Ophthalmology
14 Oct Some Children Find It Difficult To Wear Glasses During Lazy Eye Treatment
MedicalResearch.com Interview with: Dr Gail Maconachie PhD and Researcher and Professor Irene Gottlob Professor of Ophthalmology Dept. of Neuroscience, Psychology and Behaviour The University of Leicester Ulverscroft Eye Unit Leicester Royal Infirmary Leicester UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lazy eye (Amblyopia) affects 3-5% of the population. Treatment usually involves wearing glasses alone for around 18 weeks followed by occlusion of the good eye, usually a patch. Recent studies have shown, using monitors, that children often struggle with patching and patch only about half of what is prescribed. To date, no study has observed how well children with lazy eyes comply with glasses wearing. Glasses wearing is becoming increasingly important in lazy eye treatment as it has been shown to improve vision without other treatments. Therefore observing compliance may help to understand why some children do better with glasses treatment than others. We found in our subjects that adherence to glasses wearing, in children aged 3 to 11 years who are undergoing treatment for a lazy eye, very variable and often poor. We also found that during treatment when only glasses wearing were given, adherence to glasses wearing, along with age and cause of the lazy eye, significantly predicted visual outcomes.10 Oct Results of the 2-Year Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole (OASIS) Randomized Trial
MedicalResearch.com Interview with: [caption id="attachment_28685" align="alignleft" width="120"]
Dr. Pravin Dugel[/caption]
Pravin U. Dugel, MD
Retina Consultants of Arizona
Phoenix, Arizona; USC Roski Eye Institute
Keck School of Medicine
University of Southern California
Los Angeles, California
MedicalResearch.com: What is the background for this study?
Response: OASIS is an acronym for “OcriplASmIn for Treatment for Symptomatic Vitreomacular Adhesion including Macular Hole”. It was a Phase IIIB, randomized, prospective, sham-controlled, double-masked, multicenter clinical study. The goal of the study was to further evaluate the long-term (24 months) efficacy and safety of a single injection of 0.125mg of ocriplasmin in patients with symptomatic vitreomacular adhesion (VMA) and vitreomacular traction (VMT), including macular hole (MH).
OASIS evaluated 220 patients with symptomatic VMA/VMT. One hundred forty-six patients received ocriplasmin while 74 served as a sham control group. In the latter group, no intravitreal injection was administered.
06 Oct Payments to Ophthalmologists for Anti-VEGF Agents
MedicalResearch.com Interview with: [caption id="attachment_28618" align="alignleft" width="166"]
Dr. Aleksandra Rachitskaya[/caption]
Aleksandra Rachitskaya, MD
Assistant Professor of Ophthalmology
Retina Service, Department of Ophthalmology
Cole Eye Institute
Cleveland, OH 44195
MedicalResearch.com: What is the background for this study?
Response: The Centers for Medicare and Medicaid Services (CMS) Open Payments database lists payment records from drug and device manufacturers to physicians. Anti-vascular endothelial growth factor (anti-VEGF) agents such as ranibizumab (Lucentis®, Genentech, Inc., San Francisco, CA), aflibercept (Eylea™, Regeneron, Tarrytown, NY) and off-label bevacizumab (Avastin®, Genentech, Inc., San Francisco, CA) are used for a variety of indications in ophthalmology.
The current study examined the payments made to ophthalmologists related to ranibizumab and aflibercept and correlated those payments to provider usage of these medications. The former was achieved by utilizing Centers for Medicare and Medicaid Services (CMS) Provider Utilization and Payment database.
17 Sep Resistant E. Coli Produces Slimy Coating To Prevent Removal By Immune System
MedicalResearch.com Interview with: [caption id="attachment_28049" align="alignleft" width="133"]
Dr. Daria Van Tyne[/caption]
Dr. Daria Van Tyne, PhD
The Gilmore Lab
Department of Ophthalmology
Harvard Medical School
Massachusetts Eye and Ear Infirmary
Boston, Massachusetts
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A specific clone of E. coli, type ST131, which produces an extended-spectrum beta-lactamase (ESBL – an enzyme that inactivates many penicillin-type antibiotics), has rapidly spread around the globe to become the leading cause of multidrug-resistant, non-intestinal E. coli infection. Despite this, E. coli is a rare cause of infection of the cornea. A patient was recently seen at the Massachusetts Eye and Ear Infirmary with a severe E. coli infection of the cornea, and the large number of antibiotic resistances of this strain tipped us off to the possibility that it might be the highly virulent ST131 ESBL type. By sequencing the DNA of its genome, we found that it was indeed ST131 ESBL E. coli. Moreover, we discovered a new mutation in this strain that allows it to produce a slimy outer coating on its surface. This slime layer, or capsule, makes the bacteria more resistant to removal by phagocytic cells of the immune system. The slime layer also makes these particular colonies appear different on a special type of agar that contains the dye Congo Red.
13 Sep 90% of Americans Live Within Short Driving Distance To Eye Care
MedicalResearch.com Interview with: [caption id="attachment_27898" align="alignleft" width="142"]
Dr. Cecelia Lee[/caption]
Cecilia S. Lee, MD
Department of Ophthalmology
University of Washington School of Medicine
Seattle, WA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Access to eye care is a critical issue currently in the United States. With the expected increase in the aging US population, many eye diseases are age-related and there is an expected associated increase in demand for eye care. Prior studies have estimated access to care in many different ways including looking at providers per zipcode, utilization of billing codes, and distance to provider. We sought to estimate the access to eye care providers using a much more accurate way to estimate the driving distance to provider. Specifically, we recreated a driving route system similar to Google Maps or Apple Maps for navigation to plot direct driving routes.
08 Sep Building Better Eyedrops For Drug Delivery
MedicalResearch.com Interview with: [caption id="attachment_27727" align="alignleft" width="138"]
Dr. Heather Sheardown[/caption]
Heather Sheardown PhD PEng FCAE
Scientific Director 20/20 NSERC Ophthalmic Materials Network
Professor, Department of Chemical Engineering
Canada Research Chair in Ophthalmic Biomaterials
McMaster University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Putting drops in the eye is well accepted from the standpoint of practitioners but is problematic for many patients. Therefore, particularly in cases where multiple drops are required in a day such as is the case with certain infections for example or a lifetime of drops is required such as is the case with diseases like glaucoma, patient compliance is a real issue. In addition, as much as 95% of any drop instilled in the eye is lost within the first 5 minutes, meaning that drug concentrations within the drop need to be higher to ensure that the required dose gets into the patient’s eye.
Therefore there is a real need for a better alternative to traditional eyedrops is needed. We have developed a new method of formulating drugs for delivery as drops that adhere to the mucous layer of the tear film, allowing for smaller amounts of drug to be delivered over a prolonged period of time. This means that fewer drops with lower drug concentrations can be delivered. This is a micelle based system that allows for the formulation of more hydrophobic drugs. A mucoadhesive component associated with the micelle binds to the mucin layer of the tears, meaning that the residence time on the eye is similar to that of this layer - between 4 and 7 days. Drug is slowly released from the micelle, allowing for prolonged treatment.
23 Aug Contact Lens Infections Are Often Preventable With Proper Care
MedicalResearch.com Interview with: [caption id="attachment_27239" align="alignleft" width="140"]
Dr. Jennifer Cope[/caption]
Dr. Jennifer Cope MD, MPH
Medical Epidemiologist
CDC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Approximately 41 million people in the United States wear contact lenses, a safe and effective form of vision correction if worn and cared for as directed. Contact lenses are medical devices that are regulated by the Food and Drug Administration (FDA). Adverse events related to contact lenses are reported to FDA’s Medical Device Report (MDR) database.
During 2005–2015, a total of 1,075 Medical Device Reports describing contact lens–related corneal infections were reported to the FDA Medical Device Report database. Approximately 20% of these reports described a patient who suffered serious eye damage. More than 25% of the 1,075 reports described modifiable behaviors that might have put the patient at risk for a contact lens–related corneal infection, such as sleeping in lenses or wearing lenses longer than for the prescribed period.
15 Aug Stroke Risk Elevated in Some Patients with NAION
MedicalResearch.com Interview with: [caption id="attachment_26986" align="alignleft" width="128"]
Dr. Rong Kung-Tsai[/caption]
Rong-Kung Tsai MD, PhD
Professor and Director
Institute of Eye Research
Buddhist Tzu Chi Medical Center;
Director, Institute of Medical Sciences
Tzu Chi University, Hualien, Taiwan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Non-arteritic anterior ischemic optic neuropathy (NAION) is pathogenetically different from stroke, stroke is caused by thromboembolism. However, they share many (but not all) systemic vascular risk factors. Previous small scale studies got controversial results. Using the National Health Insurance Research Database (NHIRD) in Taiwan to conduct the cohort study, 414 patients were included in the NAION group and 789 in the control group (base one million beneficiaries). The incidence of NAION is 3.72/100,000 person-years in Taiwan, and patients with NAION have more chances to develop ischemic stroke (p=0.003), but not hemorrhage stroke.
The subgroup analyses further showed the risk of ischemic stroke among the subjects with NAION and with comorbidities was 3.35 times higher than those without NAION. However, in patients with NAION but no comorbidities, there is no increase risk of stroke development.
09 Aug Young Children At High Risk of Chemical Eye Burns
[caption id="attachment_26785" align="alignleft" width="142"]
Dr. R. Sterling Haring[/caption]
MedicalResearch.com Interview with:
R. Sterling Haring, DO, MPH
Center for Healthcare Quality and Patient Safety
University of Lugano, Switzerland
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Chemical burns of the eye are among the most serious and emergent of eye injuries. In the worst cases, corrosive chemicals can eat into the eye and damage internal structures, rendering the individual with little or no vision in the affected eye. Given the proximity of the eyes to one another, it is not uncommon for these injuries to be bilateral, further complicating the clinical picture.
Working-age individuals, particularly men, are known to be a high-risk group for these types of injuries. In the first nationwide study on this issue, we found that 1-year old infants were at substantially higher (1.5x) risk of these injuries than the highest-risk age group among adults; 2-year-olds were a close second. These injuries tapered off as children grew older, such that the risk among 1-year-old infants was 13 times higher than that of 7-year-old children. Across all ages, injuries occurred most frequently among lower-income households.
05 Aug Sedentary Lifestyle Linked To Increased Risk of Diabetic Retinopathy
MedicalResearch.com Interview with: [caption id="attachment_26717" align="alignleft" width="132"]
Dr. Paul Loprinzi[/caption]
Paul Dinneen Loprinzi, PhD
Health, Exercise Science and Recreation Management
University of Mississippi
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous research demonstrates that adults who have higher daily sedentary behavior tend to have worse cardiometabolic health profiles. The extent to which sedentary behavior is associated with diabetic retinopathy has yet to be evaluated in the literature before our study. Our findings provided some suggestive evidence that more sedentary behavior was associated with a higher odds of having diabetic retinopathy.
30 Jun Patient Satisfaction with LASIK Surgery For Nearsightedness Exceeded Contact Lenses Over Three Year Period
MedicalResearch.com Interview with: [caption id="attachment_25708" align="alignleft" width="160"]
Dr. Marianne Price,[/caption]
Marianne Price, Ph.D.
Executive Director
Cornea Research Foundation of America
Indianapolis, Indiana
MedicalResearch.com: What is the background for this study?
Dr. Price: Over 40% of Americans are near-sighted and the rate of near-sightedness continues to increase. The most common treatments are glasses, contact lenses, or laser refractive surgery (LASIK).
The purpose of this study was to find how patient satisfaction compares with contact lenses and with LASIK. We enrolled 1800 participants at 20 sites across the USA; 694 participants (39%) continued wearing contact lenses and 1106 (61%) had LASIK. Participants were surveyed at baseline, 1, 2 and 3 years.
28 Jun “Big Data” in Ophthalmology Clarifies Epidemiology of Rare Eye Disorders
MedicalResearch.com Interview with: [caption id="attachment_25610" align="alignleft" width="205"]
Dr. Jeffrey Willis[/caption]
Jeffrey R. Willis, MD, PhD
University of California Davis Eye Center
Sacramento, CA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The goal of this study was to understand how "Big Data" in ophthalmology could be utilized to assess the prevalence of rare diseases such as myopic choroidal neovascularization (mCNV).
Prior to our study, there was limited knowledge on the burden of this devastating condition as previous estimates were done more than 20 years ago, had a small sample size, and were not generalizable to the current U.S. population. In order to address this knowledge gap, we realized the potential of two large datasets with ophthalmic information, including the National Health and Nutrition Examination Survey (NHANES) and the IRIS Registry. The former provides nationally representative data, but with limited ophthalmic disease information. The latter dataset, supported by the American Academy of Ophthalmology (AAO), is the nation's only comprehensive database of ophthalmic patient outcomes. By triangulating data from the these two data sources in conjunction with population estimates from the U.S. Census Bureau, we were able to calculate the mCNV prevalence in the United States. Specifically, we showed that mCNV is a rare condition, affecting about 41,000 adult Americans, with a higher burden on women than men. This study effectively showed that using "Big Data" in ophthalmology could help us better understand the epidemiology of rare ophthalmic conditions in the US.
20 Jun Hands-Free Cellphone Use While Driving Also Delays Reaction Times
MedicalResearch.com Interview with: Jeff C. Rabin, O.D., M.S., Ph.D., F.A.A.O., Dipl. Vision Science Professor and Assistant Dean for Graduate Studies, Research and Assessment Chief, Visual Neurophysiology Service University of the Incarnate Word Rosenberg School of Optometry San Antonio, TX MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Rabin: The use of hand-held cellphones during driving has been widely banned but the impact of hands-free communication on visual performance remained unclear. Therefore, we used a standard automobile Bluetooth device suspended above our visual display and determined that hands-free communication significantly delayed response time to detect low contrast black-white and color targets. Moreover, hands-free communication decreased sensitivity of “color-blind” subjects to detect targets corresponding to their color deficiency and all subjects showed a tendency for decreased sensitivity for detection of small, low contrast black-white targets.09 Jun Severe Diabetic Macular Edema: EYLEA® Had Better Outcomes Than Avastin® or Lucentis® At One Year, But at Much Greater Cost
Posted at 20:39h
in Author Interviews, Cost of Health Care, JAMA, Macular Degeneration, Ophthalmology
[caption id="attachment_22245" align="alignleft" width="111"]
Adam Glassman[/caption]
MedicalResearch.com Interview with:
Adam Glassman, M.S.
Director, DRCRnet Coordinating Center
Jaeb Center for Health Research
Tampa, FL 33647
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Diabetic macular edema (DME) is the most common cause of vision loss in patients with diabetes, impairing the vision of approximately 750,000 people in the United States. The most common treatment involves the injection into the eye of one of 3 drugs that inhibit vascular endothelial growth factor (VEGF). The Diabetic Retinopathy Clinical Research Network, funded by the National Institutes of Health, conducted a randomized clinical trial on the comparative effectiveness of the 3 anti-VEGF drugs EYLEA®, Avastin®, or Lucentis® for eyes with decreased vision from diabetic macular edema. There are substantial cost differences between the three drugs. In the United States, EYLEA® costs approximately $1850, repackaged (compounded) Avastin® $60, and Lucentis® $1170 per injection. In eyes with relatively good starting vision, there were no differences in vision outcomes; all three groups, on average, had improved vision. In eyes with starting vision of 20/50 or worse, EYLEA® had better vision outcomes at 1 year than either Avastin® or Lucentis®, and better vision outcomes at 2 years than Avastin®. However, given that, on average, eyes will receive 9 to 10 injections within the first year of treatment and 5 injections in the second year, neither EYLEA® nor Lucentis® would be considered cost effective by standard benchmarks compared with Avastin® unless their prices decrease substantially.
04 Jun Listening To Music Reduces Anxiety During Awake Eye Surgery
MedicalResearch.com Interview with: Dr Gilles Guerrier Cochin University Hospital Paris, France MedicalResearch.com: What is the background for this study? Dr. Guerrier: Awake eye surgery is particularly stressful for patients. Music has long been known to reduce anxiety, minimise the need for sedatives, and make patients feel more at ease. The purpose of this pilot study was to evaluate the effect of music on anxiety in outpatients undergoing elective eye surgery under topical (local) anaesthesia. The music played was specifically composed to ease anxiety following strict criteria, including instrumental pieces only using a decreasing tempo and a progressive decrease in the number of instruments playing. Each patient was able to choose from a panel of 16 recorded music styles according to their own preferences, and listened through high quality headphones. There were various styles available, including jazz, flamenco, Cuban, classical and piano. The music was provided by MUSIC CARE, a Paris-based company that produces music aimed at preventing and managing pain, anxiety and depression.23 May Older Non-Hispanic White Women Most Affected by Visual Impairment
MedicalResearch.com Interview with: [caption id="attachment_24454" align="alignleft" width="185"] Dr. Rohit Varma[/caption] Rohit Varma, MD, MPH, USC Interim Dean, Keck School of Medicine Professor and Chair, Department of Ophthalmology Director, USC Gayle and Edward Roski Eye Institute President, USC Care Los Angeles, CA 90033 MedicalResearch.com: What is the background for this study? Dr. Varma: In a study funded by the National Eye...
17 May Corneal Crosslinking Using Brillouin Microscopy May Lead To Better Treatment of Nearsightedness
MedicalResearch.com Interview with: [caption id="attachment_24430" align="alignleft" width="200"]
Sheldon j. .J.Kwok[/caption]
Sheldon J.J. Kwok
MD/PhD Candidate
Harvard-MIT Health Sciences and Technology | Harvard Medical School
Yun Bio-Optics Lab
Wellman Center for Photomedicine
MGH
MedicalResearch.com: What is the background for this study?
Response: Corneal collagen crosslinking (CXL) using UV light and riboflavin has become a popular and effective technique for treating corneal ectatic disorders, such as keratoconus, by mechanically strengthening the corneal stroma. We were interested in enhancing the capabilities of CXL using the principle of two-photon excitation, which uses a femtosecond laser to confine crosslinking to only where the laser is focused. By scanning the laser, this allows us to crosslink any arbitrary three-dimensional region deep inside tissue.
With two-photon collagen crosslinking (2P-CXL), treatment of thin corneas is possible without affecting the underlying endothelium. Irradiation can also be patterned to improve keratocyte viability. Furthermore, selective crosslinking in three dimensions offers the possibility of modulating corneal curvature for refractive error correction.
13 May Comparison of Ranibizumab to Steroids For Central Retinal Vein Occlusion
MedicalResearch.com Interview with: [caption id="attachment_24353" align="alignleft" width="133"]
Dr. Hans Hoerauf[/caption]
Prof. Dr. med. Hans Hoerauf
Direktor der Augenklinik
Universitätsmedizin Göttingen
Göttingen
MedicalResearch.com: What is the background for this study?
Dr. Hoerauf: Two treatment options, anti-vascular endothelial growth factors (anti-VEGFs) and corticosteroids, with different mechanisms of action are available for the treatment of macular edema secondary to Central Retinal Vein Occlusion (CRVO). Our study, COMRADE-C, is the first head-to-head study to investigate the clinical efficacy and safety of the European labels of ranibizumab (anti-VEGF) versus dexamethasone intravitreal implant (corticosteroid) in patients with CRVO over six months.
12 May Ocular-Motor System Vulnerable to Cumulative Sub-Concussion Injuries
Posted at 23:11h
in Artificial Sweeteners, Author Interviews, Brain Injury, JAMA, Neurological Disorders, Ophthalmology
MedicalResearch.com Interview with:
[caption id="attachment_24260" align="alignleft" width="148"]
Dr. T. Dianne Langford[/caption]
Dr. T. Dianne Langford PhD
Associate Professor, Neuroscience and Neurovirology
Lewis Katz School of Medicine
Temple University
MedicalResearch.com: What is the background for this study?
Dr. Langford: The ocular-motor system has been shown to reflect neural damage, and one of ocular-motor functions, near point of convergence (NPC), was reported to worsen after a sport-related concussion (Mucha et al. Am J Sport Med). But the effects of subconcussive head impact, a milder form of head injury in the absence of outward symptoms remains unknown. Prior to this study, we found that in a controlled soccer heading experimental paradigm decreased NPC function, and even 24h after the headings, NPC was not normalized back to baseline (Kawata et al. 2016 Int J Sport Med). To extend our findings from the human laboratory study, we launched longitudinal clinical studies in collaboration with the Temple football team, to see if repetitive exposure to subconcussive head impacts negatively affects NPC.
12 May UV Exposure from Driving Leads To More Skin Cancers and Cataracts on Left Side
MedicalResearch.com Interview with: [caption id="attachment_24306" align="alignleft" width="164"]
Dr. Brian Boxer Wachler[/caption]
Dr. Brian Boxer Wachler MD
Boxer Wachler Vision Institute
Beverly Hills, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As an eye surgeon, I observed patients tended to have more age spots on the left side of their faces. I was examining a patient with Keratoconus and after I noted her age spots on her left cheeks, I began to look into this phenomenon. It turns out there are many studies that found more skin cancer on the left side of the face compared to the right side of the face. In Australia (where people drive on the left side of the road) it’s the opposite – more skin cancer on the right side of the face. Our study found that cars on average have significantly lower UVA (ultraviolet A) protection in the side windows compared to windshields which have universally high UVA protection. I believe this can be the missing link that can explain higher rates of skin cancer on the side of the face by the driver’s window. There are also more cataracts in left eyes vs right eyes. There was no relationship between high-end cars and low-end cars for side window UV protection – in other words many more pricey cars had just as poor side window UV protection as less expensive cars.
30 Apr Biomarker Mutations Offer Prognostic Value in Uveal Melanoma
MedicalResearch.com Interview with: [caption id="attachment_23925" align="alignleft" width="130"]
Dr. J. William Harbour[/caption]
J. William Harbour, M.D.
Leader, Eye Cancer Site Disease Group
Sylvester Comprehensive Cancer Center
University of Miami Miller School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Harbour: Uveal melanoma (UM) is the most common primary cancer of the eye which has the fatal tendency to metastasis to the liver. The molecular landscape of UMs have been well characterized and can be categorized by gene expression profiling (GEP) into two molecular classes associated with metastatic risk: Class 1 (low risk) and Class 2 (high risk). The Class 2 profile is strongly associated with mutations in the tumor suppressor BAP1. This GEP-based test is the only prognostic test for UM to undergo a prospective multicenter validation, an it is available commercially as DecisionDX-UM (Castle Biosciences, Inc). It is routinely used in many North American centers.
The identification of driver mutations in cancer has become a focus of precision medicine for prognostic and therapeutic decision making in oncology. In UM, thus far, only 5 genes have been reported to be commonly mutated: BAP1, GNA11, GNAQ, EIF1AX, and SF3B1. In this study, we analyzed the associations between these 5 mutations, and with GEP classification, clinicopathologic features, and patient outcomes. The study showed that GNAQ and GNA11 are mutually exclusive, probably occur early in tumor formation, and are not associated with prognosis. In contrast, BAP1, SF3B1, and EIF1AX, which are also nearly mutually exclusive, likely occur later in tumor formation and do have prognostic value in UM.
13 Apr Ocular Herpes Zoster Can Be Chronic and Recurrent
MedicalResearch.com Interview with: Kimberly D Tran, MD Bascom Palmer Eye Institute MedicalResearch.com: What is the background and purpose for this study? Dr. Tran: Approximately 30% of the population will suffer from herpes zoster (also known as shingles) at some point in their lifetime, with an estimated 1 million cases in the U.S. each year (1). The most common long term complication of herpes zoster is postherpetic neuralgia (PHN), or persistent neuropathic pain lasting beyond three months after initial presentation of herpes zoster. PHN can negatively affect quality of life to a degree similar to congestive heart failure, depression, acute myocardial infarction,diabetes. Postherpetic neuralgia is a leading cause of suicide in patients over 70 with chronic pain.(3,4) Of all the cases of herpes zoster, an estimated 10-20% will have herpes zoster ophthalmicus (HZO), which is defined as shingles in the area of the face near the eye, and sometimes the eye itself becomes involved. Approximately 50% of individuals with HZO will develop ocular complications without antiviral treatment, while antiviral induction within the first 72 hours of rash onset reduces this number to 20-30% (2). Randomized control trial has demonstrated the efficacy antiviral therapy in the treatment of herpes zoster on first presentation.(6) What is less understood is the course of HZ after its initial presentation. Traditionally studied and treated in the acute phase,(5-7) recent data suggest that some patients experience a chronic or recurrent disease course. Based on this data, it is clear that more information is needed on the long term clinical course of herpes zoster ophthalmicus. The purpose of this study was to characterize the epidemiology of recurrent and chronic HZO in a unique South Florida population, with an ethnically and racially mixed, predominately male population.25 Mar Vitamin C Rich Diet, Not Supplements, May Slow Progression of Cataracts
MedicalResearch.com Interview with: [caption id="attachment_22861" align="alignleft" width="151"]
Dr. Chris Hammond[/caption]
Christopher J. Hammond, MD, FRCOphth
Departments of Ophthalmology & Twin Research
King's College London
St. Thomas' Hospital
London UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Hammond: Twin studies allow us to quantify the influence of genes vs environment on a trait and this study suggests 65% of variation of cataract progression is due to environmental factors.
Vitamin C has long been linked to cataract because the lens of the eye is bathed in fluid rich in ascorbate, a derivative of vitamin C. We showed that, even in a relatively well-nourished UK population, those in the highest third of vitamin C dietary intake (equating to something like 3 times the RDA of 60mg) had a third less progression of lens opacities.
14 Mar Higher Ozone, Lower Humidity Linked to Dry Eye Disease
MedicalResearch.com Interview with: Dong Hyun Kim, M.D. Clinical assistant professor, Department of Ophthalmology, Gil Medical Center, Gachon University Incheon, Korea MedicalResearch.com: What is the background for this study? Dr. Kim: Air pollution is an important public health concern nowadays and ocular surface is continuously exposed to the outdoor air pollutants. Dry eye disease is a representative ocular surface...
14 Mar Fluoroquinolones Linked to Increase in Retinal Detachments
MedicalResearch.com Interview with: Fanny Raguideau Evaluateur en pharmaco-épidémiologie Direction Scientifique et de la Stratégie Européenne Pôle Epidémiologie des produits de santé MedicalResearch.com: What is the background for this study? What are the main findings? Response: Retinal detachment (RD), including both exudative types often associated with systemic diseases that might be receiving antibiotics for related conditions as well as rhegmatogenous which require prompt surgical intervention to reduce the chance of irreversible severe vision loss, has an annual incidence rate of 1 per 10,000 in the general population. Rhegmatogenous is the most common type. Fluoroquinolones are one of the most commonly prescribed classes of antibiotics. Thanks to their broad-spectrum antibacterial coverage, they are effective in the treatment of a wide variety of community-acquired infections. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have suggested that oral fluoroquinolone use increased the risk of Retinal detachment, however this association remains controversial. We conducted a nationwide self-matched design study to overcome limitations of previous studies. Our finding of a significant increased risk of Retinal detachment, including both rhegmatogenous and exudative types, following use of oral fluoroquinolone strongly supports the existence of this association.08 Mar Analysis of Secondary Primary Tumors In Patients With Uveal Melanoma
MedicalResearch.com Interview with: Ines Laines MD and Deeba Husain MD Associate Professor Ophthalmology Harvard Medical School Investigator Angiogenesis Laboratory Retina Service Massachusetts Eye and Ear Infirmary Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Uveal melanoma (UM) is the most common malignant tumor of the eye in adults. More than half of the patients are long-term survivors. It is well established for other malignancies that cancer survivors are especially prone to developing independent second primary neoplasms (SPNs) and that their characteristics vary according to the site of the first primary tumor. Multifactorial causes seem to be involved, including environmental exposures and genetic risk factors. The relevance of the treatment modalities applied to the first tumor also seem to play a role, in particular radiation therapy, which is currently the gold-standard treatment for most uveal melanoma. This risk is most pronounced in the organs within the irradiated fields, but has also been described in sites not directly exposed to radiation. Despite growing knowledge about treatment-induced effects on the occurrence of SPNs in patients with other malignancies, data is insufficient for uveal melanoma. We present a population-based analysis of the Surveillance, Epidemiology, and End Results (SEER) database, which is a well-validated public database with a case ascertainment rate of 98%. In this study, we evaluated whether patients with UM demonstrate an increased incidence of second primary neoplasms compared to the general population, including an analysis on whether radiation therapy is associated with a higher risk of thesesecond primary neoplasms.03 Mar Task Force Recommends Older Adults Mention Eye Problems To Their Primary Care or Ophthalmologist
MedicalResearch.com Interview with: [caption id="attachment_22300" align="alignleft" width="149"]
Dr. Albert Siu[/caption]
Dr. Albert Siu M.D., M.S.P.H.
Chair of the U.S. Preventive Services Task Force
Chairman and professor of the Brookdale Department of Geriatrics and Palliative Medicine
Icahn School of Medicine at Mount Sinai
Director of the Geriatric Research, Education, and Clinical Center
James J. Peters Veterans Affairs Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Siu: Impaired vision is a serious and common problem facing older adults and can affect their independence, ability to function, and quality of life. When the Task Force reviewed the research around screening older adults for vision impairment in a primary care setting, we concluded that the current evidence is insufficient to assess the balance of benefits and harms. As a result, we issued an I statement, which is consistent with the 2009 final and 2015 draft recommendations.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Siu: Older adults who are having problems seeing should talk to their primary care doctor or an eye specialist. Primary care doctors can explore the various causes of vision problems and do an eye exam to check for refractive error. An eye specialist can do a full eye exam to look for and treat refractive errors and other eye conditions that affect vision, such as cataracts and age-related macular degeneration (AMD). With regards to clinicians, in the absence of clear evidence, they should use their clinical judgment when deciding whether to screen patients who have not reported any concerns about their vision.
01 Mar Eyelea Improves Vision Faster In Eyes With Worse Diabetic Macular Edema
MedicalResearch.com Interview with: [caption id="attachment_22245" align="alignleft" width="111"] Adam Glassman[/caption]
Adam Glassman, M.S.
Director, DRCRnet Coordinating Center
Jaeb Center for Health Research
Tampa, FL 33647
Medical Research: What is the background for this study? What are the main findings?
Response: Diabetic macular edema (DME) involves a build-up of blood and fluid in the macula, the part of the eye needed for sharp, straight-ahead vision. Diabetic macular edema can occur in people with diabetic retinopathy and is the most common cause of diabetes-related vision loss. Anti-VEGF agents are the first line treatment for most U.S. retinal specialists to treat vision loss from DME. There are three commonly used agents to treat DME, EYLEA, Avastin, and Lucentis. Eylea and Lucentis are FDA approved for Diabetic macular edema treatment. However, Avastin is used off-label in repacked aliquots containing approximately 1/500th of the systemic dose used in cancer therapy. The costs of these agents vary substantially, with Eylea priced at $1,850 per injection, Lucentis at $1,170, and repackaged Avastin at $60. Results of this study, conducted by the Diabetic Retinopathy Clinical Research Network (DRCR.net) and funded by the NIH, found that all three agents are effective at improving vision and reducing DME over 2 years. When vision loss is relatively mild at baseline (20/32-20/40), all three agents are similarly effective at improving visual acuity. However, when vision loss at baseline is worse, Eylea outperforms Avastin at 2-years and also outperforms Lucentis at one year, but the difference between Eylea and Lucentis diminishes and is no longer statistically different at 2 years. The percentage of participants that experienced a systemic adverse events such as heart attack, stroke, or death from an unknown cause was greater with Lucentis (12%) versus Eylea (5%) and Avastin (8%). However, similar findings have not been seen in most previous studies.
01 Mar New Biomarker Stratifies High vs Low Risk Uveal Melanoma
MedicalResearch.com Interview with: [caption id="attachment_22174" align="alignleft" width="130"]
Dr. J. William Harbour[/caption]
J. William Harbour, MD
Professor & Vice Chairman
Dr. Mark J. Daily Endowed Chair
Director, Ocular Oncology Service
Bascom Palmer Eye Institute
Interim Associated Director for Basic Research
Leader, Eye Cancer Site Disease Group
Sylvester Comprehensive Cancer Center
Member Interdisciplinary Stem Cell Institute
University of Miami Miller School of Medicine
Biomedical Research Building, Room 824
Miami FL 33136
Medical Research: What is the background for this study? What are the main findings?
Dr. Harbour: Gene expression profiling has become the predominant means of molecular prognostic testing in uveal melanoma, with primary tumors being divided into Class 1 (low metastatic risk, about two thirds of cases) and Class 2 (high metastatic risk, about one third of cases). In this study, we identified a new biomarker for uveal melanoma that subdivides Class 1 tumors based on the mRNA expression of the oncogene PRAME. Class 1 tumors not expressing PRAME have an extremely low metastatic risk, whereas those expressing PRAME have an intermediate metastatic risk.