Gene variant increases risk of age-related macular degeneration

Researchers at Duke University Medical Center and Vanderbilt University Medical Center have pinpointed the first major
gene that determines an individual’s risk for developing age-related macular degeneration (AMD). The chronic, progressive
disease — which affects as many as 15 million people in the United States — is the leading cause of visual impairment and
legal blindness in the elderly.

A common variant of the gene, called complement factor H (CFH), explains approximately 43 percent of the risk of AMD among
older adults, the researchers estimated. The team identified the disease-related gene after screening 182 families affected
by AMD and 495 other individuals with the condition.

The researchers will report their findings in a forthcoming issue of Science (published online March 10, 2005, in Science Express).

The genetic advance sheds light on the mechanisms underlying the disease and could lead to new avenues for treatment, the
researchers said. The finding might also yield methods for identifying those patients at the greatest risk for developing the
condition before symptoms arise, when therapies and changes in lifestyle might be most effective in slowing the disease

“Macular degeneration is an important cause of blindness and loss of independence in the elderly,” said Margaret
Pericak-Vance, Ph.D., director of the Duke Center for
Human Genetics and senior author of the report. “This gene opens the door to a whole new understanding of the factors
that contribute to this disease.

“The finding may ultimately lead to new methods for identifying those at high risk for macular degeneration and suggests new
pathways for drug development,” she added.

AMD causes progressive impairment of central vision, and is the most common cause of legal blindness in Americans over the
age of 55. The disease causes damage to the retina, a thin layer of nervous tissue that lines the inside of the eye. The
primary site of damage occurs in the central retina, a portion called the macula.

The retina functions like film in a camera, explained ophthalmologist Eric Postel, M.D., of the Duke University Eye Center. Without proper retinal function, images
cannot be captured and sent to the brain. The macula is critical for fine, detailed vision. In patients with severe AMD,
progressive blurring and loss of central vision due to damage of the macula may leave people unable to perform everyday
activities such as driving, reading, writing checks and recognizing faces, he said.

“Fifteen million people in the United States have AMD and 1.5 million have the most severe form,” said Postel, the head
clinician on the study. “By the year 2030, as the baby boomer generation ages, the number of people with AMD is expected to

AMD exists in two forms: the “dry” form and more severe “wet” form. In the dry form, degeneration of the macula can cause
slow, progressive vision loss over the course of months to years. While there is no cure, vitamin supplements have been shown
to slow the disease in some individuals with this milder form.

In ten percent of patients, the disease progresses to the wet form in which abnormal blood vessels under the macula leak
blood and fluid causing rapid damage and a precipitous loss of vision. Patients with wet AMD can receive several treatments
to prevent further vision loss — including laser surgery and recently approved injections of a drug into the eye.

However, available therapies usually can only stall the disease progression, Postel said. None effectively reverse the course
of the disease.

While the underlying causes of AMD had remained largely unknown, risk factors include age, smoking, high blood pressure,
obesity and diet, said Pericak-Vance. In addition to such environmental factors, evidence from family and twin studies had
indicated a significant genetic contribution to the disease, she added.

Earlier studies by the Duke and Vanderbilt teams and others had linked AMD risk to a particular region on chromosome 1. To
identify the gene responsible, the researchers examined two independent data sets: the first contained 182 families including
members with and without AMD and the second contained 495 individuals with AMD and 185 unrelated individuals not affected by
the disease.

The researchers zeroed in on a smaller region of chromosome 1 with a strong association to the disease in both data sets.
Further DNA sequencing of the CFH gene that is within that region revealed that individuals with one or more copies of a
particular gene variant were more likely to have AMD compared to those with other versions of the gene, they reported. When
the researchers restricted the analysis to individuals with the more severe, wet form of AMD, the association between the
gene variant and the disease became even stronger.

The researchers estimated that the CFH variant may be responsible for up to 43 percent of all cases of AMD.

Earlier studies had suggested that CFH may play a role in protecting blood vessels from inflammation and damage, a function
which might explain its role in AMD, the researchers said.

“We knew that chronic inflammation played a role in macular degeneration, but we didn’t know if that was a primary cause of
the disease or a secondary symptom,” said Jonathan Haines, Ph.D., of Vanderbilt Center for Human Genetics Research and first
author on the report. “The finding that complement factor H is an important contributor to the disease suggests that
inflammation may be a more important aspect of the disease than had previously been appreciated.”

Given that the gene plays such a large role in AMD, further studies of CFH and the cellular components with which it
interacts might lead to a rapid increase in understanding of the biology of the disease, the researchers added. That
information, in turn, should allow scientists to advance on new treatments and preventive therapies.

Collaborators on the study include Michael Hauser, Silke Schmidt, William Scott, Paul Gallins, Shu Ying Kwan, Maher
Noureddine and John Gilbert, of the Duke Center for Human Genetics; Lana Olson, Kylee Spencer, Nathalie Schnetz-Boutaud and
Anita Agarwal, of the Vanderbilt University Medical Center. The National Eye Institute supported the work. Additional
resources came from the National Institute on Aging and the National Center for Research Resources to Vanderbilt University.

Contact: Kendall Morgan
Duke University Medical Center

R-Tech Ueno Initiates A Phase I Clinical Study Of RK-023 For The Treatment Of Hypotrichosis Of The Eyelashes

R-Tech Ueno (JASDAQ:4573) is pleased to announce the initiation of a Phase I clinical study of RK-023, a new compound that is being developed for the treatment of hypotrichosis of the eyelashes(1). The details of the trial are summarized below.

R-Tech Ueno has been developing this new compound (development code: RK-023) as a novel physiologically active fatty acid derivative for the treatment of dermatological diseases, and initiated a Phase I clinical study of this new compound in healthy adult male and female volunteers.

This is a placebo(2) -controlled, double-blind study(3) conducted under the principles of Good Clinical Practice (GCP) to evaluate the safety, tolerability, and pharmacokinetics of RK-023 in participants who will apply the study drug to the eyelid margin (at the base of the eyelashes) for 5 consecutive days. This study is conducted at medical institutions both in Japan and the UK, aiming at the global development of the drug.

Taking the possibility that the drug solution may unexpectedly enter the eyes when the study drug is applied, into consideration, we will also conduct another Phase I clinical study in Japan to evaluate the safety and pharmacokinetics of a single instillation of RK-023 into the eyes of healthy adult male volunteers.

“R-Tech Ueno has been developing RK-023 as an anti-aging or lifestyle drug in the research and development fields on which we focus our efforts. Fortunately, we could initiate the Phase I clinical study of RK-023 for the treatment of hypotrichosis of the eyelashes as scheduled, soon after the previous announcement of the completion of the Phase 2a clinical study of RK-023 for the treatment of androgenetic alopecia. The market for eyelash-related products including cosmetics such as eyelash liners is estimated at approximately 37 billion yen in Japan. In the US, only one ethical drug for the treatment of hypotrichosis of the eyelashes has been approved for marketing by the FDA(4) , and the distributor of that drug has announced an annual sales target of 500 million dollars,” the president of R-Tech Ueno, Yukihiko Mashima, MD, PhD said. “We will contribute to improve the quality of life (QOL) of patients with hypotrichosis of the eyelashes, and seek early approval of the drug by moving ahead with its global clinical development that starts with the Phase I clinical study that is conducted both in Japan and the UK.”

(1) A disease in which the eyelashes do not function properly, i.e., weak, short, sparse, or light-colored eyelashes cannot adequately protect the eyes from foreign bodies such as dust and abnormal light rays.

(2) A drug formulation that does not contain the active ingredient (RK-023)

(3) An experimental procedure to objectively conduct a clinical study, in which neither the subjects participating in the trial nor the doctors performing the trial know whether the study drug contains the active ingredient or whether a placebo is being used.

(4) Food and Drug Administration: The federal agency responsible for the administration of foods and drugs in the U.S. Based on scientific knowledge it technically implements the approval and regulation of foods, drugs, cosmetics, medical devices, and veterinary drugs; monitors the manufacture and distribution of products; regulates toxicity evaluations and clinical studies; and performs other related duties.

About development code: RK-023

RK-023 is the new compound developed by R-Tech Ueno as a novel physiologically active fatty acid derivative for the treatment of androgenetic alopecia and hypotrichosis of the eyelashes. The completion of the Phase 2a clinical study of RK-023 for the treatment of androgenetic alopecia has been announced in January 24th, 2011.


R-Tech Ueno, Ltd.

Highmark Inc. Grant Supports Blindness Prevention For Children

Highmark Inc. recently awarded
$50,000 to the Pennsylvania Association for the Blind (PAB) for its
statewide Prevention of Blindness program designed to prevent vision loss
and impairment in children.

The incidence of visual impairment in children is alarming. According
to Prevent Blindness America, vision problems affect one in 20 preschoolers
and one in four school-age children. For more than 95 years, PAB has been
Pennsylvania’s leading private association in the ongoing struggle to
prevent serious vision conditions due to disease and eye injuries.

“Eye health and clear vision are very important to the development and
education of children,” said Yvonne Cook, vice president Community Health
Initiatives at Highmark Inc. “There is documented evidence that undiagnosed
vision problems in children can result in behavior and other medical
issues. Highmark is pleased to support PAB, a vital resource for vision

As the statewide coordinator, PAB works with member agencies to ensure
standardized and accurate statewide vision screenings and educational
programs. PAB will be disbursing funds from its grant to eight of its
member agencies that provide the services. These agencies are:

— Berks County Association for the Blind

— Butler County Association for the Blind

— Keystone Blind Association

— Lawrence County Association for the Blind

— Somerset County Blind Center

— Tri-County Association for the Blind

— Vision & Blindness Resources (VBR) – Erie Center

— Westmoreland County Blind Association

“Highmark Blue Shield has shown a sincere and generous commitment to
preventing blindness and serious visual impairment in our communities,”
said Neal J. Carrigan, PAB president & CEO. “These grant funds will be
invaluable to our agencies and the children they serve in 17 counties
across the Commonwealth of Pennsylvania.”

The Prevention of Blindness program focuses on three main areas of
vision health: complete vision screenings/exam for preschool children;
educational sessions that use child-friendly DVDs, books and games; and
facilitating referrals to licensed optometrists or ophthalmologists.

In the fiscal year 2005-06, almost 70,000 children received vision
screenings and more than 40,000 children participated in educational
sessions across the state.

About Highmark

As one of the leading health insurers in Pennsylvania, Highmark Inc.’s
mission is to provide access to affordable, quality health care enabling
individuals to live longer, healthier lives. Based in Pittsburgh, Highmark
serves 4.6 million people through the company’s health care benefits
business. Highmark contributes millions of dollars to help keep quality
health care programs affordable and to support community-based programs
that work to improve people’s health. The company provides the resources to
give its members a greater hand in their health.

Highmark Inc. is an independent licensee of the Blue Cross and Blue
Shield Association, an association of independent Blue Cross and Blue
Shield Plans. For more information, visit highmark.

About the Pennsylvania Association for the Blind

The Pennsylvania Association for the Blind has been dedicated to
helping people prevent, prepare for, and manage vision loss since 1910. As
one of very few incorporated statewide blindness-related membership
agencies in the United States, PAB provides comprehensive blindness and
visual impairment services in 67 counties. Through PAB’s Prevention of
Blindness programs and Specialized Services, thousands of Pennsylvanians
benefit from PAB’s services. PAB provides: vision screenings and
educational programs, escorted transportation services, home management/
safety retrofitting, life skills training, adjustment to blindness
counseling, access technology and computer training, Braille instruction,
orientation and mobility training, financial support services, radio
reading, summer instructional programs, preschool programs, health
education, low vision clinics, vocational rehabilitation, and more.

Highmark Inc.

“Lazy Eye” Treatment Shows Promise In Adults

New evidence from a laboratory study and a pilot clinical trial confirms the promise of a simple treatment for amblyopia, or “lazy eye,” according to researchers from the U.S. and China.

The treatment was effective on 20-year-old subjects. Amblyopia was considered mostly irreversible after age eight.

Many amblyopes, especially in developing countries, are diagnosed too late for conventional treatment with an eye patch. The disorder affects about nine million people in the U.S. alone.

Results from the laboratory study will be published online the week of Mar. 3 in PNAS Early Edition.

Patients seeking treatment will need to wait for eye doctors to adopt the non-surgical procedure in their clinics, said Zhong-Lin Lu, the University of Southern California neuroscientist who led the research group.

“I would be very happy to have some clinicians use the procedure to treat patients. It will take some time for them to be convinced,” Lu said.

“We also have a lot of research to do to make the procedure better.”

In a pilot clinical trial at a Beijing hospital in 2007, 28 out of 30 patients showed dramatic gains after a 10-day course of treatment, Lu said.

“After training, they start to use both eyes. Some people got to 20/20. By clinical standards, they’re completely normal. They’re not amblyopes anymore.”

The gains averaged two to three lines on a standard eye chart. Previous studies by Lu’s group found that the improvement is long-lasting, with 90 percent of vision gain retained after at least a year.

“This is a brilliant study that addresses a very important issue,” said Dennis Levi, dean of optometry at the University of California, Berkeley. Levi was not involved in the study.

“The results have important implications for the treatment of amblyopia and possibly other clinical conditions.”

The PNAS study shows that the benefit of the training protocol which involves a very simple visual task goes far beyond the task itself. Amblyopes trained on just one task improved their overall vision, Lu said.

The improvement was much greater for amblyopes than for normal subjects, Lu added.

“For amblyopes, the neural wiring is messed up. Any improvement you can give to the system may have much larger impacts on the system than for normals,” he said.

The Lu group’s findings also have major theoretical implications. The assumption of incurability for amblyopia rested on the notion of “critical period”: that the visual system loses its plasticity and ability to change after a certain age.

The theory of critical period arose in part from experiments on the visual system of animals by David Hubel and Torsten Wiesel of Harvard Medical School, who shared the 1981 Nobel Prize in Medicine with Roger Sperry of Caltech.

“This is a challenge to the idea of critical period,” Lu said. “The system is much more plastic than the idea of critical period implies. The fact that we can drastically change people’s vision at age 20 says something.”

A critical period still exists for certain functions, Lu added, but it might be more limited than previously thought.

“Amblyopia is a great model to re-examine the notion of critical period,” Lu said.

The first study by Lu’s group on the plasticity of amblyopic brains was published in the journal Vision Research in 2006 and attracted wide media attention.

Since then, Lu has received hundreds of emails from adult amblyopes who had assumed they were beyond help.

Berkeley’s Levi cautioned that the clinical usefulness of perceptual learning, as Lu calls his treatment, remains a “sixty-four thousand dollar question.”

“It’s clear that perceptual learning in a lab setting is effective,” Levi said. “However, ultimately it needs to be adopted by clinicians and that will probably require multi-center clinical trials.”

Lu is collecting patients’ names for possible future clinical trials.

The researchers are also working to develop a home-based treatment program.

For patients who can travel, the Chinese hospital that hosted the pilot trial may be able to provide treatment.

The other members of Lu’s group are Chang-Bing Huang and Yifeng Zhou of the Vision Research Lab at the University of Science and Technology of China, in Hefei, Anhui province (Huang is currently a postdoc in Lu’s lab at USC).

Funding for the research came from the Chinese National Natural Science Foundation and the U.S. National Eye Institute.


Amblyopia affects about 3 percent of the population and cannot be rectified with glasses. People with the disorder suffer a range of symptoms: poor vision in one eye, poor depth perception, difficulty seeing three-dimensional objects, and poor motion sensitivity.

Also known as lazy eye, the disorder is caused by poor transmission of images from the eye to the brain during early childhood, leading to abnormal brain development. Lazy eye is actually a misnomer because in many cases the structure of the eye is normal.

University of Southern California
3375 S. Hoover St,
Los Angeles, CA 90089
United States

UV Protection For Eyes Especially Important During Summer Months

Ultraviolet (UV) protection is a concern for many Americans, particularly in the spring and summer months, but most people are thinking about their skin, not their eyes. The American Optometric Association (AOA) warns that prolonged exposure to the sun’s UV rays and short wavelength light (violet and blue light)
without proper protection may cause eye conditions that can lead to a variety of vision disorders.

According to the AOA’s 2007 American Eye-Q® survey, which identified Americans’ attitudes and behaviors regarding eye care and related issues, 40 percent of Americans do not think UV protection is an important factor to consider when purchasing sunglasses.

“Just as skin is ‘burned’ by UV radiation the eye can also suffer damage,” said Gregory Good, OD, Ph.D., member of AOA’s Commission on Ophthalmic Standards. “The lesson-especially for young people-is that eyes need protection, too. Protection can be achieved by simple, safe, and inexpensive methods such as wearing a brimmed hat and using eyewear that properly absorbs UV radiation.”

Overexposure to UV rays has been linked to age-related cataracts, pterygium, photokeratitis and corneal degenerative changes, the AOA said. These conditions can cause blurred vision, irritation, redness, tearing, temporary vision loss and, in some instances, blindness. And, while the correlation is still unclear, there appears to be a link between excessive summer sun exposure and retinal pigmentation.

The AOA cautions that the effects of sunlight exposure are cumulative; therefore, individuals whose work or recreational activities involve lengthy exposure to sunlight are at the greatest risk. UV radiation reflects off surfaces such as snow, water and white sand, so the risk is particularly high for people on beaches, boats or ski slopes. The risk for serious damage is greatest during the mid-day hours, generally from 10 a.m. to 3 p.m., and during summer months.

Children and teenagers are particularly susceptible to the sun’s damaging rays because they typically spend more time outdoors than adults, and the lenses of their eyes are more transparent than those of adults. The transparent lenses allow more short wavelength light to reach the retina of the eye.

The effects of UV radiation are cumulative, so it’s important to develop good protection habits early in life, such as wearing sunglasses with UV protection. The American Eye-Q® survey showed that 61 percent of Americans buy sunglasses for their children, but 23 percent do not check that the lenses provide protection against UV rays.

By educating Americans about the dangers of UV rays on the eyes and the importance of choosing proper eyewear that provides the best UV protection, doctors of optometry are helping patients protect their long-term eye health.

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

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

2. Look for quality sunglasses that offer good protection. Sunglasses 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, providing the most natural color vision.

5. Don’t forget protection for children and teenagers. They typically spend more time in the sun than adults and are at greater risk of damaging their retinas from short wavelength light.

Additionally, be sure to receive routine comprehensive eye exams from 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.

For additional information on UV protection, please visit: aoa/x4735.xml.

Survey Information

The second American Eye-Q® survey was commissioned by Opinion Research Corporation (ORC). Using a random digit dialing methodology, ORC conducted interviews with 1,005 Americans 18 years and older who embodied a nationally representative sample of U.S. households. The margin of error is ?�3.1 percent for the general population. All data is weighted to represent the U.S. general population with respect to gender, geographic region, and age group.

About the American Optometric Association (AOA)

The American Optometric Association represents more than 34,000 doctors of optometry, optometry students and paraoptometric assistants and technicians. Optometrists serve patients in nearly 6,500 communities across the country, and in 3,500 of those communities are the only eye doctors.

American Optometric Association doctors of optometry are highly qualified, trained doctors on the frontline of eye and vision care who examine, diagnose, treat and manage diseases and disorders of the eye. In addition to providing eye and vision care, optometrists play a major role in a patient’s overall health and well-being by detecting systemic diseases such as diabetes and hypertension. Doctors of optometry have the skills and training to provide more than two-thirds of all primary eye care in the United States.

Prior to optometry school, optometrists undergo three to four years of undergraduate study that typically culminates in a Bachelor of Science degree in a field such as biology or chemistry. Optometry school consists of four years of post-graduate, doctoral study concentrating on both the eye and systemic health. In addition to their formal training, doctors of optometry must undergo annual continuing education to stay current on the latest standards of care.

American Optometric Association

The Vision Care Institute™ Helping U.S. Olympic Hopefuls Keep Their Eyes On The Gold In 2008

As U.S. Olympic hopefuls prepare to compete in the Beijing 2008 Olympic Games, The Vision Care Institute™, LLC, a Johnson & Johnson Company, is helping them make sure that two of their most vital body parts are ready for competition their eyes. The Vision Care Institute, which recently announced the launch of its AchieveVision™ Program for Olympic athletes and hopefuls, announced that it is donating to the United States Olympic Committee (USOC) several pieces of vision care equipment to help athletes optimize their vision.

“There is a documented connection between optimized vision and overall performance, so it is important that our athletes maintain good eye health and determine vision correction needs regularly,” says Jeanne R. Derber, O.D., Director of Vision Clinic, United States Olympic Training Center. “Early detection and treatment of any vision and eye health issues will help ensure that our athletes truly keep their focus.”

About six out of ten (61 percent) U.S. Olympic athletes and hopefuls agree that it is “extremely important” that their vision be the best it can possibly be for them to be successful as an athlete according to a recent survey of nearly 600 U.S. Olympic and Paralympic hopeful athletes and alumni. More than half (52 percent) feel that if they could improve their current vision, it would provide them with a performance edge during competition, according to the survey, which was conducted by the USOC on behalf of Johnson & Johnson and other USOC corporate partners to better understand the health care, training, and treatment practices of athletes.

Yet, more than one-third (37 percent) say it has been two years or more since their last eye exam, and about one in five (20 percent) say it’s been three years or more since they’ve seen an eye care professional.

The survey results parallel findings from the Americans’ Attitudes & Perceptions About Vision Care survey, which was conducted by Harris Interactive® on behalf of The Vision Care Institute. In that survey of more than 3,700 Americans, findings revealed a gap between vision care knowledge and behavior, with 14 percent of Americans noting that they do not have a regular eye care professional and one-quarter (25 percent) saying it has been more than two years since their last eye exam. Further, one-third (35 percent) of parents participating in that survey reported that their child has never seen an eye care professional.

“Americans visit their doctor annually and their dentist twice a year, but do not prioritize their eyes for themselves or their children,” says Dr. Richard Clompus, O.D., Director, The Vision Care Institute. “Seeing an eye care professional regularly may not only assess your vision and need for updated prescriptions, it may also help identify and lead to a diagnosis of other health concerns such as hypertension and diabetes.”

“Whether you are an Olympic athlete or a weekend warrior, you want optimum visual acuity to see a ball or land a jump perfectly,” adds Dr. Clompus. “With this donation, examiners will be better able to assess all necessary acuity tests and other measurements to help athletes achieve peak visual performance.”

Other findings from the USOC Johnson & Johnson survey of U.S. Olympic athletes and hopefuls include:

— Over half (52 percent) of the athletes surveyed said they wear contact lenses while practicing and/or competing in their sport.

— One-third (34 percent) said they wear glasses while practicing and/or competing in their sport.

— Twelve percent report wearing goggles/sports goggles while practicing and/or competing in their sport.

About The Vision Care Institute™, LLC

The Vision Care Institute™, LLC, is an innovative professional resource for eye care providers. Headquartered in Jacksonville, Florida, the state-of-the-art facility gives participants a rare opportunity to experience the latest in vision diagnostic and treatment technologies through hands-on instruction, including training on contact lens fitting and prescribing.

Working in tandem with leading schools and associations since its launch in March 2004, The Vision Care Institute has hosted more than 2,500 students from all 19 of the schools and colleges of optometry throughout North America. The Vision Care Institutes are also located in China, Japan, South Korea, Taiwan, Thailand, Italy and Czech Republic, and offer eye care specialists around the world an opportunity to learn of new developments in the field under the leadership of top contact lens specialists. For more information, please visit tvciedu.

About the Johnson & Johnson Olympic Partnership

Johnson & Johnson is an Official Partner of the Beijing 2008 Olympic Games, a Worldwide Partner of the International Olympic Committee (IOC), and a Proud Partner of the United States Olympic Committee and the U.S. Olympic Team. As the Official Health Care Products Sponsor, the Johnson & Johnson sponsorship encompasses the Company’s consumer health care products and medical devices and diagnostics, and marks the first time a broad health care products company has become a worldwide partner of the IOC.

About the United States Olympic Committee

The United States Olympic Committee (USOC) is recognized by the International Olympic Committee as the sole entity in the United States whose mission involves training, entering and underwriting the full expenses for the U.S. teams in the Olympic, Paralympic, Pan American and Parapan American Games. In addition to being the steward of the U.S. Olympic Movement, the USOC is the moving force for support of sports in the United States that are on the program of the Olympic, Paralympic, Pan American and Parapan American Games.

Keep Eyes Safely On The Ball

Noah was seven years old when an errant paintball smashed into his left eye and sent him from the sidelines of his brothers’ game to the emergency room.

“I remember being very dizzy and I couldn’t stop vomiting,” said Noah. “I had to wait in the hospital for my eye pressure to go down and for all the blood to drain out of my eye.”

Noah later developed a cataract and a detached retina in his left eye; he subsequently underwent successful surgery to repair the traumatic cataract and retinal detachment. In spite of the fact that his traumatic cataract has been removed and his retina has been repaired, he now wears a contact lens and has some permanent double vision.

“Unfortunately this is a common story when you mix sports and the lack of proper eye protection” said Abdhish R. Bhavsar, MD, Noah’s doctor and a clinical correspondent for the Academy. “While Noah was a bystander in this instance, 40,000 people suffer from eye injuries related to sports every year.”

According to Noah’s mom, “Hand and eye coordination is now very difficult for Noah,” and though he loves baseball and tennis he has decided to take up swimming instead. Still, she says, “Noah never lets his spirits down.”

Maura knows all too well how quickly an eye injury like Noah’s can happen. Thirteen years ago at hockey practice in Connecticut, she sustained a serious hit to her eye from a teammate’s hockey stick. The accident left her with years of pain and permanent double vision in her left eye.

“She had the largest break in her eyeball that I had ever seen,” said Joel S. Schuman, MD, Maura’s doctor and clinical correspondent for the Academy. “She required multiple surgeries and we were happy and fortunate that we were able to save her eye.”

After ten surgeries Maura still struggles with her vision, but feels confident about her efforts to change the way people view eye protection and sports. Living in Washington, DC, she now does policy work, a natural outgrowth of the advocacy campaign she undertook after her injury to encourage local schools to mandate protective eyewear for school sports. Within three years after she started the effort, most of the local schools required protective eyewear for their field hockey teams.

“Instead of being taken down by this very serious injury, Maura turned it into a drive to prevent it happening to others,” said Dr. Schuman.

September is Children’s Eye Safety Awareness Month, and the American Academy of Ophthalmology reminds student athletes and school sports programs to get EyeSmart and use appropriate, sport-specific protective eyewear properly fitted by an eye care professional. Most youth sporting leagues don’t require protective eyewear, so parents should take special care to ensure their children’s eye safety. “This is an important way for parents to spare their children unnecessary injury and pain,” says Dr. Schuman.

“I recommend safety goggles for all sporting activities, even when it comes to children playing in their own homes,” said Dr. Bhavsar. “We even put on safety goggles when we play catch with a baseball in our own backyard.”

Learn more about eye injuries, eye diseases, and the names of Eye M.D.s in your area by visiting GetEyeSmart.

About the American Academy of Ophthalmology

AAO is the world’s largest association of eye physicians and surgeons-Eye M.D.s-with more than 27,000 members worldwide. Eye health care is provided by the three “O’s” – opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy’s Web site at aao.

About EyeSmart™

The EyeSmart Campaign is an initiative of the Academy, with its partner EyeCare America, to raise the public’s awareness of eye diseases, injuries and infections. For more information about the campaign and eye care information, visit geteyesmart.

American Academy of Ophthalmology

The Hierarchy Of Directional Interactions In Visual Motion Processing

Humans can accurately perceive a moving object’s direction. We can also, however, be fooled into miss-perceiving this direction.

If one views upward motion for some 30 seconds and then subsequently looks at motion in a different direction, the latter may be grossly miss-calculated. This illusion is known as the direction after-effect.

We can also be fooled into miss-calculating the directions of two superimposed motions – direction repulsion. These two illusions react similarly to various experimental manipulations, consistent with the same neural structures driving both illusions. We devised a series of experiments demonstrating that the two illusions are driven by different neural structures.

This finding furthers our understanding of the cascade of processes underlying vision.

Proceedings of the Royal Society B: Biological Sciences

Proceedings B is the Royal Society’s flagship biological research journal, dedicated to the rapid publication and broad dissemination of high-quality research papers, reviews and comment and reply papers. The scope of journal is diverse and is especially strong in organismal biology.

Proceedings of the Royal Society B: Biological Sciences

Study Finds Lack Of Diffusible VEGF Growth Factor Can Cause Retinal Defects Similar To Dry Macular Degeneration

Scientists at Schepens Eye Research Institute have found that when the eye is missing a diffusible form of vascular endothelial growth factor (VEGF), i.e. one that when secreted can reach other cells at a distance, the retina shows defects similar to “dry” macular degeneration, also called geographic atrophy (GA). This finding, published in the November 3, 2009 print edition of PNAS (Proceedings of the National Academy of Sciences), not only increases the understanding of the causes of this blinding disease, but it may also impact the use of anti-VEGF drugs, such as Lucentis, which are designed to neutralize VEGF in eyes with “wet” macular degeneration.

“These results are significant for several reasons. We know little about what causes GA or how to treat it. Our discovery may be an important piece of the puzzle. It shows that reduced VEGF from the retinal pigment epithelium (RPE), the bottommost layer of the retina, to the choriocapillaris (CC) – the small blood vessels beneath retina– leads to degeneration of the CC. Therefore, the continuous blockage of VEGF may contribute to the development of or a worsening of GA,” says Patricia D’Amore, principal investigator of the study and senior scientist at Schepens.

VEGF is a protein that stimulates the growth of new blood vessels. The eye produces several different forms of VEGF that differ in their size and their ability to move away from the producing cell.

Age-related macular degeneration (AMD) is a disease that destroys the macula, the central part of the retina responsible for detailed vision needed for reading, driving and face recognition. It comes in two types–“wet” and “dry.” In wet AMD, a pathological overproduction of VEGF leads to the development of abnormal blood vessels, which leak and damage the retina. Wet AMD can be treated with some success with anti-VEGF drugs that block abnormal blood vessel growth and leakage. Dry macular degeneration develops less rapidly, and is related to an accumulation of debris under the retina that can advance to GA where RPE and underlying vessels are lost.

Knowing that the RPE in the adult produced VEGF, the Schepens team hypothesized that in a healthy individual, the RPE produces forms of VEGF that, when secreted, can move away from the RPE and reach the underlying CC to support its function and survival. The CC vessels are extremely important as they supply the photoreceptors (the light- and color-sensitive cells in the macula) with oxygen and nutrients necessary for vision.

In the PNAS study, the researchers tested their hypothesis using a genetic mouse model in which the RPE produced a form of VEGF that was unable to diffuse. As the mice aged, they began to display an age-dependent degeneration of both the CC and RPE, culminating with the death of photoreceptors and vision loss, similar to that observed in GA.

The next step in the research, according to the first author Dr. Magali Saint-Geniez, is to determine if this model can be used to investigate the role of RPE-CC interaction in AMD and to design new therapies.

Authors of the study include: Magali Saint-Geniez(1)(2), Tomoki Kurihara(1), Eiichi Sekiyama(1)(2), Angel E. Maldonado(1), and Patricia A. D’Amore(1),(2),(3).

(1) Schepens Eye Research Institute and the Departments of (2)Ophthalmology and (3)Pathology Harvard Medical School.

Schepens Eye Research Institute is an affiliate of Harvard Medical School and the largest eye research institute in the natio.

Source: Schepens Eye Research Institute

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Identification Of Brain’s Center For Perceiving 3-D Motion

Ducking a punch or a thrown spear calls for the power of the human brain to process 3-D motion, and to perceive an object (whether it’s offensive or not) moving in three dimensions is critical to survival. It also leads to a lot of fun at 3-D movies.

Neuroscientists have now pinpointed where and how the brain processes 3-D motion using specially developed computer displays and an fMRI (functional magnetic resonance imaging) machine to scan the brain.

They found, surprisingly, that 3-D motion processing occurs in an area in the brain – located just behind the left and right ears – long thought to only be responsible for processing two-dimensional motion (up, down, left and right).

This area, known simply as MT+, and its underlying neuron circuitry are so well studied that most scientists had concluded that 3-D motion must be processed elsewhere. Until now.

“Our research suggests that a large set of rich and important functions related to 3-D motion perception may have been previously overlooked in MT+,” says Alexander Huk, assistant professor of neurobiology. “Given how much we already know about MT+, this research gives us strong clues about how the brain processes 3-D motion.”

For the study, Huk and his colleagues had people watch 3-D visualizations while lying motionless for one or two hours in an MRI scanner fitted with a customized stereovision projection system.

The fMRI scans revealed that the MT+ area had intense neural activity when participants perceived objects (in this case, small dots) moving toward and away from their eyes. Colorized images of participants’ brains show the MT+ area awash in bright blue.

The tests also revealed how the MT+ area processes 3-D motion: it simultaneously encodes two types of cues coming from moving objects.

There is a mismatch between what the left and right eyes see. This is called binocular disparity. (When you alternate between closing your left and right eye, objects appear to jump back and forth.)

For a moving object, the brain calculates the change in this mismatch over time.

Simultaneously, an object speeding directly toward the eyes will move across the left eye’s retina from right to left and the right eye’s retina from left to right.

“The brain is using both of these ways to add 3-D motion up,” says Huk. “It’s seeing a change in position over time, and it’s seeing opposite motions falling on the two retinas.”

That processing comes together in the MT+ area.

“Who cares if the tiger or the spear is going from side to side?” says Lawrence Cormack, associate professor of psychology. “The most important kind of motion you can see is something coming at you, and this critical process has been elusive to us. Now we are beginning to understand where it occurs in the brain.”

Huk, Cormack, and post-doctoral research and lead author Bas Rokers published their findings in Nature Neuroscience online the week of July 7. They are members of the Institute for Neuroscience and Center for Perceptual Systems. The research was supported by a National Science Foundation CAREER Award to Huk.

Dr. Alexander Huk

University of Texas at Austin