News & Updates
Get your eyes tested this julEYE. Seventy-five percent of vision loss is preventable or treatable if detected early enough, yet every 65 minutes an Australian loses part or all of their vision. julEYE is The Eye Foundation’s eye health awareness month that takes place during July each year.
JulEYE has three core aims:
- to raise community awareness of eye health issues
- to raise funding for research projects into the causes and cures of vision impairment and blindness
- to support international development projects whose goals are aligned with those of The Foundation.
In 2010, we're asking all Australians to get their eyes tested during julEYE. Seventy-five percent of vision loss is preventable or treatable if detected early enough, yet every 65 minutes an Australian loses part or all of their vision. Vision loss can affect people at any time in their lives, and it will often happen gradually so that by the time it becomes noticeable, the damage is done.
The Eye Foundation is asking all Australians - no matter their age - to get their eyes tested this julEYE, and place eye tests every two years on their family’s calendar of regular medical checks. You’ll find information on where you can be tested here [click here] and you can donate to the campaign and support eye health research and development projectsby clicking here
Protect your children’s vision
Good eye health begins with regular testing from birth. The first eight years of a child’s life are critical for eye development. If problems are not picked up during this time, damage and vision loss can be permanent. If you’re a parent, you should be aware that regular eye checks are just as important to a young child’s overall health and wellbeing as other health checks.
You’ll find more information on children’s eye health here along with real stories of families who have children with eye disorders by clicking here.
What you can do to prevent macular degeneration?
- If you are a smoker, work toward giving up smoking.
- Eat leafy, green vegetables. Recommended are:
- Spinach, bok choy, broccoli, leek, capsicum, sweet corn, silver beet, turnip greens.
- Eat good quality nuts, especially almonds. Also, unroasted brazil nuts, walnuts, pine nuts.
- Eat two fish meals a week, preferably with some salmon in one. Tinned sardines and tuna are good sources of Omega 3 fatty acids.
- Eat a low fat diet and make sure the fats are “good” ones. Avoid all deep fried food, palm oil, potato crisps. Pan fry or grill meat. Use virgin olive oil for cooking.
- Eat a low glycaemic index diet. This means eating foods that don’t give you a quick sugar “fix” but which keep you from feeling hungry for longer periods. For instance, chocolate is a high glycaemic index food which will fill you up for 30 minutes but soon you will feel hungry again. Muesli is mostly low glycaemic index so long as it is not toasted in bad fats, or coated in sugar or honey.
- Use the AREDS vitamin supplements for zinc and antioxidants. These can be obtained in the preparation known as “Macuvision”.
- Consider using another supplement currently under study. “Luteinvision” contains the macular pigments lutein and zeaxanthine.
- Monitor your vision with the Amsler grid on a weekly basis. Report any sudden change in vision to your eye doctor promptly.
- Have periodic eye examinations by an eye health practitioner skilled in diagnosis of macular degeneration.
"Control of Blood Sugar and Cholesterol helps treat Diabetic Eye Disease"
This prospective, multi-center study randomized 10,251 participants with type 2 diabetes who were at high risk for cardiovascular disease to receive either intensive or standard treatment for glycemia (target glycated hemoglobin level, <6.0% or 7.0 to 7.9%, respectively) and also for dyslipidemia (160 mg daily of fenofibrate plus simvastatin or placebo plus simvastatin) or for systolic blood-pressure control (target, <120 or <140 mm Hg). A large subgroup was evaluated for the effects of these interventions at four years follow-up. They found that both intensive glycemic control and intensive combination treatment of dyslipidemia, but not intensive blood-pressure control, reduced the rate of progression of diabetic retinopathy by about one-third.
Source: New England Journal of Medicine, June 29, 2010 Link: http://content.nejm.org/cgi/content/full/NEJMoa1001288#T1
Diabetic macular edema: Steroid implants start to deliver the goods
At yesterday’s Retina Subspecialty Day, Baruch D. Kuppermann, MD, PhD, provided a sneak peek at the reservoir and biodegradable steroid implants that may soon play a role in ocular drug delivery for diabetic macular edema (DME).
Already FDA-approved for uveitis, Bausch & Lomb’s fluocinolone acetonide (Retisert) implant—sutured to the sclera where it can last up to 1,000 days—has also been tested for DME. Clinical trial results showed visual acuity gain, macular edema resolution, and diabetic retinopathy stabilization, said Dr. Kuppermann. But concerns over side effects of cataract and glaucoma led the company not to file for FDA approval for DME.
Alimera Sciences’ Iluvien fluocinolone acetonide reservoir implant contains half as much drug to reduce the side effects seen with Retisert. The Iluvien implant is injected with a 25-gauge needle and floats in the vitreous cavity. Once empty, the nonbiodegradable polymer husk remains in place. Results of the phase 3 FAME trial for DME could be out by the end of this year.
Releasing triamcinolone, SurModics’ I-vation has a corkscrew design that increases the surface area for drug delivery. Screwed into the eye, the implant anchors to the sclera. At 36 months, the phase 1 study has shown macular edema reduction but also cataracts.
Called Ozurdex in the United States and Posurdex elsewhere, Allergan’s dexamethasone drug-delivery system is an injectable biodegradable copolymer implant approved by the FDA in June 2009 for persistent macular edema due to vein occlusion. In phase 2 trials involving DME patients, 35 percent of eyes receiving 700 micrograms improved 10 letters or more by Day 90, compared with 24 percent of those receiving 350 micrograms, and 13 percent in the observation group.
Gene therapy improves vision in patients with severe retinal dystrophy
Jean Bennett, MD, PhD, presented an update on her team’s ongoing development of gene therapy for Leber’s congenital amaurosis. Phase 1 study results for the treatment, the first gene therapy for a nonlethal pediatric disease and for inherited retinal degeneration in adults, were published in the Oct. 24 issue of The Lancet.
A rare autosomal recessive disease with early onset and that causes incurable retinal degeneration, Leber’s congenital amaurosis is often caused by mutations in the RPE65 gene, which is produced in the retinal pigment epithelium, where it helps to generate a vitamin A compound essential for vision. Dr. Bennett and her colleagues have developed a method to deliver a normal version of the RPE65 gene via a subretinal injection of a genetically engineered adeno-associated virus. Twelve patients ranging in age from 8 to 44 were treated in their worse eye in the phase 1 study.
Children responded best to treatment, Dr. Bennett reported, with all of them gaining ambulatory vision. Some patients improved to the extent of no longer being classified as legally blind. In addition, the pupillary light reflex was restored in eyes that were barely responsive before treatment. All patients demonstrated at least a 2-log unit response, and the subjects’ visual fields expanded. Dr. Bennett showed video of the youngest patient successfully completing an obstacle course in the laboratory using his treated eye three months after treatment, but he was unable to complete the course using only his untreated eye. The treatment appears safe and well-tolerated. A phase 3 study of the treatment is scheduled to begin in February.
Genetics may influence response to ranibizumab in wet AMD patients
A study conducted by Genentech researchers suggests that genetic polymorphisms may influence ranibizumab (Lucentis) treatment outcomes in wet AMD patients. These results, if validated by further research, could help determine future population selection for clinical trials, said Jason Ehrlich, MD, who presented the study results.
The research involved a genome-wide association study on 352 ranibizumab clinical trial subjects. The investigators identified multiple single nucleotide polymorphisms associated with significant differences in mean visual acuity change after 12 months of ranibizumab treatment. Visual acuity gains were smaller in patients with fewer of the beneficial SNPs, Dr. Ehrlich said.
Wet AMD increases the risk of falls in the elderly
Neovascular AMD: an overlooked risk factor for injurious falls
While those with neovascular age-related macular degeneration (NV-AMD) may be at increased risk of injurious falls risk due to poor central vision and suboptimal responses when falling, preserved peripheral vision and decreased activity levels may actually be protective. Compared with control participants, patients with NV-AMD had a significantly greater number of falls and almost twice the risk of injurious falls. INTRODUCTION: Impaired vision, particularly peripheral visual function, is a key risk factor for injurious falls. NV-AMD is a leading cause of severely impaired vision among older adults but is associated with a profound central, rather than peripheral, deficit.
The objective was to determine whether older women with NV-AMD are at an increased risk of falls or injurious falls. METHODS: We conducted a 12-month prospective cohort study of community-dwelling older (>/=70 years) women, enrolling 114 with NV-AMD and 132 without from a retinal clinic in Vancouver, Canada. Fall incidence was determined through monthly telephone follow-up, with fall severity classified by a blinded reviewer.
We compared mean injurious falls per person-year between groups using negative binomial regression. RESULTS: A mean of 0.37 injurious falls per person-year were experienced among NV-AMD participants, compared to 0.16 injurious falls per person-year among non-NV-AMD participants (p = 0.006). The age-adjusted incidence rate ratio for injurious falls, for an individual with NV-AMD compared to without, was 1.77 (1.07-3.02). CONCLUSIONS: Older women with NV-AMD are at almost twice the risk of injurious falls compared to those without. Clinicians caring for older adults should recognise NV-AMD as an important risk factor for injurious falls..Source: Osteoporos Int. 2009 Jul 23. ... more
Diabetics need to look after their blood sugar and blood pressure to reduce the risk of fluid in the retina.
Better glycemic and blood pressure control may reduce macular edema incidenceThis 25-year population-based study of individuals with type I diabetes taking insulin indicates that relatively high incidence rates (29 percent) of macular edema and clinically significant macular edema (17 percent) are related to glycemia, systolic and diastolic blood pressure, and nephropathy as manifest by gross proteinuria. The lower incident macular edema rate during the last period of follow-up may reflect recent improvement in care.Source: Ophthalmology, March 2009 ... more
More evidence that Lucentis improves visual acuity in patients with CRVO
Researchers prospectively recruited 20 patients (20 eyes) with central retinal vein occlusion (CRVO) from a single practice. They were injected at baseline and once-a-month for two months, and on an as needed basis thereafter for a mean of 8.5 injections over 12 months. Patients showed a significant improvement in visual acuity, beginning less than one week after the first injection, with 94 percent having stabilized or improved acuity at one year. As-needed dosing may be the best strategy in CRVO patients, they conclude. Source: American Journal of Ophthalmology, February 2009
Lucentis is better than Visudyne
Only a few years ago we treated wet macular degeneration with Visudyne injections, given into the arm and activated with a soft laser. Nowadays we use injections of Lucentis or Avastin into the eye itself for this purpose. The ANCHOR study done over two years showed that Lucentis was far superior to Visudyne in terms of preventing loss of vision and improving vision. Source: Ophthalmology 2009;116:57-65
New Complement Gene important in understanding AMD
A new candidate gene, “Serping 1” produces a protein that inhibits that activation of inflammation. Complement activation is thought to be important in AMD. Further research in this area may lead to new treatments in the future. Source: Lancet 2008;372:1828-1834
Surgical correction of astigmatism
Astigmatism is a condition in which the eye is “out of round”, ie it is more the shape of a rugby ball rather than a soccer ball. When doing cataract surgery it is now possible to optically correct for astigmatism by using what is known as a toric intraocular lens. This means that the need for glasses after cataract surgery is less likely.
Surgical correction of reading vision
Traditionally, removing a cataract and replacing it with a lens implant meant that the eye was focussed only for distance. To read print, one then had to use reading glasses. Now, in some carefully selected cases, a multifocal lens implant can be inserted after the cataract is removed. This allows the person reasonable reading vision as well as distance vision without glasses.
Shorter face down time for macular hole surgery
When repairing macular holes in the past, the patient was required to have face down positioning for two weeks. Mightily uncomfortable. Now it is possible to achieve the same surgical result with only one week of face down positioning and there is quicker recovery generally as well.
