSEE® program in 2005 to provide comprehensive eye and vision assessments to babies. Participating doctors of optometry, who assessed infants’ vision during the program’s first four years, observed rates of cause for concern to be between one-in-fourteen and one-in-nine.

Those troubling rates highlighted the need for federal funding to educate more parents and caregivers and increase access to infant eye assessments. Federal recognition and funding was secured in 2008 with the support of Sen. Robert C. Byrd (D-W.Va.) and the InfantSEE® Weeks pilot program was launched in January of 2009.

“During the past five years, the InfantSEE® program has provided considerable insight into the overall visual health of infants in this country,” said AOA president Dr. Randolph E. Brooks. “If not properly diagnosed and treated early, a number of eye and vision conditions can impair an infant’s ability to reach important developmental milestones, create lifelong learning and social problems and threaten sight.”

Many eye and vision conditions diagnosed during the 2009 InfantSEE® Weeks were those for which early treatment is both very effective and critical for normal development, including farsightedness, nearsightedness, amblyopia (lazy eye) and strabismus (crossed eyes). In addition, two infants assessed were diagnosed with retinoblastoma – the seventh most common pediatric cancer.

“We feel fortunate to have identified two cases of retinoblastoma through this important and no-cost public health program,” said Dr. Brooks. “Usually, retinoblastoma eye cancers are discovered in one in 20,000 children. Finding two cases among more than 1,000 infants is alarming and demonstrates the necessity of comprehensive eye assessments for all infants.”

InfantSEE® assessments complement a pediatrician’s routine well-care visit. However, comprehensive eye and vision assessments like those given through InfantSEE® are more thorough than typical childhood vision screenings, utilizing specialized instruments and procedures, which are not available to routine early childhood vision screening programs.

The AOA recommends that infants have an InfantSEE® assessment before their first birthday and young children have comprehensive eye exams at age three, before starting school and then every two years thereafter.

The 2009 InfantSEE® Weeks pilot program included comprehensive eye and vision assessments in Madison, Wis.; Chicago; Seattle; St. Louis and communities throughout the states of Iowa, Louisiana, North Dakota and West Virginia.

About InfantSEE®

InfantSEE® is a public health program managed by Optometry’s Charity™ The AOA Foundation. Designed to ensure that eye and vision care become an integral part of infant wellness and improve a child’s quality of life, doctors of optometry provide one-time, no-cost eye and vision assessment to infants between the ages of 6 and 12 months regardless of family income or access to insurance coverage.

About the American Optometric Association

American Optometric Association (AOA) doctors of optometry are highly qualified, trained doctors, on the frontline of eye health and vision care, who examine, diagnose, treat, and manage diseases and disorders of the eye. In addition to providing eye and vision care, optometrists play a major role in an individual’s overall health and well-being by detecting systemic diseases. Doctors of optometry have the skills and training to provide more than two-thirds of all primary eye care in the United States. The AOA represents more than 36,000 doctors of optometry, optometry students and paraoptometric assistants and technicians in nearly 6,500 communities across the country.

Source: American Optometric Association

The American Academy of Ophthalmology (Academy) has launched an expanded and authoritative eye health website to help educate consumers about eye diseases and conditions, vision correction and the preservation of healthy vision across a lifetime. The new EyeSmart® public education site, found here, is the world’s most comprehensive online resource for reliable, unbiased eye care information, written and reviewed by ophthalmologists (Eye M.D.s).

“The Academy believes it is vital that the public have a trustworthy place to turn when they have questions about their eye health,” said David W. Parke II, MD, the Academy’s CEO. “The new EyeSmart website is backed by the Academy’s extensive resources, including our trusted educational information and the expertise and knowledge of our Eye M.D.s.”

EyeSmart delivers comprehensive information on the symptoms, causes, diagnosis and treatment of common eye diseases and conditions – illustrated with photos and interactive elements, including animations, diagrams and dozens of informative videos. Much of the site is translated into Spanish as well. In addition, the website also provides:

– An extensive symptoms list, cross-referenced with potential associated conditions and diseases to help site visitors find relevant information quickly

– Recommendations for “Living EyeSmart” in a new section devoted to healthy vision tips and what consumers need to know about their eye health based on their age and other lifestyle factors

– Simulators to show how certain eye diseases and conditions can impact vision

– “Ask an Eye M.D.”: a searchable database of commonly asked eye health questions, plus the ability for site visitors to submit new questions to an Academy panel of experts

– “Find an Eye M.D.” service to locate a nearby ophthalmologist

– Tools to improve the site’s readability for visitors with low vision

– A free electronic newsletter focusing on healthy vision

The Academy’s Eye M.D.s will continue to add new eye care topics to the GetEyeSmart, plus the site will feature up-to-date news on the latest research developments that can impact people’s eye health. Articles from EyeSmart can also be easily shared to social networking sites.

“I will be letting all my patients know about the EyeSmart website, because I know what they read there is accurate, timely and reliable,” said Andrew G. Iwach, MD, a glaucoma specialist. “With EyeSmart, the public can trust that experienced eye physicians and surgeons stand behind the information, and that making sure people get the best possible care for their eyes is our goal.”

Source:

American Academy of Ophthalmology