Do Fungi Cause Retinopathies?

A research team from the Centro de Biologia Molecular Severo Ochoa (CSIC-UAM) working in collaboration with the Cl?�nica Barraquer in Barcelona have focused their research on the study of fungi as a possible cause of strange retinopathies such as AZOOR.

There are several retinopathies of unknown cause; among them AZOOR, Multifocal choroiditis, Serpiginous choroiditis, Idiopathic Blind Spot Enlargement Syndrome ??� etc. The progressive nature of these conditions causes most patients to gradually lose their vision until many of them are left blinded. It must be considered that not only is the diagnosis most patients not easy, especially in the early stages of the disease, but that the identification of faster diagnosis methods would lead to the correct treatment sooner, avoiding in this manner the increasing loss of visual acuity. Without a doubt, discovering the cause of each of these retinopathies would bring new hope of their treatments. Three years ago, with the help and financial support of ONCE, a research team led by Luis Carrasco professor of microbiology at the Universidad Aut??noma de Madrid, noticed that a patient suffering form AZOOR was also infected by a type of yeast called Candida famata. In collaboration with the Cl?�nica Barraquer, these studies have been extended to other patients with AZOOR or with Serpiginous choroiditis. In January this year, information about the fungal infection in these patients was published in the Journal of Clinical Microbiology (Pisa, D., M. Ramos, P. Garc?�a, R. Escoto, R. Barraquer, S. Molina y L. Carrasco. Fungal infection in patients with Serpiginous choroiditis or acute zonal occult outer retinopathy. J. Clin. Microbiol. 46, 130-135 (2008)).

To carry out this investigation the researchers analyzed blood samples looking for antibodies against yeasts, as well as different fungal components such as proteins and DNA. These results indicate the existence of a disseminated mycosis in most of the analyzed patients which suggests that retinopathies like AZOOR and Serpiginous choroiditis are caused by fungal infections. Looking for treatments based on current anti fungal drugs could offer great benefits for these patients. The clinical studies about the effects of anti fungal compounds in the evolution of these patients will be crucial to determine whether the presence of mycosis is the cause of the loss of visual acuity.

Future investigations by Dr. Luis Carrasco’s research group will lean towards the improvement of diagnosis techniques for fungal infections and the cause of other retinopathies. These techniques will also be useful for the analysis of the evolution and effectiveness of the possible anti fungal treatments that are implemented with these patients.

C/ Alcal?? 30-32, 3??planta

Back-To-School Checklist Should Include Trip To Eye Doctor

Parents and students throughout the country are crossing items off their back-to-school checklists, but most are missing an important task to ensure learning success – a visit to the eye doctor for a comprehensive eye exam. According to an American Optometric Association (AOA) survey of K-12 teachers, 81 percent believe vision and learning are interdependent.

“Healthy vision is critical to learning and excelling in school,” said Dr. Pamela Lowe, optometrist and the AOA’s vision & learning specialist. “Comprehensive eye exams should be performed to detect problems like astigmatism, eye coordination and moderate amounts of farsightedness, conditions that can prohibit optimal learning.”

Many experts believe that approximately 80 percent of learning comes through a child’s eyes. Reading, writing and computer work are just a few of the tasks students are expected to perform daily that require visual skills. As classrooms adopt more technologically advanced tools, such as interactive blackboard presentations, the dependence on adequate visual capabilities will increase.

Below are essential elements an optometrist will check during a comprehensive eye exam to make certain learning is maximized through good vision.

– Visual acuity is measured at several distances so students can comfortably and efficiently read, work on the computer and see the blackboard.

– Focusing is an important skill that is tested. Eyes must be able to focus on a specific object and to easily shift focus from one object to another. This allows the child to move visual attention from a book to the blackboard and back.

– Visual alignment and ocular motility are evaluated. Ideally, the muscles that aim each eye converge so that both eyes are aimed at the same object, refining depth perception.

– Binocular fusion (eye teaming) skills are assessed. These skills are critical to coordinate and align the eyes precisely so the brain can fuse the pictures it receives from each eye into a single image.

– Eye tracking skills are tested to determine whether the child can track across a page accurately and efficiently while reading, and can copy material quickly and easily from the blackboard or another piece of paper.

– Testing preschoolers’ color vision is important because a large part of the early educational process involves the use of color identification.

– Eye-hand-body coordination, critical for handwriting, throwing a ball or playing an instrument, and visual perception, used to interpret and understand visual information like form, size, orientation, texture and color perception, are important visual functions that are reviewed.

– Overall eye health is determined by examining the structures of the eye.

Studies indicate that some children with undetected vision problems can be misdiagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHA). The AOA survey revealed that 64 percent of teachers witnessed a direct improvement in a child’s academic performance and/or classroom behavior after an eye or vision problem was diagnosed and treated. If your child experiences any of the following, an optometrist should be consulted about a possible vision problem:

– Loses place while reading

– Avoids close work

– Tends to rub eyes

– Has headaches

– Turns or tilts head

– Makes frequent reversals when reading or writing

– Uses finger to maintain place when reading

– Omits or confuses small words when reading

– Consistently performs below potential

– Struggles to complete homework

– Squints while reading or watching television

– Has behavioral problems
Holds reading material closer than normal

Early detection and treatment are key in correcting vision problems and helping children see clearly. The AOA recommends that a child’s first eye assessment take place at 6 months of age. Comprehensive eye exams should be conducted beginning at age 3, before a child enters school, and then every two years, unless otherwise advised by an optometrist. In between exams, parents and teachers should monitor children for the more prevalent signs that a student’s vision may be impaired.

To find an optometrist in your area, or for additional information on children’s vision or the importance of back-to-school eye exams, please visit here.

About the AOA teacher survey

The survey was created and commissioned in conjunction with TNS. From May 13-17, 2010, using an online methodology, TNS interviewed 300 full- and part-time teachers for grades kindergarten through grade 8, and 100 full- and part-time teachers for grades 9-12. All respondents were 18 years and older and embodied a nationally representative sample of full- and part-time teachers. (Margin of error at 90 percent confidence level.) TNS is part of Kantar the world’s largest research, insight and consultancy network.


American Optometric Association (AOA)

Not Just Your Imagination: The Brain Perceives Optical Illusions As Real Motion

Ever get a little motion sick from an illusion graphic designed to look like it’s moving? A new study suggests that these illusions do more than trick the eye; they may also convince the brain that the graphic is actually moving.

Researchers in Japan, led by Akiyoshi Kitaoka of Kyoto’s Ritsumeikan University, monitored brain activity as participants viewed the Rotating Snakes illusion, where concentric circles appear to rotate continuously. The resulting article, Functional brain imaging of the Rotating Snakes illusion by fMRI, was recently published in the Association of Research in Vision and Ophthalmology’s Journal of Vision as part of a collection of papers on neuroimaging in vision science.

Prior to the study, scientists believed illusions that simulated movement involved higher-level brain activity – the imagination. But this study found the illusion sparked brain activity generated by a bottom-up process in the visual cortex.

“This is the part of the brain that processes real physical movement,” explained research team member Ichiro Kuriki, PhD (associate professor, Tohoku University). “The illusory motion percept is not just the observer’s imagination.”

The researchers compared levels of eye movements as participants watched the Rotating Snakes illusion. When participants moved their eyes while watching the illusion, the study reported higher activity in the motion-perception area of the brain.

Kuriki said the study has ramifications for makers of instrument panels for vehicles, aircraft and other forms of transportation. “Our findings could be important to the designers of such visual displays, as well as creators of multimedia content online or for film and television,” he said.

A better understanding of motion perception can help designers avoid patterns that stimulate the motion-sensitive area in the cortex so users will not experience motion sickness or other discomfort.

ARVO is the largest eye and vision research organization in the world. Members include some 12,500 eye and vision researchers from over 73 countries. The Association encourages and assists research, training, publication and dissemination of knowledge in vision and ophthalmology. For more information, visit arvo/.

The Journal of Vision is ARVO’s peer-reviewed, open-access online scientific journal devoted to all aspects of vision function in humans and other organisms. Visit journalofvision.

Source: Joanne Olson

Association for Research in Vision and Ophthalmology

Healthy Diet Associated With Lower Risk Of Cataracts In Women

Women who eat foods rich in a variety of vitamins and minerals may have a lower risk of developing the most common type of cataract that occurs in the United States, according to a report in the June issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Cataracts, which increase in prevalence with age, are the most important cause of blindness in the world; in the United States, cataract is the most prevalent cause of visual impairment due to eye disease according to background in the article. “There are limited studies published to date in which nutritional risk factors are evaluated concurrently with a comprehensive set of other lifestyle, ocular health and physical risk factors.”

Julie A. Mares, Ph.D., University of Wisconsin, Madison, and colleagues studied 1,808 women (age 55 to 86) who participated in the Carotenoids in Age-Related Eye Disease study, residing in Iowa, Wisconsin and Oregon. The estimates of daily food and nutrition intake were made from previous responses to a semi-quantitative food frequency questionnaire used at the time as part of the Women’s Health Initiative study. Additionally, “adherence to the 1990 dietary guidelines for Americans and the 1992 food guide pyramid, reflecting dietary recommendations at the time women entered the Women’s Health Initiative, was estimated by the 1995 Healthy Eating Index scores adapted to this questionnaire.” Foods that contributed to higher diet scores were intakes at or above recommended levels for vegetables, fruits, grains, milk, meat (or beans, fish or eggs) and below recommended levels for fat, saturated fat, cholesterol and sodium.

According to the study, nuclear cataract was common in the sample with 29 percent (454 women) reporting the eye disease with a lens in at least one eye. Additionally, 282 women (16 percent) had reported cataract extractions in either eye. Overall, 736 women (41 percent) had either nuclear cataracts evident from lens photographs or reported having a cataract extracted. “Results from this study indicate that healthy diets, which reflect adherence to the U.S. dietary guidelines at the time of entry in the Women’s Health Initiative study, are more strongly related to the lower occurrence of nuclear cataracts than any other modifiable risk factor or protective factor studied in this sample of women,” the study states.

“In conclusion, this study adds to the body of literature suggesting that healthy diets are associated with lower risk for cataract,” the authors write. “Lifestyle improvements that include healthy diets, smoking cessation, and avoiding obesity may substantively lower the need for and economic burden of cataract surgery in aging American women.”

Archives of Opthalmology. 2010;128[6]:738-749.

Archives of Opthalmology

American Academy Of Ophthalmology Grants International Ophthalmologist Education Award

The American Academy of Ophthalmology (AAO) conferred its International Ophthalmologists Education Award to 33 physicians in 2009. The International Ophthalmologist Education Award was developed to recognize AAO members practicing outside the United States who participate in continuing ophthalmic education through the AAO and report their activities.

To qualify, international members must have finished their residency training and complete 90 continuing medical education (CME) credits over a period of three years. Half the credits must be AAO-sponsored CME.

“The mission of the AAO is to promote lifelong learning for ophthalmologists, resulting in improved patient care,” said David W. Parke II, MD, executive vice president and CEO of the AAO. “We are very proud of our international members who have taken the mission to heart, and we feel it is equally important to recognize their efforts towards professional growth. We encourage all our international members – most of whom are already using AAO’s educational resources – to report their CME and allow us to acknowledge their efforts.”

The 2009 International Ophthalmologist Education Award recipients are:

– Alfredo G. Kotlik, MD (Argentina)
– Antonio Ferreras, MD (Spain)
– Arnold I. Kravetz, MD (Canada)
– Bruno M. Fontes, MD (Brazil)
– Carlo De Conciliis, MD (Italy)
– Colin S Tan, MBBS (Singapore)
– Ernesto S. Yapur, MD (Argentina)
– Francesco P. Bernardini, MD (Italy)
– Giovanni Cardini, MD (Italy)
– Gopal Lal Verma, MD (India)
– Hazem A. El-Sabagh, MBBS (Saudi Arabia)
– Jerman M. Alqahtani, MBBS (Saudi Arabia)
– Juan Salinas, MD (United Kingdom)
– Karen Salcedo, MD (Venezuela)
– Konstadinos Chatzinikolas, MD (Greece)
– Laurentino Biccas Neto, MD (Brazil)
– Madhav Rao Kenja MD (United Arab Emirates)
– Manuel Moriche Carretero, MD (Spain)
– Marco Antonio C. Olytho Jr., MD (Brazil)
– Mario Robert Ventresca, MD, FRCSC (Canada)
– Massimo Busin, MD (Italy)
– Matthias Christian Grieshaber, MD (Switzerland)
– Mehdi Modarres, MD (Iran)
– Miloslav B. Bozdech, MD (Canada)
– Palaniswamy Sunderraj, MD (England)
– Paul Aron Adler, MBBS (Australia)
– Prasan M. Rao, MBBS, MS (United Arab Emirates)
– Robert F. Stevenson, MD (Canada)
– Sathish Srinivasan, MBBS, FRCSEd, FRCOphth (Scotland)
– Sergio E. Echeverria, MD (Chile)
– Tarun Sharma, MBBS (India)
– Teodoro Mylonopoulos Caripdis, MD (Spain)
– Vasiliki Flindri, MD (Greece)

Congratulations to the 2009 recipients and all of the recipients of the Education Award from years prior.

American Academy of Ophthalmology

Glaucoma Procedure May Prevent Further Eye Damage

For the first time in Florida, patients with glaucoma have a new treatment option known as the Trabectome. The minimally invasive procedure, which is available at Mayo Clinic and takes about 20 minutes, is designed to decrease pressure within the eye and stabilize the vision.

“The goal of this procedure is to prevent further damage within the eye,” says ophthalmologist Rajesh Shetty, M.D. He says that some patients have been able to reduce or eliminate use of daily eye drop medications that regulate intraocular pressure.

Glaucoma, the second leading cause of blindness, is a disease that causes irreversible damage to the optic nerve from increasing pressure within the eye. This occurs because the eye produces a clear fluid that does not drain adequately and raises the eye pressure. The first sign of glaucoma is a loss of peripheral vision that is usually not noticed by the patient until it affects the central vision. Unfortunately, vision lost to glaucoma can’t be restored so treatment aims to reduce eye pressure to prevent further damage.

Traditionally, ophthalmologists first prescribe eye drops to reduce the eye pressure, and if that doesn’t work, they can perform a laser procedure (trabeculoplasty) to the existing internal drainage canal around the base of the cornea. A more invasive treatment is trabeculectomy, a surgical technique to create a new drain for the eye.

The Trabectome procedure uses a small probe that opens the eye’s drainage system through a tiny incision in the eye’s cornea. “It removes a small portion of the eye’s natural drainage system so that it functions better,” says Dr. Shetty. He says it should be used when eye drops and laser trabeculoplasty fail to reduce pressure and before trabeculectomy is considered. “I see this as another rung in the ladder of treatment for glaucoma,” he says.

So far, more than a dozen patients have had the procedure at Mayo Clinic in Florida, although the technique has been available at Mayo Clinic in Rochester for a few years. To date, several thousand procedures have been done nationwide, according to Dr. Shetty.

The procedure requires very little sedation and patients generally recover within a week. “We have been pleased with the results,” he says, noting that although lost vision cannot be restored with the procedure, some patients have reported improved vision overall after surgery.

An estimated 4 million Americans are affected by glaucoma. Glaucoma screenings are suggested for anyone over 40 every two to four years. A routine exam can help identify risk for glaucoma and early signs of the disease. Risk factors for glaucoma include: a family history of the disease, African or Hispanic ancestry, diabetes, certain rare eye diseases and having had an eye injury or having used any corticosteroid preparation for a prolonged period.

Source: Cynthia Nelson

Mayo Clinic

European Commission Grants Promedior’s PRM-151 Orphan Drug Designation For The Prevention Of Scarring Post Glaucoma Filtration Surgery

Promedior, Inc., a leader in the development of novel therapeutics for the treatment of fibrotic diseases and tissue remodeling, announced today that the European Commission has granted Orphan Medicinal Product Designation to its lead drug candidate PRM-151 for use in the prevention of scarring post glaucoma filtration surgery. Glaucoma filtration surgery generally is used to treat patients with advanced glaucoma that are at high risk for visual loss. Scarring post glaucoma surgery is a serious complication that causes poor surgical outcomes and may lead to progressive loss of vision for these high risk patients.

PRM-151(rhSAP) is a recombinant form of human Serum Amyloid P, a highly conserved natural human serum protein that mediates its anti-fibrotic activity by targeting the specific cell populations that orchestrate fibrosis and tissue remodeling, namely monocytes and macrophages. PRM-151 has demonstrated an outstanding safety profile and robust preclinical efficacy by reducing fibrosis in multiple tissues, organs, and disease models. Promedior initiated a Phase 1 clinical trial of PRM-151 in July 2009 to evaluate the safety, tolerability, pharmacokinetics and exploratory pharmacodynamics of ascending single intravenous doses of PRM-151.

The EMEA’s orphan medicinal products program is designed to promote the development of products for the diagnosis, prevention or treatment of rare, life-threatening or chronically debilitating conditions. Orphan medicinal product designation provides several incentives to sponsors, including 10 years of marketing exclusivity, protocol assistance and scientific advice during product development, and fee reductions or exemptions for regulatory activities including scientific advice, applications for marketing authorization, inspections, and renewals.

“The orphan medicinal product designation for PRM-151 reflects the therapeutic potential of PRM-151 to prevent scarring post glaucoma filtration surgery and the lack of approved alternative therapies for this serious surgical complication,” said Dominick Colangelo, Chief Executive Officer of Promedior. “This designation provides Promedior significant development and commercial advantages as we continue the development of this first-in-class therapy for the treatment of diseases involving scarring and fibrosis in the eye and other organ systems.”

About Glaucoma Filtration Surgery

Glaucoma, one of the leading causes of blindness in the world, is an optic neuropathy that affects the optic nerve and leads to progressive loss of vision. Elevated intraocular pressure (IOP) is a characteristic symptom in most types of glaucoma and reduction of elevated IOP is the current standard of treatment to prevent disease progression. Glaucoma filtration surgery generally is used to treat patients with advanced glaucoma and persistently elevated IOP that are at high risk for visual loss. The goal of glaucoma filtration surgery is to reduce IOP by facilitating drainage of aqueous humor through a surgically created fistula into a filtering bleb, where the fluid is captured and reabsorbed into the systemic circulation. Scarring post glaucoma surgery is a serious complication that diminishes the functionality of the bleb and the IOP-lowering effect of the surgery, resulting in the loss of IOP control and risk of progression to visual loss or blindness.

Promedior, Inc.

Alcon Launches New AcrySof(R) ReSTOR(R) Intraocular Lens For Presbyopia Outside The U.S.

Alcon, Inc. (NYSE: ACL), the world’s leader in eye care and intraocular lenses (IOLs), announced the commercial launch outside the U.S. of the new +3.0 Add Power AcrySof® ReSTOR® Aspheric IOL during the 2008 European Society of Cataract and Refractive Surgeons (ESCRS) annual meeting in Berlin, Germany. This lens is another technology advancement to the proven AcrySof® ReSTOR® Aspheric platform which has been the number one choice for correcting presbyopia in cataract patients since it was introduced last year.

“While this lens maintains the original optical design of the +4.0 Add Power AcrySof® ReSTOR® Aspheric IOL, the new add power gives me flexibility to tailor my surgery to my patients’ vision needs and lifestyle. My clinical experience is that this new lens allows many of my patients to read at a more comfortable distance and also improves their intermediate vision, without affecting visual disturbances or image contrast,” said Jos?� F. Alfonso, MD, PhD, Head of the Refractive Surgery Department at the Instituto Oftalmol??gico Fern??ndez-Vega, in Oviedo, Spain.

Clinical trial results demonstrated that the +3.0 Add Power AcrySof® ReSTOR® Aspheric IOL optimally manages light energy delivered to the retina regardless of the lighting situation to provide patients with high resolution image quality and minimal visual disturbances. At the three-month follow-up exam, 95 percent of patients had combined distance corrected visual acuities (near, intermediate and distance) of 20/40 or better. The clinical studies also showed a high rate of patient satisfaction with 96 percent of patients stating that they would have this lens implanted again.

“Advanced technology IOLs that correct for presbyopia or astigmatism are the fastest growing segment in the IOL market. The addition of the +3.0 Add Power AcrySof® ReSTOR® Aspheric IOL provides surgeons with an additional IOL option to meet the clinical needs of their patients and further enhances our leadership position in this category,” said Kevin Buehler, senior vice president, global markets and chief marketing officer.

Alcon completed its CE Mark of the +3.0 Add Power AcrySof® ReSTOR® Aspheric IOL during the third quarter of 2007 and is now available in most major markets outside the United States. The company filed a Pre-Market Application for the lens in June of 2008 with the U.S. Food and Drug Administration (FDA) where it is currently under review.

About AcrySof® Intraocular Lenses

Alcon’s AcrySof® intraocular lenses are the most frequently implanted lenses in the world, with more than 35 million implants since their introduction in the early 1990s. Alcon’s AcrySof® IOLs offer cataract patients a variety of benefits that give cataract patients a full range of quality vision. The AcrySof® IQ, AcrySof® Toric and AcrySof® ReSTOR® Aspheric IOLs are part of Alcon’s AcrySof® product portfolio. Since the introduction of the AcrySof® ReSTOR® platform, Alcon has accounted for more than half of all presbyopia correcting lenses implanted.

About Cataract Surgery

A cataract is a “clouding” of the eye’s natural lens, which results in blurred or defocused vision. IOLs are implanted during cataract surgery to replace the patient’s natural lens that has been removed during surgery. Cataracts cannot be prevented and are the leading cause of treatable blindness worldwide.

About Alcon

Alcon, Inc. is the world’s leading eye care company, with sales of approximately $5.6 billion in 2007. Alcon, which has been dedicated to the ophthalmic industry for 60 years, researches, develops, manufactures and markets pharmaceuticals, surgical equipment and devices, contact lens care solutions and other vision care products that treat diseases, disorders and other conditions of the eye. Alcon’s majority shareholder is Nestl?�, S.A., the world’s largest food company.

Caution Concerning Forward-Looking Statements

This press release may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Any forward- looking statements reflect the views of our management as of the date of this press release with respect to future events and are based on assumptions and subject to risks and uncertainties. Given these uncertainties, you should not place undue reliance on these forward-looking statements. Except to the extent required under the federal securities laws and the rules and regulations promulgated by the Securities and Exchange Commission, we undertake no obligation to publicly update or revise any of these forward-looking statements, whether to reflect new information or future events or circumstances or otherwise.

Alcon, Inc.

A Genetic Marker For Nearsightedness? Update On Vitamins And AMD, And Recovery From Optic Neuritis

The June 2008 issue of Ophthalmology, the journal of the American Academy of Ophthalmology, includes a groundbreaking study on genetic factors and nearsightedness, a cautionary tale on age-related macular degeneration (AMD) patients’ vitamin use, and good news for people who have had an acute attack of optic neuritis.

Strong Evidence for a Genetic Marker for Nearsightedness

Research by Gu Zhu, M.D., and colleagues supports the theory that the refractive errors known as nearsightedness and farsightedness are primarily inherited. The group also identified the probable location—on the long arm of chromosome 5—of genes that help determine axial length, a key factor in these refractive errors. Axial length is a specific measurement from the front to back of the eye; this distance is longer than normal when a person is nearsighted and shorter than normal in a farsighted person. Dr. Zhu’s study focused on nearsightedness, or myopia, building on previous research on genetic aspects and environmental factors. Myopia compromises the eye’s ability to focus on and see objects clearly at a distance. Especially when myopia is severe, it is expensive to treat and costly to patients’ quality of life. The disorder is on the rise in the United States and globally and research efforts have intensified accordingly.

Dr. Zhu’s team recruited 893 individuals from the Tasmania Twin Eye Study and Brisbane Adolescent Twin Study (BATS), Australia, and obtained axial length measurements. They analyzed the proportional impacts of genetic and environmental factors on axial length in this sample of identical and fraternal twins, and found that genetic factors explained approximately 80 percent of the axial length values, after adjusting for age and sex. This study breaks new ground in linking axial length to the heritability of refractive error. Research team member David Mackey, M.D., said that new measurement techniques will likely make collection of axial length data routine in future research on myopia and other refractive error.

By performing a genome scan on a subset of 318 individuals, the researchers found “strong evidence” for the role of chromosome 5 (specifically the 5q region) in the inheritance of axial length. Dr. Zhu’s team has launched a genomic analysis of a larger study group to confirm and refine this finding. Other studies have suggested that environmental factors such as regular periods of outdoor play during childhood—rather than having children concentrate only on reading and other “near work”—might help reduce the development of nearsightedness, at least in those who are genetically susceptible. Identifying strong genetic markers could further this and other preventive efforts.

Vitamins Help Prevent Vision Loss from AMD—If Used Correctly

A study of individuals with age-related macular degeneration (AMD), based at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, found that nearly 40 percent of those likely to benefit from specific vitamin/mineral supplements were either not taking the supplements or not using the recommended dosage. The study also showed that some patients used high-dose supplements even in the absence of evidence that these would be effective for their levels of AMD or other eye conditions. The ophthalmic researchers, led by Susan B. Bressler, M.D., concluded that AMD patients appear to lack a clear understanding of supplement use in AMD treatment, and that “improved patient education may be vital to maximize the potential” of this therapy.

The public health impact could be substantial: in the United States if the appropriate patients used the correct supplements, about 300,000 people could potentially avoid advanced AMD within a five year period. At least eight million Americans are at risk for advanced AMD which can destroy the central vision needed to recognize faces, read, drive and enjoy daily life. In 2001 the Age-Related Eye Disease Study (AREDS) reported findings on its clinical trial that identified a specific formula of antioxidants (vitamin C, vitamin E and beta-carotene) and zinc that reduced the probability of progression to advanced AMD by 25 percent- either the “wet” or central geographic atrophy forms—among individuals at risk. Those who have AMD and smoke may need to use a formula that omits beta-carotene since high doses of this micronutrient have been associated with increased rates of lung cancer and mortality. Though effective treatment for advanced AMD is available, it can be expensive and is limited to the “wet” form. Also, since such treatment may not restore vision already lost to the illness, it remains important to use all effective approaches to preventing AMD progression.

The Wilmer Institute-based study surveyed 332 individuals who identified themselves as having AMD; the median participant age was 79 years. Of these, 228 were considered candidates for benefit from the AREDS formula, but only 140 patients (61 percent) in this group were using the correct formula as recommended. Nearly 50 percent of the candidates-for-benefit did not correctly answer questions on the relevance of vitamin/mineral supplements to their eye condition and how their vision might benefit. But patients who indicated that they partially or fully understood the rationale for supplements were about twice as likely to be using the AREDS formula correctly.

Optic Neuritis Patients Recover Good Vision

What are the long term vision consequences when a person has an acute attack of optic neuritis, a sudden-onset eye disease of the nerves that carry visual signals to the brain? Are the consequences different if the person is treated with corticosteroids, or if the patient’s attack is complicated by having multiple sclerosis (MS)? The Optic Neuritis Study Group recently conducted a 15-year follow-up study of 454 patients who had acute optic neuritis–a disorder that is often the first sign of MS—in one eye and who participated in the Optic Neuritis Treatment Trial (ONTT), a 1988 – 1991 randomized clinical trial. Optic neuritis causes symptoms such as blurred vision, blind spots, dimmed colors and sometimes eye pain.

The researchers concluded that ophthalmologists (Eye MDs) can advise acute optic neuritis patients that the “long-term outlook for their vision is favorable,” even if they currently have or develop MS. Of the original ONTT study cohort, 294 patients completed the follow-up exam in 2006. Seventy-two percent of patients had 20/20 vision or better in the affected eye and 66 percent had 20/20 or better vision in both eyes. Mild decreases in vision (20/25 to 20/40) were attributed to lens changes in nine patients, which would be expected in an age group with an average age of 48, the life-stage when the eye’s lens becomes less flexible and many people need reading glasses. Long-term vision quality was similar among patients who were treated with high-dose intravenous corticosteroids and patients who were not, although the initial recovery period was shorter for treated patients.

Even though their vision was found to be normal about 60 percent of the time, the patients with MS were more likely to report somewhat reduced quality-of-life, including: difficulty with daily tasks like parking a car and using a computer, and problems such as double vision and trouble focusing on moving objects. The study was funded by the National Eye Institute of the National Institutes of Health.

About the American Academy of Ophthalmology

The American Academy of Ophthalmology 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.

American Academy of Ophthalmology

Allergan Receives FDA Approval For ZYMAXID™ Ophthalmic Solution

Allergan, Inc. (NYSE: AGN) today announced that the United States Food and Drug Administration (FDA) has approved ZYMAXID™ (gatifloxacin ophthalmic solution) 0.5%, a topical fluoroquinolone anti-infective indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms; Haemophilus influenzae, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mitis group*, Streptococcus oralis*, Streptococcus pneumonia. ZYMAXID™ is now the highest concentration gatifloxacin ophthalmic solution on the market in the United States.

ZYMAXID™ contains 0.5% gatifloxacin, a well-established fluoroquinolone, and is formulated with the preservative benzalkonium chloride (BAK). In clinical studies, ZYMAXID™ ophthalmic solution demonstrated a statistically superior eradication of bacterial conjunctivitis – approximately 90 percent (301/333) versus 70 percent (228/325) for vehicle (the recommended dosage is one drop every two hours in the affected eye(s) while awake, up to eight times on Day one and then two to four times daily while awake on Days two through seven).1 ZYMAXID™ is efficacious against a broad spectrum of gram-positive and gram-negative pathogens.

“As pathogens continue to evolve and become more resistant to antibiotics, it is important to develop more potent formulations of anti-infective drugs,” said Scott Whitcup, M.D., Allergan’s Executive Vice President, Research and Development and Chief Scientific Officer. “Allergan has a history of innovation in ocular anti-infective drugs dating back to OCUFLOX® ophthalmic solution in the early 1990s, and we are pleased to offer a new option to eye care professionals and their patients.”

The efficacy of ZYMAXID™ ophthalmic solution was assessed in two multicenter, double-masked, randomized dual-arm comparison studies involving 1,437 patients receiving either ZYMAXID™ or vehicle. In the clinical studies, the efficacy of ZYMAXID™ was defined as complete clearance of conjunctival hyperaemia and conjunctival discharge, and when all bacterial species present at baseline were eradicated. Results of these studies demonstrated that at Day six, complete clearance of conjunctival hyperaemia and conjunctival discharge was achieved in 58 percent of patients (193/333) treated with ZYMAXID™ ophthalmic solution compared to 45 percent (148/325) in the vehicle group.

ZYMAXID™ is expected to be available to physicians and patients in the United States in June 2010.

* Efficacy for this organism was studied in fewer than 10 infections.

Indications And Usage

ZYMAXID™ (gatifloxacin ophthalmic solution) 0.5% solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms

Aerobic Gram-Positive Bacteria:
Staphylococcus aureus
Staphylococcus epidermidis
Streptococcus mitis group*
Streptococcus oralis*
Streptococcus pneumoniae

*Efficacy for this organism was studied in fewer than 10 infections.

Dosage And Administration

Patients one year of age or older: Instill one drop every two hours in the affected eye(s) while awake, up to eight times on Day one. Instill one drop two to four times daily in the affected eye(s) while awake on Days two through seven.

Important Safety Information

Warnings And Precautions

ZYMAXID™ solution should not be introduced directly into the anterior chamber of the eye. As with other anti-infectives, prolonged use of ZYMAXID™ may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, discontinue use and institute alternative therapy. Patients should be advised not to wear contact lenses if they have signs and symptoms of bacterial conjunctivitis or during the course of therapy with ZYMAXID™.

Adverse Reactions

The most frequently reported adverse reactions occurring in > 1% of patients in the gatifloxacin study population (N=717) were: worsening of the conjunctivitis, eye irritation, dysgeusia, and eye pain.

Additional adverse events reported with other formulations of gatifloxacin ophthalmic solution include chemosis, conjunctival hemorrhage, dry eye, eye discharge, eyelid edema, headache, increased lacrimation, keratitis, papillary conjunctivitis, and reduced visual acuity.

1 Data on file, Allergan, Inc. 2010.

Allergan, Inc.

View drug information on Ocuflox; Zymaxid.