Cataract Surgery: Wait Times And Quality Of Life

When does the wait time for cataract surgery cross over from being inconvenient to affecting health and quality of life? Dr. William Hodge and colleagues report on their systematic review of studies that assessed the relation between wait times for cataract surgery and patient outcomes. They found that patients who received cataract surgery within 6 weeks of surgical booking experienced better visual and quality-of-life outcomes and experienced fewer adverse events (e.g., falling) than patients who waited 6 months or longer. However, the outcomes associated with wait times between 6 weeks and 6 months remain unclear. This makes it difficult to determine a reasonable wait-time benchmark.

Cataracts are the most common eye disorder in North America. About 50% of people between 55 and 64 years of age, and 85% of people over 75 years of age, will have cataracts within a 10-year period. An opaqueness that develops in the lens of the eye, a cataract interferes with clear vision, affecting a person’s quality of life and even safety. Cataracts are usually diagnosed by a family physician or an optometrist. Statistics on wait times for cataract surgery do not take into account the considerable time that may pass between the visit to the primary physician and follow-up visit with a specialist.

p. 1285 – The consequences of waiting for cataract surgery: a systematic review
W. Hodge

Contact: Dr. William Gerald Hodge

Canadian Medical Association Journal

Will Digital Switchover Switch Off Radio For Blind People?

A move from analogue to DAB radio may leave people with sight problems left out of Britain’s digital revolution if steps are not taken to assist in the switchover, laid out today in the communications Minister Lord Carter’s Digital Britain report.

Radio is repeatedly cited as one of the most important pastimes by blind and partially sighted people and continued access to it is vital. While Lord Carter’s report leaves the door open for further discussions around a Digital Help Scheme similar to that used for switchover to digital television, The Royal National Institute of Blind People (RNIB) believes such a scheme is absolutely essential.

The remit of the Consumer Expert Group, which includes RNIB that informed the Digital TV switchover process, is to be extended to cover radio, and RNIB welcomes this government decision. An analysis of the potential costs and benefits will also go ahead.

The report suggests that all technical criteria for migration to digital radio should be complete by 2015. RNIB is calling on the government to provide a scheme to help people with sight problems in making the transition.

Leen Petre, Principal Manager – Media and Culture for RNIB, says: “Digital Britain calls for fairness and access for all, but has left key issues unresolved that seriously affect how fair in practice a digital radio switchover will be to the thousands of blind and partially sighted people who depend on radio as their main source of news and entertainment.

“The digital TV switchover help scheme was a great step forward, and we would like to see similar support offered for a digital radio switchover. A plan is essential to help those who’ll struggle with technical practicalities and the inaccessibility of digital radio equipment.”

The Digital Britain report also states that DAB is the medium of consumer choice, and while this may be true, steps will have to be taken to ensure that DAB equipment that meets the needs of people with sight and dexterity problems is available at an affordable price. RNIB is calling for a help scheme to provide equipment to this effect, and for a usability standard mark to be provided on all products.

A piece of research recently commissioned by the RNIB showed that nearly 70 percent of people with sight problems need ongoing help to use digital radios without voice output1. The results also showed that many people felt significant improvements could be made with relatively simple design changes. Features such as larger buttons of a different, contrasting colour to that of the casing and larger display screens also prove popular with sighted customers.

More information on RNIB’s digital radio work.

For further information and to arrange interviews with RNIB experts, please contact Gary Hartley or Yashoda Sutton at the RNIB press office on 020 7391 2223


The Digital Britain report can be found on the Department for culture, media and sport’s website.

Reference to a Digital Help Scheme for radio can be found at Chapter 3b point 15

Voice output on digital radio is a system whereby spoken feedback is provided to the user to enable easy use and navigation of the radio. First a voice can confirm the buttons a user presses or functions a user alters, and second a voice can read out t he information that appears on the radio’s text display (e.g. station name, time, programme name). This feature is particularly beneficial for users with sight problems, but it can also help make digital radio easier to use for others.

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 0303 123 9999.

Royal National Institute of Blind People

Study Of Anti-PDGF And Anti-VEGF Therapy Shows Significant Neovascular Regression And Enhanced Visual Outcome

Ophthotech Corp. announced positive results of a phase 1 clinical study evaluating E10030, its novel anti-platelet derived growth factor (anti-PDGF) in conjunction with an anti-vascular endothelial growth factor (anti-VEGF), to treat wet age-related macular degeneration (wet AMD). Anti-PDGF therapy resulted in enhanced visual outcome and was associated with significant neovascular regression. The results were presented at the Association for Research in Vision and Ophthalmology (ARVO) 2009 Annual Meeting in Fort Lauderdale.

59% percent of patients treated with anti-PDGF and anti-VEGF gained significant vision (3-line gain) at week 12 after therapy. 100% of treated patients demonstrated neovascular regression. E10030 was well tolerated with no evidence of drug-related adverse events. Current standard of care treatment utilizing monotherapy anti-VEGF results in 3-line visual gain in approximately one third of patients and without significant neovascular regression.

“Marked neovascular regression, a first in any study, with an outstanding level of visual gain, is very promising for our patients. My clinical experience with current monotherapy anti-VEGF regimen in wet AMD is consistent with published studies, which show that on average neovascular regression does not occur,” said Dr. Lawrence J. Singerman, Clinical Professor at Case Western Reserve University and a principal investigator in over 50 macular clinical trials.

E10030 is an aptamer targeting PDGF, a key molecule involved in the recruitment and maturation of pericytes. Pericytes in neovascular tissue have been shown to be protective and play a major role in anti-VEGF treatment resistance. E10030 strips the pericytes from the neovascular tissue rendering it highly sensitive to an anti-VEGF attack.

“The objective and robust response of neovascular regression is consistent with the biologic activity of E10030. I look forward to a randomized trial design to confirm the strong proof of concept data of this study,” said Dr. Donald J. D’Amico, Professor and Chairman, Department of Ophthalmology, Weill Cornell Medical College, New York-Presbyterian Hospital.

“It is exciting to see our clinical trial confirm the strong preclinical data from oncology and ophthalmic studies targeting the molecules regulating pericyte and endothelial cell survival. Ophthotech will continue to devote its resources towards an accelerated development of our anti-PDGF compound,” said Dr. Samir C. Patel, President and CEO of Ophthotech Corp.

Wet AMD is characterized by the abnormal growth of blood vessels (neovascularization) beneath the retina, which leak blood and fluid and can cause permanent damage to cells in the center of the retina (the macula). This form of AMD is the most severe form of the disease, and often leads to permanent vision loss.

E10030 is one of three compounds that Ophthotech is developing to treat wet and dry AMD. Additional molecular entities include an anti-C5 aptamer and volociximab, an anti-angiogenic monoclonal antibody targeting the a5B1 integrin, both currently in a Phase I study.

About anti-PDGF E10030

E10030 is an aptamer-based compound directed against PDGF-B. Pharmacology studies indicate that E10030 binds to PDGF-B with high specificity and affinity and inhibits the functions of PDGF-B both in vitro and in vivo. In preclinical studies, E10030 demonstrated the potential to regress neovascularization when used in combination with a VEGF-A inhibitor. In experiments involving models of ocular vascularization, concurrent inhibition of PDGF-B and VEGF-A signaling was superior to inhibition of the VEGF-A pathway alone.

About AMD

Age-related macular degeneration (AMD) is the leading cause of blindness for people over the age of 50 in the United States and Europe. The role of abnormal neovascularization, or angiogenesis, in the pathogenesis of neovascular AMD has been well established. There are two forms of the disease, namely “dry” and “wet” AMD. The “wet” form is characterized by the growth of new blood vessels into the central region of the retina. These new vessels cause severe visual loss due to retinal damage caused by subsequent leakage and scar formation. Anti-VEGF therapies and photodynamic therapies have been approved for “wet” AMD. “Dry” AMD accounts for up to 90 percent of all cases of AMD. There is no approved therapy for “dry” AMD, which afflicts 8 million patients in the United States and an additional 8 million in Europe. Visual loss in “dry” AMD is typically not as severe as “wet” AMD, however, over time, “dry” AMD can progress to the wet form of the disease.

About Ophthotech

Ophthotech Corp. is a privately held biopharmaceutical company based in Princeton, NJ and New York, NY focused on developing and commercializing therapies for back-of-the-eye diseases. Ophthotech plans to develop a pipeline of compounds with strong scientific foundations for the treatment of AMD and bring them to market in an accelerated manner.

Source: Ophthotech Corp

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