Month: August 2014

Preliminary research shows encouraging results with transplantation of retinal cells in patients with blindness caused by retinitis pigmentosa (RP) and age-related macular degeneration (AMD), according to a report in the August issue of American Journal of Ophthalmology (AJO).

In the FDA-monitored study, Dr. Norman D. Radtke of University of Louisville, Ky., lead author of the study and colleagues performed the experimental transplant procedure in ten patients with vision loss resulting from retinal degeneration: six patients with RP and four with the “dry” form of AMD. Although they have different causes, both RP and AMD lead to destruction of the light-receiving (photoreceptor) cells of the retina. There is currently no effective treatment for recovery of visual loss from either condition.

All patients underwent transplantation of fetal retinal cells. The cells were implanted along with their attached retinal pigment epithelium, which plays a key role in nourishing the photoreceptor cells. The concept behind the experimental procedure was that the new cells would grow to replace the damaged photoreceptor cells, connecting to the patient’s remaining retina.

Follow-up testing showed visual improvements in seven of the ten patients: three of the patients with RP and all four patients with AMD. Although vision remained in the “legally blind” range for all patients, the gains in vision were significant and measurable.

“This clinical evidence shows the promise of our method to alter progressive vision loss due to incurable degenerative diseases of the retina,” comments Dr. Radtke.

In one patient with RP, the visual improvement was still present up to six years after surgery, while vision in the opposite (untreated) eye continued to deteriorate. In the same patient, specialized tests showed a 27 percent increase in light sensitivity in the treated eye.

There were no problems with rejection of the transplants by the patients’ immune systems, despite the lack of a perfect immunological match between the transplant donors and recipients. This likely reflected the special “immunologic protection” of tissues within the eye. Two patients also had improved vision in the untreated eyes. The reason for this unexpected result is unknown, but may involve some effect of transplantation on the immune system.

The experimental transplant procedure was designed on the basis of animal studies showing that transplantation of retinal cells can lead to the development of new retinal tissues. Previous “phase I” studies established the safety of the procedure. The new “phase II” trial provides the first evidence of improved vision the first treatment of any type to restore lost vision in patients with RP or AMD.

Much further research will be needed to determine the potential for retinal transplantation to improve vision in patients with these diseases. “Retinal implants that combine retina and retinal pigment epithelium demonstrated an apparent ability to integrate with host retinas and to re-establish the visual pathways interrupted by disease,” adds Dr. Radtke. “What we have learned will help us to refine this method and obtain further evidence that retinal implants may be a viable therapy for retinal degenerative disease.”

ELSEVIER
Radarweg 29
Amsterdam
elsevier

The World Health Organization reports that 366 million cases of diabetes are projected by 2030, raising concerns among eyecare professionals globally because of the risk posed to healthy sight by diabetes. Additionally, recent consumer research conducted by Transitions Optical, Inc. reveals a dangerous lack of awareness about these eye health risks, with less than 40 percent of the population surveyed correctly identifying vision issues as possible complications of diabetes.

In this survey, the majority of diabetics queried were similarly unaware of the risks of vision-compromising direct and indirect effects of diabetes on the eyes, despite the fact that diabetes is currently recognized as the leading cause of new cases of blindness among adults ages 20-74. The research also reveals that there is a higher incidence of diabetes among minority groups. Both African-Americans and Hispanic-Americans are nearly twice as likely to have diabetes and their lack of awareness is equally low.

“Diabetes has reached epidemic proportions worldwide. Aside from its direct effects in decreasing visual acuity and causing blindness, diabetes can also significantly impact quality of vision by reducing contrast sensitivity and accentuating glare,” says Dr. Susan Stenson, ophthalmologist and global medical director at Transitions Optical. “While the major recognized direct ocular complication of diabetes is diabetic retinopathy, diabetes also appears to increase susceptibility to a number of common vision-threatening diseases, such as cataract, glaucoma and macular degeneration. Furthermore, diabetics may be at a higher risk for the development of UVR-related ocular diseases,” she added.

According to Dr. Stenson, certain medications taken by diabetics can complicate the vision picture even more, altering the refractive state, increasing photosensitivity, and potentiating adverse effects of UVR on the eyes.

“Low awareness of the impact of diabetes on vision and ocular health poses a real danger to diabetic patients,” warns Dr. Stenson. “Regular eye exams are essential to detect diabetes and its ocular complications early and to treat them promptly and effectively, especially since more than 90 percent of severe vision loss and blindness caused by diabetic retinopathy can be prevented with proper eyecare,” she added.

An important component of preventative and maintenance eyecare is the prescription of appropriate eyewear to protect the eyes from such risk factors as impact and ultraviolet radiation and to promote quality of vision, visual comfort, and visual convenience for the wearer. Spectacle lens enhancements, such as photochromic lenses, represent an excellent choice for the diabetic individual. They provide continuous 100% protection from UVA and UVB, and, because they titrate incoming light for the wearer, they enhance contrast, reduce glare, and promote visual comfort and convenience under varying conditions of illumination. This serves to decrease eye strain and eye fatigue.

“The most important advice I can offer to individuals with diabetes is to take proper care of themselves — and of their eyes. Many, if not most, of the devastating complications of diabetes in the eyes, as well as in the rest of the body, are potentially preventable or treatable. I would also advise any individuals who may not have diabetes — or may not be aware that they have diabetes, since as many as 50% of diabetics remain undiagnosed — of the importance of regular medical and ophthalmic screening, particularly in the presence of such risk factors for diabetes as obesity or a family history of the disease. Talk to your eyecare professional about scheduling an appointment for a complete eye exam,” Dr. Stenson concluded.

Additional Findings from Transitions Optical and the World Health Organization:

— More than 90 percent of severe vision loss and blindness caused by diabetic retinopathy can be prevented with proper eyecare

— Between 21 and 45 percent of diabetics do not receive regular eye exams

— Between 17 and 37 percent of diabetics do not wear protective eyewear, such as prescription or non-prescription sunglasses or photochromic lenses, like Transitions(R) lenses

To learn more about the impact of diabetes on eye health, visit Transitions/diabetes.

About Transitions Optical, Inc.

Transitions Optical is a joint venture of PPG Industries, Inc. and Essilor International. The first to successfully commercialize a plastic photochromic lens in 1990, today the company is a leading provider of photochromics to optical manufacturers worldwide. Transitions Optical offers the most advanced photochromic technology in the widest selection of lens designs, materials and brand names.

Transitions(R) lenses are the ideal everyday choice for healthy sight. They are clear indoors and at night. Outdoors, they automatically darken as light conditions change. Transitions lenses provide visual comfort, and enhance visual quality by reducing glare and enhancing contrast, helping you to see better today. Transitions lenses block 100 percent of harmful UVA and UVB rays — helping to protect the health and wellness of your eyes — so you can see better tomorrow as well.

Transitions Optical, Inc.
Transitions/diabetes

The Royal National Institute of Blind People (RNIB) is funding legal action against a Primary Care Trust for operating an illegal blanket ban on providing sight-saving treatments.

The charity is supporting 84-year-old Henley pensioner Dennis Devier, who suffers from the sight-threatening condition wet AMD (age-related macular degeneration), in taking action against Oxfordshire PCT.

The trust claims to have a policy that considers funding treatment for “exceptional cases” on a case-by-case basis, yet has not funded a single course of anti-VEGF drugs which treat wet AMD. This is despite more than 70 patients in their care needing treatment. Dennis is a war veteran, blind in one eye, cares for his disabled wife, has diabetes and Paget’s disease but is not considered “exceptional”.

RNIB is taking the unprecedented step of supporting Dennis in instructing national law firm Irwin Mitchell in the hope that this action will force Oxfordshire PCT to treat Dennis and other patients. Irwin Mitchell successfully fought, in the first case of its kind, for cancer sufferers to get the drug Herceptin. If the trust refuses to reconsider its position, it will have to defend its policy in the High Court.

Steve Winyard, RNIB’s Head of Campaigns, said: “Oxfordshire PCT has told Dennis that for him to be eligible for sight-saving treatment he must be an ‘exceptional case’. In RNIB’s view he is. Oxfordshire PCT claim to be operating a policy where they consider treatment on an individual basis but as far as we understand they have not funded a single case of anti-VEGF treatment. Dennis has had his appeal turned down three times now. If Dennis isn’t an ‘exceptional case’, then my question to Oxfordshire PCT is, who is?”

Wet AMD is the leading cause of sight loss in the UK and affects 26,000 people each year. If left untreated, the condition can lead to blindness in as little as three months.

Steve Winyard continued: “Anti-VEGF drugs are licensed for use on the NHS to treat wet AMD, but until they have been appraised by health watchdog NICE (National Institute for Health and Clinical Excellence), PCTs are formulating their own policies for treating patients. Yet we know PCTs across England and Wales are denying treatment to thousands of patients who are forced to either find the money to pay for the drugs privately, or go blind.

“Oxfordshire PCT is a particularly bad example, but they are far from the only PCT choosing to save money rather than people’s sight. Oxfordshire is the first trust we are supporting legal action against, but we will be looking at every PCT’s performance and will not hesitate to support further legal action against each and every PCT in the country if we believe they are acting illegally.”

NICE recently announced preliminary guidelines, which could deny all but one in five patients in England and Wales treatment, and only then after the patient has gone blind in one eye. Final guidance from NICE is expected in September.

AMD treatments campaign

— Every day another 100 people 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 www.rnib

— Wet AMD is the leading cause of sight loss in the UK and can lead to blindness in as little as three months. People need prompt treatment if they are to minimise the risk of permanent sight loss.

— Anti-VEGF treatments target VEGF (vascular endothelial growth factor), a protein involved in the formation of new blood vessels. In the eye, high levels of VEGF can cause proliferation of blood vessels and fluid leakage. The number of times patients require treatment with an anti-VEGF drug varies – some patients require injections for two years or more.

— Two anti-VEGF treatments are licensed for use on the NHS: Macugen, marketed by Pfizer, was licensed for use in May 2006, and Lucentis, marketed by Novartis was licensed for use in January 2007.

— The National Institute for Health and Clinical Excellence (NICE) is currently appraising Macugen and Lucentis. Until NICE issues guidance, the Department of Health says it has ‘made it clear to PCTs that funding for treatments should not be withheld simply because guidance from NICE is unavailable’.

— Each year 26,000 people in the UK develop wet AMD. Approximately a quarter of a million people in the UK are thought to have the condition.

— RNIB campaigns for PCTs to fund sight saving treatments for wet AMD. The latest figures suggest that 80 per cent of PCTs are failing to fund anti-VEGF treatments. Even when they do provide funding, it is for very low numbers of patients. Very often, patients also have to fight to get treatment.

— RNIB and The Macular Disease Society have launched an AMD advocacy service called Action for AMD Treatments. Any patient needing help accessing licensed anti-VEGF treatments should call RNIB’s Helpline on 0845 766 9999.

— Monocular vision causes problems with depth perception, decreases peripheral vision and therefore the visual field affecting eye/hand co-ordination, mobility and balance (thus also increasing the risk of falls).

Royal National Institute of Blind People

View drug information on Herceptin; Lucentis; Macugen.

An international team led by NYU Cancer Institute have identified a protein complex that regulates the formation of cilia, which are found on virtually all mature human cells and are essential to normal cell function.

The new report, published this week by Developmental Cell and selected as the featured publication of the open-access online edition, describes how three proteins work together to regulate the formation of primary cilia. The study led by Brian Dynlacht, Ph.D., professor of pathology and director of NYU Cancer Institute Genomics Facility, investigates these antenna-like structures, once thought to be vestigial remnants of cell evolution, which have recently emerged as a focal point of research in developmental cell biology.

“We are trying to understand the regulation of processes that are fundamental to normal cell development and health in humans,” said William Y. Tsang, Ph.D., of the NYU School of Medicine and Cancer Institute, and first author of the paper. “Defective cilia are implicated in a wide range of serious illnesses such as polycystic kidney disease, retinal degeneration, and neurological disorders. Inappropriate activation of signaling molecules that normally reside at the primary cilium, may lead to certain cancers.”

At the center of the process lies the protein CEP290, which normally promotes primary cilia formation in mature cells. Dr. Tsang and his colleagues discovered that a second protein, CP110, normally suppresses the function of CEP290 until cells are fully mature. At that point, CP110 is destroyed, freeing CEP290 to interact with a third protein, Rab8a, to promote cilia formation on the surface of the mature cell.

The team’s findings may help to identify potential targets for future drug design.

“Ciliogenesis is a fundamental process. These structures are found in almost every type of human cell you can imagine,” Dr. Tsang said. “If we can ever design drugs that will restore the formation and function of cilia even in the presence of CEP290 mutations, then that would be one way to cure the defects that lead to ciliary diseases.”

Research so far has been using in vitro human cell lines. However, team members from the University of Michigan and National Eye Institute have developed a mouse model with a CEP290 mutation implicated in retinal degeneration, and the NYU group is planning a study of human CEP290 mutations to see if they can correlate genotypes to their expression in specific ciliary diseases.

The authors of this study are NYU Cancer Institute scientists William Y. Tsang and Brian David Dynlacht; Carine Bossard (Centre for Genomic Regulation, Barcelona); Hemant Khanna (Department of Ophthalmology and Visual Sciences, University of Michigan); Johan Per?�nen (Institute of Biotechnology, Program in Cellular Biotechnology, University of Helsinki), Anand Swaroop (Department of Ophthalmology and Visual Sciences, University of Michigan / National Eye Institute, Neurobiology Neurodegeneration & Repair Laboratory, Bethesda, MD); and Vivek Malhotra (Centre for Genomic Regulation, Barcelona).

Click here to access the complete article.

Source: Jennifer Berman

NYU Langone Medical Center / New York University School of Medicine

The AMD Alliance International (AMDAI) today issued a global call to action to the vision care community, to ensure appropriate access to care for patients living with wet age-related macular degeneration (AMD), a condition where new blood vessels grow into the back of the eye, seriously damaging vision, and to support ongoing research for improved treatment options. The global call to action stems from a pending report that underscores the need to recognize wet AMD as a chronic disease, and the significant emotional, physical and economic burden associated with treating the disease as an acute condition. A webcast discussing details to the report will be taking place today at 10am EST/3pm BST/4pm CEST, and can be accessed here.

Chronic disease is defined as persistent, lasting, generally incurable, and requiring ongoing treatment; yet in some countries, wet AMD is treated and reimbursed as an acute disease-decreasing access, limiting patient outcomes, and potentially endangering sight.

Age-related macular degeneration is a leading cause of blindness in the developed world, and is twice as prevalent as Alzheimer’s disease, affecting approximately 30 million people worldwide. Some health care systems, including in developed countries, focus on informal care for patients with episodes of acute illness, a model that is not cost-effective for treating wet AMD and other chronic diseases. In fact, data on asthma and congestive heart failure indicate that cost savings and quality improvements result from long-term management of the chronic diseases outside the hospital, by preventing acute episodes from occurring.[1] Globally, the cost of visual impairment due to AMD in 2010 is estimated at $343 billion.[2] This is due not only to the direct costs of treating the disease, but also with the associated dangers that come with diminished eyesight. Further, people suffering from AMD were deprived of the equivalent of an estimated six million years of healthy life due to disability and premature death.

“For those of us involved in and concerned about vision care, this report highlights the need to continue advocating for patient access to the ongoing care that is required to prevent vision loss from wet AMD,” said Narinder Sharma, Chief Executive Officer of AMDAI. “The burden that this disease places on patients, caregivers, health care systems, and society at large can currently be relieved only through timely diagnosis, earlier intervention, and sustained therapy-all core practices for managing chronic conditions-until there are newer, better treatments, and hopefully one day a cure.”

The report incorporates input from an expert panel of patient and policy advocates, as well as patient focus groups across Europe and the United States. Based on the findings, AMDAI will lead its more than 70 patient groups around the world to advocate for those living with wet AMD, call for access to appropriate care and approved, safe therapies to help AMD patients maintain sight as long as possible and live full, productive lives through:

– Early diagnosis and access to regular treatment: Early detection is key to saving vision. Wet AMD progresses rapidly, but progression can be slowed with unimpeded access to appropriate treatment.

– Increased patient and physician awareness: Public awareness about wet AMD must be enhanced, so that signs and symptoms are more easily recognized, particularly among populations at risk.

– New and better treatments for wet AMD: Drugs in development must have proven clinical safety and long-term efficacy, be made available to all who live with wet AMD, and ultimately arrest disease progression and restore sight.

– An integrated model of care that includes prevention, diagnosis, treatment, and rehabilitation: Health care teams should educate themselves and their patients about wet AMD to intervene and preserve vision to the fullest extent, as well as provide resources for support and rehabilitation.

The report asserts that treating wet AMD as a chronic disease will help ensure that affected patients get the early medical attention and treatment they need to live longer, healthier, more independent lives, thereby reducing the need for high-cost medical care and social services. The report covers the global challenge of AMD; current and developing treatments; necessary intervention, treatment, rehabilitation and emotional support; improving physicians’ ability to educate and care for wet AMD patients; and empowering patients to advocate on their own behalf.

There is no cure for wet AMD, but there are several approved therapies on the market for the treatment of wet AMD. Wet AMD approved treatments include laser surgery, photodynamic therapy, and, most recently, anti-VEGF therapy that is administered by a drug injection into the eye. This latter treatment can arrest and, in some cases, reverse vision loss.

While anti-VEGF therapy represents a significant advancement in the treatment of wet AMD, there is still no cure. Eye care specialists and global leaders point to significant remaining unmet needs:[3] improved drug delivery methods, improved efficacy for drugs that are injected into the eye, reduced frequency of treatment and dosing, combined therapies that can improve efficacy and the burden of treatment on physicians and patients, drugs that reverse the disease process, and most importantly, a standardized, integrated treatment paradigm that accounts for chronic management of wet AMD.

About AMD

Age-related macular degeneration is a leading cause of blindness in the developed world, and is twice as prevalent as Alzheimer’s disease, affecting approximately 30 million people worldwide. AMD progressively and gradually diminishes the central vision necessary to see objects clearly and to perform common tasks, such as reading and driving. In some cases, AMD advances so slowly that people notice little change in their vision; in others, progression may rapidly lead to loss of vision in both eyes. Although AMD may occur during middle age, people over age 60 are at greater risk than younger people.

AMD occurs in two forms: dry and wet. Dry AMD is an early stage of the disease that occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. It may result from aging and thinning of the macular tissues. Over time, as less of the macula functions, central vision is gradually lost in the affected eye. The dry AMD patent will likely have blurred vision, have difficulty recognizing faces, and need more light for reading and other activities. Dry AMD generally affects both eyes, but vision can be lost in only one eye while the other eye seems unaffected.[4]

In 10 to 15 percent of cases, dry AMD advances to wet AMD. Wet AMD is the leading cause of blindness in people over the age of 65 in the U.S. and Europe. In wet AMD, abnormal blood vessels develop behind the macula and leak blood and fluid that lead to visual impairment. Wet AMD can lead to sight loss in as little as three months.

[1] Thrall, James H., MD, , Prevalence and Costs of Chronic Disease in a Health Care System Structured for Treatment of Acute Illness, Radiology, 2005

[2] The Global Economic Cost of Visual Impairment, Access Economics, prepared for AMD Alliance International, March 2010 (costs reported in 2008 US dollars).

[3] DataMonitor: Ophthalmology: Stakeholders Opinions – Leading Brands Under Threat, March 2010

[4] National Eye Institute, US National Institutes of Health

Source:

AMD Alliance International

View drug information on Photodynamic Therapy.

In recognition of
National Healthy Vision Month, Enhanced Vision — the leading developer of
products for people with low vision, is offering a FREE no obligation
demonstration to individuals with low vision. Enhanced Vision’s products are
designed to give people with low vision and their loved ones an opportunity to
learn more about the newest technology and devices available today to help
individuals regain their visual independence. To arrange a free
demonstration, contact Enhanced Vision at 888-811-3161, ext. 26.

A Major Public Health Concern

More than 13 million Americans suffer from uncorrectable vision loss
through macular degeneration, glaucoma, retinitis pigmentosa, and other eye
diseases. And in the next 30 years, it is estimated that this number will
more than double. Those who are affected by low vision often experience a
loss of independence and are more likely to feel depressed and isolated from
friends and loved loves. Although there is no cure for low vision, many
people with these conditions can benefit from the use of low vision devices
from Enhanced Vision. Designed for use in a variety of situations and
environments, including home, work and school, these systems incorporate the
latest advancements in technology to help people with low vision to see, read,
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lets me do things I enjoy doing again such as reading,” commented Dr. Bernard
Davis, an Enhanced Vision Customer.

A Solution for Every Low Vision Need

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For a free in-home demonstration or for more information on treating low
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enhancedvision.

Enhanced Vision
enhancedvision

The Glaucoma Research Foundation will be one of the organizations marking World Glaucoma Day on March 12, 2009 in order to draw attention to the disease known as the “sneak thief of sight.”

This is the second year of the event founded by the World Glaucoma Association and the World Glaucoma Patient Organization. This year, events will include public education displays and screening clinics around the globe that are designed to make people more aware of the risk factors and importance of early glaucoma detection.

“The Glaucoma Research Foundation is an enthusiastic supporter of World Glaucoma Day because of the attention it focuses on the need for early screening and prevention,” said Thomas M. Brunner, CEO and President of the Glaucoma Research Foundation. “As one of the key resources of education materials on glaucoma, the Foundation will be working to educate as many people as possible on the day.”

Congressional Briefing

As part of its participation in World Glaucoma Day, the Glaucoma Research Foundation is among a number of organizations that is sponsoring a Congressional briefing in Washington, D.C. on March 10. Entitled “Glaucoma – The Stealth Robber of Vision,” the briefing will include a talk by Rohit Varma, MD, MPH, Director of the Glaucoma Service at the Doheny Eye Institute, University of Southern California. Dr.Varma was recently honored by the Glaucoma Research Foundation with the President’s Award for his groundbreaking research that shows the Latino community to be among those at highest risk for development of glaucoma.

Other sponsors of the Congressional briefing are the Alliance for Eye and Vision Research (AEVR), the American Glaucoma Society, the Association for Research in Vision and Ophthalmology (ARVO) and the Glaucoma Foundation.

What is Glaucoma?

Glaucoma is a group of eye diseases that gradually steal sight without warning. In the early stages of the disease, there may be no symptoms. Glaucoma leads to blindness by damaging the optic nerve. Elevated pressure in the eye is a risk factor, but even people with normal pressure can lose vision to glaucoma. Glaucoma is the second leading cause of blindness in the United States and the leading cause in African-Americans. Anyone is at risk, but there are certain population groups that are more at risk:

– Persons over 60 years of age
– Persons of African descent
– Hispanics in older age groups
– Relatives of those with glaucoma
– Persons who are very nearsighted
– Diabetics

About 50% of persons with glaucoma in the United States are unaware that they have it, while this number can reach 90% in developing countries. Persons at high risk for glaucoma should have their eyes examined for the disease at least every two years by an eye care professional.

About the Glaucoma Research Foundation

Located in San Francisco, the Glaucoma Research Foundation is the nation’s most experienced foundation dedicated solely to glaucoma research and education. In addition to funding innovative research like the Catalyst For a Cure research consortium and its Shaffer Grants for Innovative Glaucoma Research, GRF also is the “go to” agency for education materials, including the definitive reference for newly diagnosed, Understanding and Living with Glaucoma (available in both English and Spanish editions); a special brochure serving those at highest risk, including African-Americans, Latinos, and children; and a toll free phone line, 800-826-6693, staffed during office hours with an information specialist to handle a variety of inquiries.

For more information about Glaucoma Research Foundation, call 415.986.3162 or visit: glaucoma

About the World Glaucoma Association

The World Glaucoma Association is a global organization dedicated to the overall improvement of glaucoma science and care. Comprised of leading medical experts and institutions throughout the world, the group’s overall goal is to optimize the quality of glaucoma research and treatment through increased communication and cooperation among international glaucoma societies, industries, and patient organizations.

About the World Glaucoma Patient Association

The World Glaucoma Patient Association is an umbrella organization that supports glaucoma associations and networks worldwide in their efforts to educate and support their members so that all people with glaucoma can understand and better manage their disease. The WGPA facilitates the establishment of glaucoma support groups in many nations and coordinates communication and cooperation between existing groups, in addition to promoting international awareness of glaucoma as a cause of preventable blindness.
For more information on World Glaucoma Day, please visit: wgday

World Glaucoma Association

Exciting results from the Argus™ II Retinal Prosthesis System (‘Argus II’) clinical trial were presented at the Association for Research in Vision and Ophthalmology, Inc. (ARVO) 2011 Annual Meeting. The clinical trial included 30 subjects implanted in 10 centers worldwide, and has run for nearly 4 years. The results that were presented from the trial showed that the Argus II System provided significant improvements in vision for the blind subjects who are suffering from profound Retinitis Pigmentosa (RP). Two paper presentations outlined the safety, reliability and performance of the system. In February 2011, Argus II became the first such treatment for the blind to obtain the CE Mark and make the leap from research to the marketplace in Europe. An application for FDA approval in the US is being submitted in 2011.

Argus II is Second Sight’s second generation implantable device intended to treat blind people suffering from degenerative diseases such as RP. The system works by converting video images captured from a miniature camera, housed in the patient’s glasses, into a series of small electrical pulses that are transmitted wirelessly to an array of electrodes on the surface of the retina (epi-retinal). These pulses are intended to stimulate the retina’s remaining cells resulting in the corresponding perception of patterns of light in the brain. Patients can learn to interpret these visual patterns thereby gaining some functional vision.

Mark S. Humayun, MD, PhD, Professor of Biomedical Sciences, Professor of Ophthalmology, Biomedical Engineering, Cell and Neurobiology, Doheny Eye Institute, University of Southern California, presented the interim performance results from the Argus II Retinal Prosthesis trial:

With over 70 cumulative subject-years of follow-up on 30 subjects, this is the largest trial of a visual prosthesis to date. The results confirm previous reports of the ability of Argus II to provide visual function over the long- term.

“All subjects implanted with a Second Sight® Argus II Retinal Prosthesis System previously had only bare light perception or worse vision due to RP or related outer retinal degenerative disease. During the clinical trial we were pleased to observe the promising results of the system that revealed that all 30 subjects in the trial obtained visual perceptions from the device. A large majority of them experienced benefit from the system in terms of visual function tests that ranged from localizing and identifying an object to grating visual acuity. Functional vision orientation and mobility tests demonstrate that subjects were significantly better at performing visual tasks such as following a line or finding a door with the system ON vs. OFF. These gains in vision were maintained by many subjects during long-term follow-up (i.e. > 2 years),” explained Professor Humayun.

Dr. Humayun also reported on research conducted by Dr. Paulo Stanga, Consultant Ophthalmologist and Vitreoretinal Surgeon for the Manchester Royal Eye Hospital, Manchester, UK, that showed that subjects fitted with Argus II were able to consistently perceive colors.

“We were delighted to observe, for the first time ever, that nine participants were able to reliably and repeatedly perceive up to eight different colors using Argus II”, said Dr. Stanga. “Color perception could be achieved by precisely controlling aspects of the electrical stimulation. Color vision obtained in this manner represents a unique feature of an epi-retinal approach employing an external camera and processor.”

Argus II is the first retinal prosthesis in which the feasibility of reading sentences with prosthetic vision has been demonstrated.

As cited by Professor Sahel, Chairman, Department of Ophthalmology: Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, Paris, France. “The fact that two of our patients implanted with Argus II were actually able to correctly read 4-word sentences, was beyond our highest expectations. We were also excited to observe that reading speeds increased quickly for these motivated patients, and that one patient was able to read at the rate of ten words per minute”.

Source: Second Sight Medical Products, Inc

Dry eye syndrome, also known as keratoconjunctivitis sicca (KCS), keratitis sicca, sicca syndrome, xerophthalmia, or simply dry eyes, is an eye disease in which tear film evaporation is high or tear production is low. Dry eye syndrome is commonly found in humans and some animals. The patient’s eyes dry out and become inflamed.

According to the National Health Service (NHS), UK, approximately between 17% and 30% of people have dry eyes at some time in their life.

Our eyes are producing tears all the time, not just when we cry or experience a sudden rush of emotion or after yawning. Healthy eyes are covered with a fluid all the time, known as a tear film, which is designed to remain stable between each blink. A stable tear film prevents the eyes from becoming dry, and keeps the eyes clear, and with comfortable vision.

If the tear glands produce a lower quantity of tears, the tear film can become destabilized. The tear film can break down quickly, creating dry spots on the surface of the eyes.

Dry eye syndrome can occur at any age, and in people who are otherwise healthy. It is more common with older age, when the individual produces fewer tears. In some parts of the world, where malnutrition results in a vitamin A deficiency, dry eye syndrome is much more common.

According to Medilexicon’s medical dictionary, keratoconjunctivitis sicca is “keratoconjunctivitis associated with decreased tears.”
What are the signs and symptoms of dry eye syndrome?
A symptom is something the patient feels and reports, while a sign is something other people, including a doctor or nurse may detect. For example, pain may be a symptom while a rash may be a sign.

A patient with dry eye syndrome may have the following signs and symptoms:

A stinging sensation in the eyes
A burning sensation in the eyes
Feeling of dryness in the eyes
Feeling of grittiness and soreness in the eyes
Stringy mucus in or around the eyes
Eye sensitivity to smoke
Eye sensitivity to wind (eyes water more in the wind)
Redness of the eyes
Eye fatigue, even after reading for a relatively short period
Photophobia – sensitivity to light
Discomfort when wearing contact lenses
Tearing
Blurred vision – usually worse towards the end of the day
Double vision
Eyelids stick together when waking up

Complications of dry eye syndrome may have the following signs and symptoms:

Eye redness worsens
Photophobia (light sensitivity) worsens
Eyes become more painful
Eyesight deteriorates

What are the causes of dry eye syndrome?
There are more to our tears than simply water. Tears are made of water, fatty oils, protein, electrolytes, substances to fight off bacteria, and growth factors. Tears are made of a mixture that helps keep the surface of our eyes smooth and clear. Without tears we cannot see properly.

In some cases dry eyes are the result of an imbalance in the tear mixture, while in others not enough tears are produced for the requirements of good eye health. Other causes of dry eye syndrome include eyelid problems, some drugs, and environmental factors.

Tear quality – the tear film has three layers – oil, water and mucus. If any of these layers are not right, the patient may develop dry eye symptoms.
Oil (the top layer) – this oil is produced by the meibomian glands, located on the edge of the eyelids. They produce lipids (fatty oils). The oil smoothes the tear surface as well as slowing down the rate of evaporation. When oil levels are not right the tears may evaporate too rapidly. If a patient’s meibomian glands are blocked (clogged) the likelihood of developing dry eyes is much greater. Patients with blepharitis (inflammation along the edge of the eyelids), rosacea and some other skin disorders have a greater risk of having clogged meibomian glands.
Water (the middle layer) – this is the thickest layer, which consists of water and some salt. This layer is produced by the lacrimal glands (tear glands). They cleanse the eyes and wash away particles and irritants. If this layer is not right the patient is susceptible to film instability. If the water layer is too thin the oil and mucus layers may touch each other, resulting in a stringy discharge – a hallmark sign of dry eyes.
Mucus (the inner layer) – this layer makes it possible for the tears to spread evenly over the surfaces of the eyes. If the mucus layer is not right, dry patches may develop on the cornea (the front surface of the eye).
Reduced tear production – we tend to produce fewer tears after the age of 40 years. When tear production lowers to a certain point, the eyes can become dry and easily irritated and inflamed.

Dry eyes caused by reduced tear production is more common among females than males; and especially more common among post-menopausal females. Experts say that this is due to hormonal changes.

Reduced tear production is also linked to:

Inflammation
Radiation
Diabetes
Rheumatoid arthritis
Lupus
Scleroderma
Sjogren’s syndrome
Vitamin A deficiency
Refractive eye surgeries, such as LASIK (laser-assisted in-situ keratomileusis). In such surgeries, the symptoms are usually temporary.

Eyelid problems – each time we blink our eyelids spread a thin film of tears across the surface of the eyes. Most of us blink about five times a minute. If a patient has a problem with their eyelids, the blinking motion which evenly spreads the tear film may be affected. People with ectropion (eyelid turns outward) or entropion (eyelid turns inward) are examples of eyelid problems. Inflammation along the edge of the eyelids (blepharitis) may also cause dry eyes.
Medications – the following prescription and OTC (over-the-counter, non-prescription) medications may also cause dry eyes:

Some diuretics
ACE (Angiotensin-converting enzyme) inhibitors
Antihistamines
Decongestants
Some sleeping pills
Birth control pills
Some antidepressants
Some acne drugs (isotretinoin-type medications)
Morphine and other opiate-based painkillers

The following may also cause dry eyes:

Sun
Wind
High altitude
A very dry climate
Hot blowing air
Very dry air (airplane cabin air)
Working in front of a computer monitor (may slow down blinking rate)
Driving a vehicle (may slow down blinking rate)
Reading (may slow down blinking rate)
Smoke
Contact lenses
Shingles
Bell’s palsy
HIV
The examples above which are linked to a slowing down of blinking rate are usually because of intense visual concentration.

What is the Lacrimal Functional Unit?
Doctors and some other health care professionals use the term Lacrimal Functional Unit when referring to several body parts that work together in the production and regulation of tears. They include:

The lacrimal gland – produces mainly water with a bit of salt. The main constituents of tears.
The meibomian gland – produces a fatty liquid which is the outer layer of the tear film. Holds the tears in place and slows down evaporation.
The eyelid – spreads tears evenly across the surface of the eye each time we blink.
The cornea – a clear layer at the front of the eye. It contains smaller glands which produce liquids that make up our tears.
The tear duct (lacrimal duct) – a small channel at the side of the eye that allows tears to run off into our nose.

Diagnosis of dry eye syndrome
Most GPs (general practitioners, primary care physicians) can diagnose dry eye syndrome from signs, asking the patient about symptoms and looking at the patient’s medical history. The GP will need to know what medications the patient is currently taking, as well as information on their occupation and personal circumstances.

The GP may refer the patient to an optometrist; a health care professional who is licensed to provide primary eye care services. With the aid of special devices the optometrist will be able to diagnose dry eye syndrome, as well as other conditions and possible complications, and offer treatment advice.

The optometrist may carry out a number of tests, including:

The Schirmer test – the aim here is to determine the quantity of tears behind the eyelid over a set period. Small strips of blotting-paper-like material are placed under the patient’s eyelid. A few minutes later they are removed to see how wet they are.
The Rose Bengal test – a Royal Bengal (a liquid stain, dye) is dropped onto the surface of the eye. The red dye helps the optometrist determine whether the tear film is functioning properly, as well as measuring the rate of tear evaporation.

The patient may be referred to an ophthalmologist if diagnosis is unclear, or if special tests and treatments are needed. An ophthalmologist is a doctor/surgeon who is specialized in diseases and treatments of eye conditions and diseases.
What are the treatment options for dry eye syndrome?
Treatment for dry eye syndrome depends on many factors, the main one being what is the underlying cause. The aim is to keep the eyes well lubricated.

Eyelid problems – if the patient has something physically wrong with the eyelid, or an incomplete blink that causes dry eyes, the doctor may refer him/her to an oculoplastic surgeon – a surgeon specialized in eyelid problems.

If the patient has blepharitis (inflammation of the eyelid) regular cleaning of the affected area with a dilute solution of baby shampoo may be recommended. The doctor may also prescribe antibiotic drops or ointment for night time use. The patient may alternatively be prescribed an oral antibiotic, such as tetracycline or doxycycline.
Artificial tears – in mild dry eye cases the patient may find effective treatment simply by using OTC artificial tears. It is best to ask the doctor which ones are the most suitable.

Eye drops without preservatives can be used at will, as many times a day as you like. Those with preservative usually have a maximum safe dosage of four times a day. Eye drops for removing redness should not be used.

It may be a good idea to apply eye drops before activities which you know may exacerbate dry eye symptoms.

Ointments are generally better for night time use, because they may blur vision.
Keeping tears around for longer – tear ducts, which drain tears away, may be deliberately partially or completely blocked as a measure to conserve tears. Silicone plugs can be placed in the tear ducts to block them – they help keep your tears on your eyes for longer, as well as any artificial tears you apply.

The doctor may apply a hot wire that shrinks the tissues of the drainage area, which closes the tear duct. This is called thermal cautery.

Patients with severe symptoms are more likely to require silicone plugs, while those with mild symptoms may find that just using artificial tears are effective.
Boston Scleral Lens – this contact lens rests on the sclera (the white part of the eye). It creates a fluid-filled layer over the cornea, preventing it from drying out.
Medications – patients with chronic dry eyes may be prescribed cyclosporine (Restasis). Cyclosporine reduces eye-surface inflammation and triggers increased production of tears. Patients with an eye infection, as well as those with a history of herpes viral infection of the eye should not use this drug.

Steroid drops may help reduce inflammation for patients whose symptoms remain severe, even after frequent use of eyedrops.

Some studies indicate that omega-3 fatty acid consumption may help reduce the risk and/or incidence of dry eyes.
Specialist eyewear – some patients benefit from wearing moisture chamber spectacles, which wrap around the eyes like goggles. The spectacles help retain moisture in the eyes, as well as protecting them from wind and other irritants. Moisture chamber spectacles are more popular than they used to be because of their current sporty designs. They used to have an unattractive design and were unpopular.
Salivary gland transplantation – this surgical procedure is only ever considered in persistent and severe cases that have not responded to other treatments. Some of the salivary glands are removed from the lower lip and grafted, or placed into the side of the eyes. The saliva they produce becomes a substitute for tears.

Possible complications of dry eye syndrome

Ulceration of the cornea – inflammation linked to severe and untreated cases of dry eye syndrome can damage the surface of the cornea, leading to ulceration (scarring). The patient’s vision may become affected.
Conjunctivitis – most conjunctivitis caused by dry eye require no treatment. Sometimes, however, conjunctivitis can become chronic (long-term or recurring) and severe. In such cases the patient should see a health care professional.
Reflex tears – it is ironic that people with dry eye syndrome may sometimes produce too many tears. There are two types of tear production: 1. Basic tears; tears are produced at a slow and steady rate. 2. Reflex tears – tears are produced in large quantities in response to some irritant or emotion. Reflex tears have a much higher water content and a much lower mucus and oils content than do basic tears.

When our eyes are irritated because of dryness, the lacrimal glands produce large quantities of reflex tears, which flood the tear ducts, resulting in overflowing eyelids. Because these tears have a different make up of water, oils and mucus, compared to basic tears, they do not help control dryness – they do not help keep the eye moist. So, the eye may react further and produce more reflex tears.

The majority of people with dry eye syndrome experience no long-term problems or complications. Untreated dry eyes, especially if symptoms are more than mild, may result in eye inflammation, infection and damage to the surface of the cornea.

Prevention of dry eye syndrome

Keep the eyes clean – people with clean eyes are less likely to develop blepharitis. Use warm/hot (not boiling) water, dab some cotton wool into it, and gently clean your eyes. Massage your eye gently with a clean finger in a circular motion – this will help move the mucus from the eyelid glands.
Wind – wear wraparound glasses for protection from wind and hot air, which can cause dry eyes.
Computer monitor – the monitor should be just below eye level.
Avoid smoky places – if you smoke, give up. If you don’t, avoid places where people smoke.
Humidifier – a humidifier in the home will help moisten the air, which will help reduce the risk of dry eyes. Some people say that spraying curtains with a fine spray of water also helps keep the air humid.
Nutrition – evidence is starting to appear indicating that a diet rich in omega-3 fatty acids may help prevent dry eye syndrome. Sources of omega-3 fats include salmon, trout, tuna, herring and sardines. If you are vegetarian/vegan, the following foods are rich in omega-3 fatty acids: canola oil, English walnuts, flax oil, ground flax seed, hemp oil, hemp seed, olive oil, pumpkin seeds, and soybeans.

View drug information on Restasis.

A new study by vision scientists at the University of California, Berkeley, finds that the human visual system is better able to discriminate the movements of a single person when his or her actions are coordinated in a meaningful way with a second individual.

When shown a pair of figures in motion, for instance, the brain is better able to pick out an individual if it perceives that one person is throwing a punch while another is making a defensive block, the researchers said.

This is especially important when the view is somehow obscured or impaired, according to the study, published in the September issue of the journal Nature Neuroscience.

“Our study reveals a greater degree of complexity in human visual processing than previously understood,” said Dennis Levi, UC Berkeley dean of optometry and principal investigator of the study. “When we watch two people interacting, knowing what one is doing helps us understand the actions of the other. We think of it as ‘It takes two to Tango.'”

Other researchers on the team are Peter Neri, a UC Berkeley post-doctoral fellow in Levi’s laboratory, and Jennifer Luu, an undergraduate who joined the group as part of the UC Berkeley Undergraduate Research Apprentice Program. Luu is now a UC Berkeley Ph.D. student in bioengineering.

This research provides insight into how accurately we can interpret what we see from grainy security cameras, particularly when identifying whether a crime is taking place. There is even research taking place on the development of artificial intelligence computer programs that can automatically detect which actions are suspicious.

At its most fundamental level, the human brain’s ability to interpret and react to the action it sees within a fraction of a second is a matter of life and death, such as identifying that a tiger lunging forward with teeth bared is a threat and then deciding how best to get away.

But this skill – when not impaired by such disorders as autism – is also essential to our success as a social species, allowing us to determine whether someone is happy, sad or nervous based upon visual cues both subtle and obvious.

“Our study is the first to provide quantitative evidence that this ability to interpret action enhances the processing of visual discrimination,” said Neri, the lead author.

To build their dataset of human actions, the researchers outfitted members of the UC Martial Arts Program and the UC Ballroom Dance Team with sports suits that each contained 13 lights marking key body parts, such as the head, hands, knees and feet. The “actors” were then asked to fight or dance in a dark room while the researchers filmed the movements.

Using motion capture technology, the lights in the video were converted into dots that the researchers could manipulate. The original samples of each action – fighting or dancing – lasted 22 seconds each. In the synchronized video files, figures’ actions corresponded naturally with each other.

The researchers also created desynchronized files in which the movements of one figure filmed in the first 11 seconds were paired with those for the other figure in the second 11 seconds. In these files, the movements of the two figures were no longer coordinated with each other.

Four UC Berkeley undergraduate students with normal vision who had been recruited for the study were then shown 1.5- to 3-second sequences that were randomly selected from either the synchronized or desynchronized files. In half of the sequences, the researchers had further scrambled the dots of one figure and added many other dots to the sequence to mask the action. The researchers were able to vary the amount of dots to measure participants’ tolerance for “noise” or “fog.”

The participants had to determine whether the dots they were viewing represented one or two figures.

“We found that people can tolerate more masking dots and answer correctly when the figures’ actions are interacting in a meaningful way,” said Neri, who also participated in the study. “If the sequence is desynchronized, we can tolerate 10 dots. When viewing synchronized action, we can tolerate a minimum of 20 and up to 100 dots. Having the action coordinated improves the performance by at least a factor of two.”

The researchers noted that the relationship between two figures held true whether the movements were coordinated but antagonistic, as in the fighting sequences, or coordinated and cooperative, as in the dancing movements.

“This study shows that the cortex encodes complex information about actions, and that there can be a clear evolutionary advantage – improved visual discrimination – to doing so,” said Neri.

The researchers pointed out that the human brain is constantly adapting to limited amounts of visual information, enabling us to imagine a full picture of a tiger, for instance, even if trees and bushes obscure parts of its body.

The brain also allows us to understand when a group of dots or lines represents a human being. When presented with a group of dots in motion, the human visual system can distinguish whether the dots comprise a male or a female, and even judge the figure’s emotional state, the researchers said.

“We used to talk about how the eye is a camera that passes information intact to the brain, but that’s actually not how we see,” said Levi. “Things are always changing before our eyes, and our brain is constantly making best guesses about what it’s seeing.”

When the view is somehow obscured, that task naturally becomes more difficult. This guessing game played by the visual system is also why the brain is susceptible to optical illusions, Levi added. This best-guess approach to interpreting what we see is also an important factor when considering eyewitness accounts of events, the researchers said.

The National Institute of Health helped support this research.

Contact: Sarah Yang

University of California – Berkeley