Month: September 2014

FDA on Friday approved Genentech’s Lucentis, the first drug proven to restore vision in a significant percentage of people with wet age-related macular degeneration, the San Francisco Chronicle reports (Tansey, San Francisco Chronicle, 7/1). Wet age-related macular degeneration is caused by the abnormal growth of blood vessels behind the eye, which can leak blood and other fluid and create scar tissue that over time destroys the center of the retina. Lucentis inhibits a protein that is believed to assist the formation of the abnormal blood vessels. Two major studies find that 95% of patients with the disease who were treated with Lucentis experienced no decline in vision during one year and that 34% to 40% experienced improved sight. Lucentis is not a treatment for dry age-related macular degeneration, which is more common and less serious than the wet type, the San Jose Mercury News reports (Johnson, San Jose Mercury News, 7/1). Lucentis will cost $1,950 per injection, which is more than 100 times the lowest price for a small dose of Avastin, a similar Genentech drug used by some doctors to treat the disease (Wall Street Journal, 7/1). Avastin is approved to treat cancer, but some doctors since late 2005 have been using the injectable medication to treat wet macular degeneration. Avastin costs about $50,000 per year to treat cancer, but because the amount needed for eye injections is small, the cost for treating wet macular degeneration is about $1,000 or less per year. Both drugs were designed to block vascular endothelial growth factor, which controls abnormal blood vessel growth. Lucentis was designed to be a smaller drug that more effectively penetrates the eye and concentrates its effects, minimizing side effects, according to Susan Desmond-Hellmann, president of product development at Genentech (Kaiser Daily Health Policy Report, 6/29). Lucentis’ FDA-approved label recommends monthly injections, but Genentech said the average patient will receive only five to seven injections in their first year because of the risk of eye pain, inflammation and increased pressure. Genentech said there are about 242,000 U.S. candidates for Lucentis treatment (San Francisco Chronicle, 7/1).

Comments
Genentech “emphasiz[ed] that it has not studied the safety or effectiveness of Avastin in treating the disease, nor does it plan to do so,” the AP/Chicago Tribune reports. Genentech’s Chief Medical Officer Hal Barron said, “We believe Lucentis is a much better choice” (Bridges, AP/Chicago Tribune, 7/1). Eugene de Juan, president of the American Society of Retina Specialists and a professor of ophthalmology at the University of California-San Francisco, said, “This is important and a major change in ophthalmology” (San Jose Mercury News, 7/1). De Juan added, “From a retina doctor’s point of view, this is pretty close to penicillin. It’s like reversing aging.” Genentech officials said the company has established programs to provide Lucentis at no cost to uninsured patients and to cover Medicare copayments for qualified applicants. Joshua Schimmer, an analyst for SG Cowen, said Lucentis’ biggest competition would be Avastin. Schimmer estimated the total market for wet macular degeneration treatments at $750 million to $1 billion (San Francisco Chronicle, 7/1). Maryann Redford of NIH’s National Eye Institute said her agency has received an outside proposal to conduct a head-to-head trial comparing Avastin and Lucentis (AP/Chicago Tribune, 7/1).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

View drug information on Avastin; Lucentis.

Face blindness is a condition that affects about 2% of the population’s
ability to do what many consider an effortless task – to recognize
faces of family, friends, and other acquaintances. A small number of
people find it difficult to identify the person with whom they are
meting or remembering people that they have previously met. Some, in
fact, cannot recognize the faces of spouses, children, or even
their own faces. To better understand developmental face disorders,
recent research on face blindness stresses the importance of using
naturalistic
emotional faces and bodies.

A study published in the open-access journal PLoS ONE
and researchers from the Netherlands and Massachusetts
General
Hospital discusses an interesting finding about how the brain
interprets face information. Beatrice de Gelder (Tilburg
University, Tilburg, The Netherlands) and colleagues demonstrate that
increased neural activity in the fusiform face area (FFA, the area of
the brain associated with face recognition) is associated with the
presence of emotional
information in the face. The researchers believe that this finding can
assist the design of new assessment and training programs. In addition,
the study reveals that people with face blindness do not have body and
face sensitive processes are that are as
categorically segregated, which suggests cortical specialization as a
potential cause of the disorder.

Faces offer information on a person’s gender, age,
emotion, familiarity, and attractiveness. Depending on the
context, these details can be called
upon and used either quite rapidly or after full recognition of facial
attributes, including a name. In order to evaluate face recognition
problems and to understand it neuro-functional basis and potential
deficits, the
contextual requirements and the task settings are very important.

De Gelder and colleagues used functional magnetic resonance imaging
(fMRI) to assess how well a group of individuals could process faces.
The participants all suffered developmental prosopagnosics;
that is, they reported life-long problems in recognizing people and
particular
difficulties when meeting familiar people unexpectedly. These people
were compared with a control group that was matched for age, sex and
education level. The aim of the research was to find out how the neural
underpinnings of
face and body processing in prosopagnosia are changed by emotional
information in the face and the body. The participants received a
series of tests that assessed their ability to recognize objects and
faces, their perception, and their ability to match and memorize faces.

The analysis by De Gelder and colleagues revealed that the
developmental prosopagnosia group displayed a similar activation level
as the control group
in FFA for the emotional faces, but the developmental
prosopagnosia also displayed a lower activation in this area for
neutral faces. Therefore, there is a higher threshold for the
recognition of neutral faces in these prosopagnosics. Neutral faces are
believed to be more difficult because these faces
are more difficult stimuli than the other categories with which they
are usually compared.

Faces that are showing emotion contain an additional feature that
provides important communicative information and thus the emotional
stimuli trigger a higher level of
arousal. The researchers also observed that when prosopagnosics looked
at emotional faces, there were high activity levels in the amygdala –
the region of the brain that deals with emotional reactions – than when
looking at neutral ones.

The authors conclude that: “The results from the present study clearly
demonstrate the importance of emotional information in face processing
and urge (future imaging) studies to take the modulatory effect of
emotion into account, in order to further untangle the complex nature
of DP [developmental prosopagnosia].”

Neural Correlates of Perceiving Emotional Faces and Bodies in
Developmental Prosopagnosia: An Event-Related fMRI-Study
Van den Stock J, van de Riet WAC, Righart R, de Gelder B
PLoS ONE (2008). 3(9):e3195.
doi:10.1371/journal.pone.0003195
Click
Here to View Article

About PLoS ONE

PLoS ONE is the first journal of primary research
from all areas of science to employ both pre- and post-publication peer
review to maximize the impact of every report it publishes. PLoS
ONE is published by the Public Library of Science (PLoS), the
open-access publisher whose goal is to make the world’s scientific and
medical literature a public resource.

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization
of scientists and physicians committed to making the world’s
scientific and medical literature a freely available public resource.
For more information, visit plos

: Peter M Crosta

The General Optical Council (GOC) sent letters to student registrants who have failed to apply for retention of their registration for the year beginning 1 September. The student retention deadline was 15 July. A total of 3,434 students have renewed their registration, but 733 applications are still outstanding (18 per cent). The total includes 344 student optometrists and 389 student dispensing opticians.

Universities and colleges have been sent lists of students who have failed to renew. The College of Optometrists and ABDO are also being notified of pre-registration students with applications outstanding. Those who fail to renew by 31 August will not be eligible to continue with their studies or clinical training from 1 September.

The GOC’s letter includes a warning that any unregistered student who carries out restricted acts may face prosecution, and that the GOC may not recognise the qualifications of students who have not been registered throughout their course, when they apply for full registration.

Pre-registration students are being asked to renew their student registration, even if they intend to apply for full registration before 31 August. In these cases, the GOC will deduct the student retention fee from their full registration fee.

GOC registrar Peter Coe explained: “Students need to make sure there is no gap when they are training or working, where they are not registered with the GOC. Registration is a legal requirement, and it is essential to ensure proper protection for patients involved in students’ clinical training. Just as importantly, registering, and maintaining registration, with the GOC is part of the code of conduct, and core to professionalism. Students need to demonstrate a professional approach and attitude, in addition to technical skills and knowledge.”

First years starting optometry or dispensing optics courses this year will need to register before starting their course. The GOC will be visiting all the universities and colleges providing GOC approved courses at the start of term to talk to students and collect remaining applications.

1. Optometry and dispensing optics come into contact with patients during their educational courses and vocational training. Since 30 June 2005, it has been a legal requirement for optometry and dispensing optics students to be registered with the General Optical Council.

2. There are a total of 4,167 students on the Council’s registers, including 1,511 student dispensing opticians and 2,439 student optometrists.

About the General Optical Council

The GOC is the regulator for the optical professions in the UK. Its purpose is to protect the public by promoting high standards of education and conduct amongst opticians. The Council currently registers around 22,000 optometrists, dispensing opticians, student opticians and optical businesses.

optical

Compared to glasses, contact lens wear significantly improves how children and teenagers feel about their appearance and participation in activities a newly published study shows. These quality of life improvement measures following a switch from glasses to contacts indicate that children eight to 12 years of age who require vision correction should be given the option of being fitted with contact lenses say study investigators. Researchers reported the results of the study in the November issue of Eye & Contact Lens, the official publication of the Contact Lens Association of Ophthalmologists.

Teenagers are frequently fitted with contact lenses to correct refractive errors by eye care practitioners, but children younger than 13 are generally not given the option of contact lens wear, often because eye care practitioners or parents believe that children don’t have the maturity to properly care for them.

“Children as young as eight years old who need vision correction are as capable as teenagers at wearing and caring for soft contact lenses and should be presented with the option of contact lens wear when vision correction is required,” says Jeffrey J. Walline, O.D., Ph.D., from the Ohio State University College of Optometry and study leader of The Contact Lens in Pediatrics (CLIP) Study. “This research demonstrates that both children and teens derive a number of quality of life benefits from contact lenses, which leads to greater satisfaction with their vision correction.”

“Contact lenses often provide a more convenient mode of correction for young wearers and this study demonstrates that both children and teens can adapt to contact lens wear and derive similar benefits,” adds Mary Lou French, O.D., F.A.A.O., M.Ed, a private practitioner in Orland Park, IL. “With a wide variety of contact lenses available, eye care practitioners can work with young patients and their parents to determine what modality best fits each child’s personality, maturity and lifestyle.”

About the Study

The CLIP Study is the first clinical investigation to compare children and teens using silicone hydrogel contact lenses. The study compared the function and quality of life benefits of silicone hydrogel contact lenses among first-time wearers ages eight to 12 and 13 to 17.

Children ages 8-12 (n =84) and teenagers ages 13-17 (n=85) who participated in the study required vision correction to see optimally. Fifty-seven percent of the subjects were female and 48 percent were white. Following baseline examinations, participants were initially fitted with either ACUVUE® ADVANCE® Brand Contact Lenses with HYDRACLEAR™ or ACUVUE® ADVANCE® for ASTIGMATISM.

Participants completed the Pediatric Refractive Error Profile (PREP) survey at the baseline visit, while wearing glasses, and at the one-week and one-month visits while wearing contact lenses. The PREP survey compares the vision-specific quality of life between children wearing contact lenses and children wearing glasses. PREP scores are calculated on a scale that ranges from zero (poor quality of life) to 100 (excellent quality of life).

The mean overall PREP for glasses score was similar for both groups 63.6 ?�10.7 for children and 63.0 ?� 9.8 for teens (p=0.12). Likewise, both groups reported similar PREP scores for contact lenses. The children’s overall PREP score for contact lenses at one-week was 74.7 ?� 10.4 and the teens’ average score was 71.8 ?� 9.2 (p=0.10). At one month, children’s overall PREP for contact lenses score was 74.5 ?� 9.6 and teens’ average score was 72.1 ?� 8.7 (p=0.23). “The data show that children and teens perceive similar improvement in their quality of life when wearing contact lenses versus glasses,” says Dr. Walline.

Participants were also asked questions apart from the PREP, like how they felt about wearing contact lenses during sporting activities; 95.9 percent of children and 92.6 percent of teens said they “loved” or “liked” to wear contact lenses during sports. When asked about their sporting performance, 58.9 percent of children and 62 percent of teens felt their performance was “much better” or “better” while wearing contact lenses.

When asked which they liked better (or equally), 71.2 percent of children and 78.5 percent of teens said that they liked wearing contact lenses “a little better” or “a lot better” than glasses. Children said that they “always” or “usually” liked to wear their contact lenses 76.7 percent of the time, and teens reported the same 85.2 percent of the time. After three months of contact lens wear, each group wore their contact lenses on average 11 hours per day.

Other study parameters examined included short-term safety, vision correction, fitting and training time, and a series of questionnaires completed by patients and their parents. The three-month study was conducted at three sites the Ohio State University College of Optometry, the New England College of Optometry and the University of Houston School of Optometry. The study was sponsored by Vistakon®, Division of Johnson & Johnson Vision Care, Inc.

About ACUVUE® ADVANCE® with HYDRACLEAR™ and ACUVUE® ADVANCE® FOR ASTIGMATISM

ACUVUE® ADVANCE® Brand Contact Lenses with HYDRACLEAR™ and ACUVUE ADVANCE® for ASTIGMATISM are available by prescription and are indicated for daily wear vision correction. As with all contact lenses, eye problems, including corneal ulcers, can develop. Some wearers may also experience mild irritation, itching or discomfort. Lenses should not be worn if the wearer has an eye infection or experiences eye discomfort, excessive tearing, vision changes, redness or other eye problems. If these conditions occur, the wearer should contact their eye care professional. Consult the patient information guide available from your doctor for complete information.

Johnson and Johnson
Johnson and Johnson

Choroideremia is a rare, inherited disorder found almost exclusively in males and is characterized by progressive loss of vision due to degeneration of the choroid and retina. The disorder is caused by a mutation in the CHM gene on the X chromosome, which codes for an important protein called the Rab escort protein-1 (REP-1), which shuttles other cellular proteins towards the cell membrane to allow the passage of nutrients in and out of the cell. The absence of REP-1 results in nutrient deficiency and degeneration of light-sensitive photoreceptors embedded within the thin layer at the rear of the eye (the retinal pigment epithelium, RPE), and the choroid (a layer filled with blood vessels that nourish the retina).

In a study appearing online on January 12 in advance of print publication in the February 2006 issue of the Journal of Clinical Investigation, Miguel Seabra and colleagues from Imperial College London report the development of the first mouse model of this degenerative eye disease. The authors go on to demonstrate that choroideremia involves independently triggered degeneration of photoreceptors and the RPE, and that these events are caused by different trafficking defects in various subsets of defective Rab proteins. This is an important finding as it was previously believed that RPE degeneration resulted in photoreceptor degeneration, and vice-versa. Development of an animal model for this disease will allow researchers to assess potential therapies and gain a better understanding of disease mechanisms.

TITLE: Independent generation of photoreceptors and retinal pigment epithelium in conditional knockout mouse models of choroideremia

Brooke Grindlinger
press_releasesthe-jci
Journal of Clinical Investigation
jci

A new type of procedure for correcting short-sightedness could be safer than laser eye surgery, according to a new Cochrane Systematic Review. The study also shows that patients prefer the new procedure, despite there being little difference between the two in terms of improving vision.

Myopia or short-sightedness is a condition where the eye focuses images in front of the retina instead of directly on it. Myopia affects around a quarter of the population in Western countries and is becoming more common. In recent years, the preferred corrective procedure for people wanting to avoid wearing glasses or contact lenses has been excimer laser refractive surgery, but a new alternative is the insertion of phakic intraocular lenses (IOLs). Both procedures work by changing the path of the light entering the eye and bringing images into focus in the right place. Laser surgery does this by removing parts of the cornea, whereas the new procedure uses a synthetic lens inserted in front of the natural lens.

Until now, there has be no systematic review comparing the accuracy and safety of the two procedures and insertion of phakic IOLs has only been practiced in more severely short-sighted patients. However, the new study suggests the procedure could be more widely used.

“Our findings suggest phakic IOLs are safer than excimer laser surgery for correcting moderate to high levels of short-sightedness,” says lead author Allon Barsam of the Moorfields Eye Hospital NHS Foundation Trust in London, UK. “Although it’s not currently standard clinical practice, it could be worth considering phakic IOL treatment over the more common laser surgery for patients with moderate short-sightedness.”

The researchers reviewed data from three trials comparing the two types of surgery, which together included surgeries performed on 228 eyes in 132 patients. A year after surgery, the percentage of eyes with 20/20 vision without spectacles was the same for both procedures, but patients undergoing phakic IOL treatment had clearer spectacle corrected vision and better contrast sensitivity. Patients also scored the phakic IOL procedure more highly in patient satisfaction questionnaires.

Phakic IOL treatment carries a slightly increased risk of cataract, but further investigation of long term adverse effects is needed, according to the researchers. “There may be more long term risks unique to patients with phakic IOLs that are not apparent after one year of follow-up,” says Barsam.

Source:
Jennifer Beal

Wiley-Blackwell

A combined analysis of two
landmark clinical glaucoma trials — the Ocular Hypertension Treatment
Study (OHTS) and the European Glaucoma Prevention Study (EGPS) — confirms
the benefit of a five-year risk assessment model to help ophthalmologists
better predict which patients have an increased risk of developing
glaucoma. Glaucoma is the second leading cause of blindness in the world,
affecting approximately 70 million people, and can lead to blindness if
left untreated. These new data were presented this week at the annual
American Academy of Ophthalmology meeting.

The analysis showed that patients with elevated intraocular pressure
(IOP) — along with other predictive risk factors, such as older age (40+)
— are at highest risk of progressing to primary open-angle glaucoma
(POAG). The results are similar to the 2005 risk-assessment model reported
by Dr. Robert N. Weinreb and Dr. Felipe A. Medeiros based on findings from
the 2002 Ocular Hypertension Treatment Study (OHTS), a five-year National
Eye Institute- sponsored trial that found early intervention with
IOP-lowering medications could prevent glaucoma in at-risk patients.

“It is critical to continue to evaluate and refine innovative,
predictive models in ophthalmic medicine in order to provide the best
treatment possible for patients,” said Dr. Michael Kass. “We hope this tool
will become as universally adapted as predictive models used in other
therapeutic areas, such as the Framingham Study, which provided a basis for
accurate cardiac risk assessment.”

“For some time we have known that if we could identify those patients
most likely to progress to glaucoma, earlier intervention with effective
treatments could help reduce the risk of vision impairment,” said Dr.
Robert N. Weinreb, director of the Hamilton Glaucoma Center and
Distinguished Professor of Ophthalmology at the University of California,
San Diego, USA. “This new analysis provides a larger-scale validation of
breakthrough findings of the OHTS group and reinforces to clinicians how
the tool can be useful in assessing which patients are most at risk.”

The OHTS prediction model was tested on patients in the EGPS placebo
group and the two study samples from the control (non-treated) arms were
pooled to increase precision and generalizability of a five-year predictive
model for developing POAG. The OHTS observation group contained 819
patients with a median follow up of every six months for 6.6 years. The
EGPS placebo group contained 500 patients with a median follow up of every
six months for 4.8 years.

“We know that awareness of these predictors, particularly elevated
intraocular pressure, and central corneal thickness, is critical in
treating and potentially preventing damage to the optic nerve caused by
glaucoma progression,” said Professor Stefano Miglior, director of the
Department of Ophthalmology, Policlinico di Monza, University of Milan
Bicocca, Italy, and Chairman of EGPS. “The large-scale validation, which
includes a European patient population for the first time, reinforces the
consensus about the importance of informed dialogue between physicians and
patients on how often eye examinations are needed and when it might be
appropriate to initiate treatment.”

The research was supported by grants from Pfizer Inc, the National Eye
Institute and the National Center for Minority Health and Health
Disparities, National Institutes of Health, the European Commission and
Research to Prevent Blindness and Merck Research Laboratories.

Pfizer’s current product line includes the most prescribed treatment to
lower elevated eye pressure in patients with ocular hypertension
(abnormally high eye pressure) or open-angle glaucoma. In collaboration
with (OSI) Eyetech, the division also includes a treatment for neovascular.

CE Pfizer Inc
pfizer

Sirion Therapeutics,
Inc., a privately held ophthalmic-focused biopharmaceutical company,
announced positive preliminary results from its Phase III difluprednate
(ST-601) program, which evaluated the steroid’s potential to rapidly
resolve inflammation in the eye following ocular surgery.

“We are very pleased with the data that demonstrate difluprednate’s
potential as a potent, well-tolerated steroid treatment for post-operative
inflammation,” said Dr. Roger Vogel, Sirion’s Chief Medical Officer. “Based
on these data, Sirion is moving forward with its plans to submit a New Drug
Application to the FDA.”

The Phase III program consisted of two multi-center, randomized,
double- masked studies that compared the safety and efficacy of
difluprednate 0.05% to placebo, dosed two (BID) or four (QID) times daily
beginning 24 hours after surgery. The studies included 439 subjects who
presented with Grade 2 (an inflammatory cell count greater than or equal to
10) or higher the day after surgery. Inflammation was measured by the
number of cells in the anterior chamber of the eye with a Grade 0 equaling
less than or equal to one cell. The primary efficacy endpoint measured the
proportion of subjects whose inflammation reached Grade 0 at Day 8.

Both difluprednate dosing regimens were superior to placebo at the
primary endpoint, reaching high statistical significance at Day 8 and
maintaining superiority through both the treatment period (Day 15) and the
tapering period (Day 29). At Day 15, 56% of subjects on the BID regimen
reached Grade 0 compared to 16% in the control group (p

The analysis demonstrated comparable clinical efficacy and acceptable
safety profiles for both BID and QID dosing of difluprednate.

“These are extremely robust data,” said Dr. Michael Korenfeld, an
ophthalmologist with Comprehensive Eye Care in Washington, Missouri who was
an investigator in the trial. “Being able to treat ocular inflammatory
disease with a more convenient dosing regimen and having the potential to
offer rapid resolution of inflammation after ocular surgery would represent
a meaningful advance for patients.”

“Sirion is very excited about these results. When we started this
program, we felt that difluprednate had the potential to be a major step
forward in the control of ocular inflammation. These results met our
highest expectations” said Barry Butler, President and CEO of Sirion. “We
look forward to bringing this important new treatment option to
ophthalmologists and patients.”

About Post-Operative Inflammation

There are more than 3.5 million ophthalmic surgeries performed each
year in the United States. Post-operative inflammation is a common
occurrence following these procedures. While it tends to be self-resolving,
some cases can lead to serious sequelae. If left untreated, inflammation
following ocular surgery can interfere with the patient’s visual
rehabilitation or lead to further complications, such as acute pain and
discomfort, chronic cystoid macular edema, posterior capsule fibrosis,
keratopathy, fibrin reaction, or chronic uveitis. As there is no way to
predict which patients might develop inflammatory complications, doctors
often prescribe steroids and/or NSAID drops. Most often, post-operative
inflammation lasts a relatively short time, though severe forms of
inflammation can persist for a longer period of time.

About Difluprednate (ST-601)

Difluprednate is a potent ophthalmic steroid emulsion that has the
potential to treat patients suffering from ocular inflammatory disease.
Difluprednate’s unique formulation permits rapid penetration of the cornea,
which promotes quick resolution of anterior chamber cells and flare. A
Phase 3 program evaluating difluprednate in patients with post-surgical
inflammation was completed in September of 2007, showing difluprednate’s
potential to rapidly eradicate ocular inflammation versus placebo while
maintaining an acceptable safety profile. In addition to post-surgical
inflammation, difluprednate is being evaluated in a Phase 3 program as a
treatment for patients with uveitis.

About Sirion Therapeutics, Inc.

Sirion Therapeutics is a privately held biopharmaceutical company
pursuing the discovery, development and commercialization of products
addressing unmet medical needs in the protection and preservation of
eyesight. Sirion’s pipeline includes four late-stage opportunities:
ganciclovir, a topical antiviral for herpetic keratitis with a planned NDA
submission in early 2008; difluprednate, a potent topical steroid in Phase
III development for post- operative inflammation and uveitis; cyclosporine,
a topical immunomodulator in Phase III testing for dry eye and fenretinide,
a first-in-class oral vitamin A binding protein antagonist in Phase II
development for geographic atrophy associated with dry AMD. In addition,
Sirion plans to leverage its expertise in ophthalmology and vision research
to identify additional candidates in back of the eye diseases, through both
internal research efforts and partnering opportunities. For more
information regarding Sirion, please visit Sirion’s website at
siriontherapeutics.

Sirion Therapeutics, Inc.
siriontherapeutics

Weightlifting may cause a temporary increase in pressure within the eye, with higher pressure occurring with breath-holding during a weightlifting exercise, according to a report in the September issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Intraocular pressure (the pressure within the eyeball) is generally decreased after aerobic exercise, such as running and biking, and nonaerobic exercise, including weightlifting, according to background information in the article. However, higher intraocular pressure has been reported during the Valsalva maneuver, in which air is forced against a closed windpipe and pressure increases in the chest. This action occurs during coughing, vomiting, playing wind instruments and sometimes weightlifting.

Geraldo Magela Vieira, M.D., Institute of Specialized Ophthalmology and UNIPLAC School of Medicine, Bras?�lia, Brazil, and colleagues measured intraocular pressure during weightlifting in 30 males age 18 to 40 (average age 26) without glaucoma. The participants, who all had normal (less than 21 millimeters of mercury) eye pressure, performed four repetitions of a bench press exercise in two ways. The first time, pressure was measured in the right eye and the weightlifters held their breath during the last repetition. The second time, pressure was measured in the left eye and the participants breathed normally throughout the exercise. Eye pressure was measured during the fourth repetition.

During the first round of exercise, intraocular pressure increased in 27 (90 percent) of the participants, by an average of 4.3 millimeters of mercury. During the second round, pressure increased in 18 (62 percent) of weightlifters by an average of 2.2 millimeters of mercury. The increased pressure could be due to the Valsalva maneuver or a similar motion performed during bench presses; the even higher pressure during the first repetitions “may be due to greater intrathoracic [chest] pressure caused by the air retained in the lungs when the subjects held their breath during intraocular pressure measurement,” the authors write.

The authors note that a certain type of glaucoma (normal-tension glaucoma) is more common in individuals who are subjected to frequent changes in eye pressure. “Prolonged weightlifting could be a potential risk factor for the development or progression of glaucoma. Intermittent intraocular pressure increases during weightlifting should be suspected in patients with normal-tension glaucoma who perform such exercises,” they conclude. “Patients with normal-tension glaucoma should be questioned as to a history of regular weightlifting.”

This study was supported in part by the Joseph and Marilyn Rosen Research Fund of the New York Glaucoma Research Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Contact: Jean Thomas

JAMA and Archives Journals

Ultraviolet (UV) radiation is a concern for many Americans, but most people are thinking about protecting their skin, not their eyes. Whether it’s a cloudy or sunny day, summer or winter, the American Optometric Association (AOA) reminds Americans to take specific measures to protect their eyes from the sun’s UV rays in order to decrease the risk of vision disorders.

The sun’s primary danger is in the form of UV radiation. UV radiation is a component of solar radiation, but can be given off by artificial sources like tanning beds.

According to the AOA’s 2008 American Eye-Q® survey, which identified Americans’ attitudes and behaviors regarding eye care and related issues, only 49 percent of Americans said UV protection was the most important factor when purchasing sunglasses. Respondents said that the price and style of sunglasses were among the most important factors to them.

“Overexposure to UV rays has been linked to a variety of problems, including age-related cataracts and degeneration of the cornea,” said Gregory W. Good, O.D., PhD, optometrist and AOA’s UV Protection Expert. “Other disorders that can occur are abnormal growths on the eye’s surface and even sunburn of the eyes. These conditions can cause blurred vision, irritation, redness, tearing, temporary vision loss and, in some instances, blindness.”

According to Dr. Good, the effects of solar radiation are cumulative; therefore optometrists recommend parents purchase proper eyewear for young children and teenagers. The longer the eyes are exposed to solar radiation, the greater risk a person has for developing conditions later in life such as cataracts or macular degeneration.

It is not clear how much exposure to solar radiation will cause damage, so the AOA recommends wearing quality sunglasses that offer proper UV protection and a wide-brimmed hat whenever people spend time outdoors. Also, certain contact lenses incorporate an ultraviolet blocker in the lens, which helps further reduce exposure to UV light that eventually can cause cataracts and other eye problems. Patients can ask their optometrist for additional information about these contact lenses.

The following top five tips from the American Optometric Association can help prevent eye damage from exposure to UV radiation:

1. Wear protective eyewear any time the eyes are exposed to UV rays, even on cloudy days and during the winter.

2. Look for quality sunglasses or contact lenses that offer good protection. Sunglasses or protective contact lenses should block out 99 to 100 percent of UV-A and UV-B radiation and screen out 75 to 90 percent of visible light.

3. Check to make sure sunglass lenses are perfectly matched in color and free of distortions or imperfections.

4. Purchase gray-colored lenses because they reduce light intensity without altering the color of objects to provide the most natural color vision.

5. Don’t forget protection for young children and teenagers, who typically spend more time in the sun than adults and thus are at greater risk for damage.

Additionally, be sure to schedule periodic comprehensive eye exams with an eye doctor. It’s a good way to monitor eye health, maintain good vision, and keep up-to-date on the latest in UV radiation protection.

Other interesting facts from the American Eye-Q® survey include:

– 46 percent of survey respondents have worn lenses (contacts lenses or regular glasses) that provide UV protection.
– 35 percent of respondents wear prescription sunglasses.
– Some respondents understand that dry eye (32 percent), temporary blindness (30 percent), and sunburn (29 percent) can result from overexposure to UV rays.
– By comparison, fewer respondents link eye diseases such as cataracts (24 percent), eye cancer (24 percent), macular degeneration (19 percent); and glaucoma (17 percent) to overexposure to solar rays. (17 percent) to overexposure to solar rays.
– 67 percent of parents purchase sunglasses for their children; however, 13 percent of parents do not check to make sure the glasses protect against UV rays.

For additional information on UV protection, please visit: aoa/x4735.xml. Or to view a copy of the AOA’s Shopping Guide for Sunglasses, please visit: aoa/documents/SunglassShoppingGuide0810.pdf.

About the survey

The third annual American Eye-Q® survey was created and commissioned in conjunction with Penn, Schoen & Berland Associates (PSB). From May 17-19, 2008, using an online methodology, PSB interviewed 1,001 Americans 18 years and older who embodied a nationally representative sample of U.S. general population. (Margin of error at 95 percent confidence level.)

Source
American Optometric Association