Author Interviews, CMAJ, Ophthalmology, Pediatrics / 20.07.2020

MedicalResearch.com Interview with: Mayu Nishimura Department of Ophthalmology and Vision Sciences Director of Research Kindergarten Vision Screening Program  MedicalResearch.com: What is the background for this study? child-looking-vision Response: Children's visual problems are difficult to identify without formal tests but most parents do not realize the importance of early eye checks nor are they aware that well-child visits to the family doctor/pediatrician are not enough. We are researchers at McMaster University (Hamilton, ON) and SickKids Hospital (Toronto, ON) who examined if it is possible to implement a vision screening program for kindergartners in diverse Ontario communities. Below are the main findings:
  • We screened nearly 5000 kindergarten children in 15 communities and found that 11% of screened children had a visual problem, with 2/3 of the children being identified for the first time.
  • There was great support for the program from the children, parents, teachers, and optometrists.
  • Screening required 15-20 minutes per child and cost $10/child.
  • When parents received a letter permitting them to opt out of screening, 4% did so. When parents were required to return a signed letter to opt in, 30% did not.
  • Referral rates varied across schools but were higher for children in junior kindergarten (average 53%) than children in senior kindergarten (average 34%).
  • Successful treatment depends on the parents’ awareness of the importance of eye exams and glasses, and access to optometrists and glasses without worrying about costs.
(more…)
Author Interviews, Ophthalmology, Technology / 18.06.2020

MedicalResearch.com Interview with: Prof. FanProf. FAN Zhiyong PhD University of California, Irvine HKUST School of Engineering MedicalResearch.com: What is the background for this study? What are the main findings? Response: According to the report of The World Health Organization, there are over 252 million people suffering from visual impairment globally and 15 million of them are difficult to cure by conventional medical methods. However, today, even the best bionic eyes have only 200 clinical trials, less than 1 ppm of all the patients, mainly due to their poor performance and high cost. The huge gap in supply and demand triggers the study of bionic eyes with performance comparable to human eyes. One important reason for their poor performance is the mismatch in shape between the flat bionic eyes and concave sclera. To protect the soft tissue in eyes from being damaged by the bionic surface, the implanted bionic eyes have to be small. This has limited the sensing area and further the electrodes number, and finally yielded poor image sensing characters with low resolution and narrow field-of-view. In this work, we are trying to achieve high performance image sensing by biomimeticing human eyes. The high-density NWs are well aligned and embedded in a hemispherical template to serve as retina. The conformal attachment of bionic eyes with sclera enables the large sensing area and wide visual angle. In addition, each individual high-density nanowires can potentially work as an individual pixel. By addressing these challenges, our device design has huge potential to improve the image sensing performance of bionic eyes. (more…)
Author Interviews, Endocrinology, NEJM, Thyroid Disease / 23.01.2020

MedicalResearch.com Interview with: Raymond S Douglas MD PhD Professor of Surgery, Division of Ophthalmology Director of the Orbital and Thyroid Eye Disease Program Cedars Sinai Medical Center MedicalResearch.com: What is the background for this study? Response: Thyroid eye disease (TED) is a debilitating disease that affects all aspects of a patients life. It is often associated with Graves' disease and thyroid abnormalities. TED causes profound bulging of the eyes impairing vision, causing eye pain and facial disfigurement. (more…)
Author Interviews, JAMA, Neurology, Ophthalmology, Pain Research / 27.11.2019

MedicalResearch.com Interview with: Priv.-Doz. Dr. med. Christoph Schankin Consultant Head University Headache Clinic Department of Neurology Inselspital, Bern University Hospital University of Bern MedicalResearch.com: What is the background for this study? Response: Visual snow syndrome is a debilitating disorder with a continuous TV snow-like visual disturbance that persists over years. Patients have additional visual problems, such as severe afterimages, floaters or photophobia. The syndrome is associated with migraine and migraine aura, but the interaction between the two remains unclear. (more…)
Accidents & Violence, Author Interviews, JAMA, Ophthalmology, Pediatrics / 03.11.2019

MedicalResearch.com Interview with: Joyce Nanjinga Mbekeani, M.B.B.S. Associate Professor Department of Ophthalmology and Visual Sciences Montefiore Medical Center, Bronx, New York MedicalResearch.com: What is the background for this study? Response: The United States has the highest incidence of gun violence, of all affluent, OECD countries. Thus, firearms are a major public health concern, ranking second among causes of pediatric trauma-related injuries that result in significant morbidity and mortality. However, most scientific reports addressing pediatric firearm-related eye injuries have evaluated non-powder (recreational) firearm injuries. Our study used the large National Trauma Data Bank (NTDB) to study firearm-related eye injuries for all types of firearms from all intentions of injury. The NTDB collects de-identified submissions of trauma admissions from over 900 facilities in the US.  (more…)
Accidents & Violence, Author Interviews, Ophthalmology / 18.10.2019

MedicalResearch.com Interview with: Jonathon Ng MD Clinical Senior Lecturer Faculty of Health and Medical Sciences, Population and Public Health University of Western Australia MedicalResearch.com: What is the background for this study? Response: This study was a part of a programme of research into cataract surgery and motor vehicle accidents spanning a decade. The older population is the fastest growing group of drivers and continuing to drive is an important part of maintaining independence. However, ageing also leads to a variety of conditions, including eye diseases such as cataract which affects vision and driving ability. We conducted this current study to try and better understand driving performance in people having cataract surgery. This was prompted by our earlier work 10 years ago that found decreased motor vehicle accidents after cataract surgery in a study of 28,000 people using linked health and administrative data.  (more…)
Author Interviews, Macular Degeneration, Ophthalmology / 08.08.2019

MedicalResearch.com Interview with: Matthew Campbell, PhD Smurfit Institute of Genetics Trinity College Dublin Dublin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age related macular degeneration (AMD) is the most common form of central retinal blindness in the world. However the underlying causes and initiating factors for disease progression are still not clear. It is classically a disease of the outer retina, where cells called retinal pigment epithelial (RPE) cells degenerate. However, our findings suggest that some of the early initiating events that promote AMD progression are actually coming from the inner retina and more specifically the microvasculature of the inner retina. We discovered that a gene called claudin-5 appears to be regulated by a circadian rhythm that in turn can regulate what gets into and out of the retina on a daily basis. Dysregulating the levels of this component made the inner retinal blood vessels marginally leaky and promoted a pathology that was AMD-like in animal models.  We also showed that the blood vessels of the retina appear to be highly dynamic in human subjects and can appear leakier at different times of the day, likely a mechanism that allows for clearance and replenishment of material into and out of the retina.  It is this process we believe breaks down in early AMD.  (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, JAMA, Ophthalmology / 01.08.2019

MedicalResearch.com Interview with: Daejoon Alex Hwang, PhD Instructor in Ophthalmology Investigator, Schepens Eye Research Institute of Mass. Eye and Ear Harvard Medical School MedicalResearch.com: What is the background for this study?   Response: Yellow night driving glasses are sold with promises to reduce headlight glare from oncoming traffic and help aging individuals see better at night. Despite a 1997 ruling by the Federal Trade Commission against one company’s claims, the products still remain popular online. We tested three commercially available yellow lens night driving glasses and compare their effectiveness with clear lens glasses on our novel headlight glare simulator in the driving simulator. (more…)
Author Interviews, Geriatrics, JAMA, Ophthalmology, University of Michigan / 21.06.2019

MedicalResearch.com Interview with: Joshua R. Ehrlich, MD, MPH Assistant Professor, Ophthalmology and Visual Sciences Kellogg Eye Center Department of Ophthalmology and Visual Sciences University of Michigan  MedicalResearch.com: What is the background for this study?   Response: This study came out of data collected as part of the National Poll on Healthy Aging (NPHA). The NPHA is funded by AARP and the Institute for Healthcare Policy and Innovation at the University of Michigan to inform the public, healthcare providers, and policymakers on a variety issues related to health. The vision survey, conducted in March 2018, was just one of many NPHA surveys. Due to aging of the population, the number of older U.S. adults with blindness and vision impairment is expected to double over the next 30 years. Thus, this study was designed to provide crucial data  on contemporary data on patterns of eye care utilization in older adults. (more…)
Author Interviews, Diabetes, Ophthalmology, Regeneron / 17.05.2019

MedicalResearch.com Interview with: Robert L. Vitti, MD, MBA Vice President and Head, Ophthalmology Regeneron Pharmaceuticals Dr. Vitti discusses the recent announcement that the FDA has approved EYLEA to treat all stages of diabetic retinopathy. MedicalResearch.com: Can you provide additional background on this approval? Would you briefly explain diabetic retinopathy and it's impact on patients? Response: The FDA has approved EYLEA (aflibercept) Injection to treat all stages of diabetic retinopathy (DR). DR is the leading cause of blindness among working-aged American adults. Approximately 8 million people live with DR, a complication of diabetes characterized by damage to the blood vessels in the retina (per 2010 data). The disease generally starts as non-proliferative diabetic retinopathy (NPDR) and often has no warning signs or symptoms. Over time, NPDR often progresses to proliferative diabetic retinopathy (PDR), a stage in which abnormal blood vessels grow on the surface of the retina and into the vitreous cavity, potentially causing severe vision loss. (more…)
Author Interviews / 26.04.2019

MedicalResearch.com Interview with: "IMG_9416" by ianpatterson99 is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Dr. Yi Liu Department of ophthalmology, Beijing Tongren Hospital, Beijing, P.R.China  MedicalResearch.com: What is the background for this study? Response: Though rare, sports-related ocular traumas may result in devastating and disabling consequences. Badminton is popular in Southeast Asia, such as in Malaysia, Philippines, Indonesia, and China. It is in the leading cause list of sport-related ocular injury. Badminton related ocular injuries were also occurred and reported in western countries such as Canada, Australia. The popularity of badminton is partially because it is considered relatively safe, as it does not involve physical contact. The growing popularity of badminton has led to an increased incidence of physical and ocular injuries. Although the latter are uncommon, they can lead to significant ocular morbidity and some patients suffer a permanent decrease in vision, and even blindness. We believe that the awareness of badminton-related ocular injuries is of great importance. The main purpose of this study was to summarize the clinical sports-related features of 85 patients with badminton related ocular injuries and made preventive recommendations to the general population from ocular injuries in badminton playing.  (more…)
Author Interviews, Inflammation, Ophthalmology, PNAS / 25.04.2019

MedicalResearch.com Interview with: Kip Connor, Ph.D. Harvard Medical School Associate Professor of Ophthalmology Department of Ophthalmology Massachusetts Eye and Ear MGH ECOR Ophthalmology Representative Associate Scientist MedicalResearch.com: What is the background for this study? Response: Classically, the retina and the central nervous system (CNS) have long been considered immunoprivileged sites within the body. This is not to say that these sites lack immunity; rather, they are capable of exhibiting a contained yet modifiable form of immunological response. Indeed, an intricate immune surveillance system exists within the retina that can interact with the retinal cellular milieu both during development and in response to injury or disease. While activation of this surveillance system can help protect and repair the delicate neural tissue of the retina in certain disease states, over-activation of this system can exacerbate disease pathology, thereby worsening vision loss. Microglia are the resident immune cells of the central nervous system, including the retina, and are thought to function acutely in the homeostatic maintenance of the neuro-retinal microenvironment.  However in chronic conditions, like autoimmune uveitis, we hypothesized that microglia become neurodegenerative. In our current study we show for the first time a role for microglia in directing the initiation of this autoimmune disease by orchestrating the inflammatory response within the retina through the retinal vessels. (more…)
Author Interviews, Diabetes, JAMA, Primary Care / 01.02.2019

MedicalResearch.com Interview with: Diane M. Gibson, Ph.D. Executive Director – New York Federal Statistical Research Data Center, Baruch RDC Associate Professor – Marxe School of Public and International Affairs, Baruch College - CUNY MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior studies have found that screening for diabetic retinopathy in primary care settings using telemedicine increased screening rates among individuals with diabetes and among subgroups of individuals with diabetes who are at high risk of missing recommended eye exams.  In a previous paper I looked at how often U.S. adults with diabetes visited primary care and eye care providers for recommended diabetes preventive care services using a sample from the 2007-2013 Medical Expenditure Panel Survey.  I found that while visits to eye care providers were often skipped, most adults with diabetes did visit primary care physicians.  I argued that these findings suggest that screening for diabetic retinopathy in primary care settings using telemedicine has the potential to fulfill unmet needs and reach most U.S. adults with diabetes. My brief report in JAMA Ophthalmology examines patterns of eye examination receipt and visits to primary care physicians among U.S. adults with diabetes using a sample from the 2016 National Health Interview Survey.  The report pays particular attention to individuals who are at high-risk of missing recommended eye exams. The study found that 87.7% of the sample of adults with diabetes visited a primary care physician in the past year and that, except for the uninsured subgroup, more than 78% of each high-risk subgroup visited a primary care provider in the past year.  (more…)
Author Interviews, JAMA, Ophthalmology, Pediatrics / 19.11.2018

MedicalResearch.com Interview with: "i have a lazy eye but it's a good thing" by jessica mullen is licensed under CC BY 2.0Eileen E. Birch, PhD Director, Crystal Charity Ball Pediatric Vision Evaluation Center Retina Foundation of the Southwest Adjunct Professor of Ophthalmology UT Southwestern Medical Center   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We previously reported that amblyopia, but not nonamblyopic strabismus or anisometropia, is associated with slower reading speed (Kelly et al  Journal of AAPOS 2015) and that this is related to abnormal eye movements and unstable fixation associated with amblyopia (Kelly et al 2017).  We have also shown that amblyopic children are slower at completing Scantron answer sheets (JAMA Ophthalmology 2018).  We thought that these difficulties experiences in school-age children with amblyopia might affect their self-perception. (more…)
Author Interviews, Health Care Systems, Ophthalmology / 07.11.2018

MedicalResearch.com Interview with: Nathan Radcliffe, MD Senior Faculty, Ophthalmology Glaucoma and Cataract surgeon Mount Sinai Health System MedicalResearch.com: What is the background for this study? Response: Glaucoma is a leading cause of blindness and the mainstay of therapy is to lower the intraocular pressure (IOP) with topical eye drops. Up to 40% of patients may require more than one eye drop to control the disease, and yet taking more than one eye drop bottle can result in higher costs, more eye irritation, worse therapeutic compliance, and possibly worse outcomes, be sure to consult your eye surgeon before increasing any eye treatment to ensure it won't do any further damage to the eye. Compounded therapies (not FDA approved, but made at the physician’s request by a compounding pharmacy) can be created to contain multiple glaucoma therapies in one bottle. We sought to determine if a compounded solution containing three or four drops in one bottle could control glaucoma as well as three or four separate bottles (standard of care) in patients requiring three or four eye drop bottles to control glaucoma. We performed a multi-center, randomized, observer-masked, parallel-group study comparing a compounded therapy containing latanoprost 0.05%, dorzolamide hydrochloride 2%, timolol maleate 0.5%, brimonidine tartrate 0.2% with 0.01% BAK to standard three or four bottle regaimins. We measured IOP and corneal staining (a sign of preservative toxicity), as well as other safety measures at week one, month one, two and three. (more…)
Author Interviews, Columbia, Environmental Risks, Genetic Research, Ophthalmology, PLoS / 09.10.2018

MedicalResearch.com Interview with: Andrei V. Tkatchenko, M.D., Ph.D. Associate Professor Columbia University Medical Center Edward S. Harkness Eye Institute New York, NY 10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clear distance vision is rapidly becoming a rare privilege around the world, especially in Asia, due to increasing prevalence of myopia. Although much effort has been directed towards elucidating the mechanisms underlying refractive eye development and myopia, treatment options for myopia are mostly limited to optical correction, which does not prevent progression of myopia or pathological blinding complications often associated with the disease. During early childhood development, the axial length of the eye normally grows to match its optical power in a process called emmetropization, producing focused images on the retina. However, very often environmental and genetic factors lead to a mismatch between the optical power of the eye and its axial length resulting in the development of myopia if eyes grow too long for their optical power. Experimental studies in many animal species suggest that emmetropization is regulated by optical defocus. The eye can compensate for imposed negative and positive optical defocus by increasing or decreasing its growth rate, respectively. However, the molecular mechanisms underlying emmetropization are poorly understood which prevents development of anti-myopia drugs. (more…)
Author Interviews, JAMA, Ophthalmology, Toxin Research / 14.09.2018

MedicalResearch.com Interview with: “Vision” by Victoria Ford is licensed under CC BY 2.0Adam J. Paulsen MS Associate Researcher EpiSense Research Program Department of Ophthalmology&  Visual Sciences University of Wisconsin - Madison MedicalResearch.com: What is the background for this study? Response: Contrast Sensitivity is a measure of visual function that indicates how well a person is able to distinguish an object against its background.  Tests of CS determine how faint a visual signal can be identified.  CS can be diminished even in those with appropriately corrected visual acuity, has been shown to have effects on daily activities (including near vision tasks), risk of falls, and driving ability.  The causes of and risks for CS impairment are understudied.  Cadmium (Cd) and Lead (Pb) are known neurotoxins that have been shown to accumulate in the retina.  Both Cd and Pb have common sources of exposure in the general population.  Our studied aimed to investigate risk factors for incident CS impairment, including Cd and Pb exposure. (more…)
Author Interviews, JAMA, Ophthalmology, Primary Care, University of Michigan / 11.09.2018

MedicalResearch.com Interview with: Joshua Ehrlich, MD, MPH Assistant Professor of Ophthalmology and Visual Sciences University of Michigan  MedicalResearch.com: --Describe the “important role” that primary care providers play in promoting eye health? Response: Primary care is the entryway into the health system for many individuals. The poll suggests that when primary care providers discuss vision with their patients, they are more likely to get eye exams. It also suggests that primary care providers are having these conversations most often with those who have certain risk factors for eye disease, such as diabetes or a family history of vision problems, as well as those with fewer economic resources. Promoting these kinds of conversations could bolster this trend, increasing the number of diabetics and other high risk individuals who get appropriate eye care. (more…)
Author Interviews, Compliance, JAMA, Macular Degeneration, Ophthalmology / 25.08.2018

MedicalResearch.com Interview with: Jason Hsu, MD Retina Service, Wills Eye Hospital Associate Professor of Ophthalmology Thomas Jefferson University Mid Atlantic Retina Anthony Obeid MD MPH School of Public Health The University of Sydney · MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Neovascular age-related macular degeneration (nAMD) is a vision-threatening disease that often afflicts elderly patients. The introduction of intravitreal anti-vascular endothelial growth factor treatment drastically improved the prognosis of eyes with nAMD. Despite its efficacy, patients require consistent follow-up (sometimes as often as monthly), with ongoing injections to maintain the visual benefits of the drug. Unfortunately, few studies have reported the number of patients that do not follow-up with recommended guidelines. Moreover, there remains limited evidence on the risk factors associated with loss to follow-up. Our study, consisting of 9007 patients with a history of nAMD receiving treatment between 2012 and 2016, evaluated both these parameters. We defined loss to follow-up as having at least one injection without a subsequent follow-up visit within 12 months post-treatment. Using this definition, we found that over 20% of patients are lost to follow-up over the entire study period. We further identified key risk factors associated with loss to follow-up, which included patients of older age, race, patients residing in a region of a lower average adjusted gross income, patients living at greater distances from clinic, patients with active nAMD in only one eye, and patients with worse visual acuity. (more…)
Author Interviews, Education, JAMA, Ophthalmology, Pediatrics / 20.07.2018

MedicalResearch.com Interview with: Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Developmental dyslexia is a specific learning disability of neurobiological origin whose core cognitive deficit is widely believed to involve language (phonological) processing. Although reading is also a visual task, the potential role of vision has been controversial, and experts have historically dismissed claims that visual processing might contribute meaningfully to the deficits seen in developmental dyslexia. Nevertheless, behavioral optometrists have for decades offered vision therapy on the premise that correcting peripheral visual deficits will facilitate reading. Yet there is a surprising dearth of controlled studies documenting that such deficits are more common in children with developmental dyslexia, much less whether treating them could improve reading. In the present study, we simply assessed the prevalence and nature of visual deficits in 29 school aged children with developmental dyslexia compared to 33 typically developing readers. We found that deficits in accommodation 6 times more frequent in the children with developmental dyslexia and deficits in ocular motor tracking were 4 times more frequent. In all, more than three-quarters of the children with developmental dyslexia had a deficit in one or more domain of visual function domain compared to only one third of the typically reading group. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Neurology / 25.06.2018

MedicalResearch.com Interview with: Paul Foster BMedSci(Hons) BMBS PhD FRCS(Ed) FRCOphth FRCS(Eng) Professor of Glaucoma Studies & Ophthalmic Epidemiology Research Theme Lead Integrative Epidemiology & Visual Function UCL Institute of Ophthalmology & Moorfields Eye Hospital London  MedicalResearch.com: What is the background for this study?  Response:  Dementia is the medical challenge of the moment – increasingly common, adversely impacting quality of life for millions, and a great worry for all. Efforts to identify treatments or interventions rely on being able to identify those people at greatest risk. Our motivation was to help identify those people, primarily to aid in the development of treatments through clinical trials. (more…)
Author Interviews, Ophthalmology, Pediatrics / 14.06.2018

MedicalResearch.com Interview with: multiple choice test takingKrista Kelly, PhD Postdoctoral Fellow Crystal Charity Ball Pediatric Vision Evaluation Center Retina Foundation of the Southwest Dallas, TX 75231 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in seeing whether the fine motor deficits typically seen in amblyopia (lazy eye) and strabismus (crossed eyes) translate to an academic setting. Namely, transferring answers to a multiple choice answer form widely used in standardized testing in schools. Children with amblyopia and strabismus took about 28% longer than their peers transferring answers to a multiple choice answer form, even though they have good vision in one or both eyes.  (more…)
Author Interviews, Ophthalmology, Stem Cells, Stroke / 28.03.2018

MedicalResearch.com Interview with: Steven Levy MD CEO, MD Stem Cells Study Director, Stem Cell Treatment Studies MedicalResearch.com: What is the background for this study? Response: MD Stem Cells is the sponsor of the Stem Cell Ophthalmology Treatment Study II (SCOTS 2) the largest stem cell study currently addressing retinal and optic nerve disease (NCT 03011541). SCOTS uses autologous bone marrow derived stem cells (BMSC) typically provided to the eyes by combining retrobulbar, subtenons and intravenous injections. Many retinal and optic nerve diseases are eligible including Retinitis Pigmentosa (RP), Age Related Macular Degeneration (AMD), Stargardts, Ushers, Glaucoma, Ischemic Optic Neuropathy, Optic Atrophy and others. Statistically significant improvements have been documented in key diseases and positive responses have been noted across most conditions treated. Mechanisms of action may include differentiation of the CD34 cells into neurons, secretion of neurotrophic factors, transfer of mitochondria and release of mRNA. These may benefit existing stressed cells as well as provide replacement of damaged or absent cells. (more…)
Author Interviews, Ophthalmology, Technology / 28.03.2018

MedicalResearch.com Interview with: Dr. Caroline A. Blackie, OD PhD FAAO Medical Director, Dry Eye Johnson & Johnson Vision MedicalResearch.com: What is the background for these studies? Would you briefly explain the problem of dry eye, how common it is and why it is difficult to treat?  Response: Dry eye disease is a condition where the eyelids and/or the tear film are unable to protect the ocular surface from the negative effects of desiccating stress. If left untreated, a vicious cycle ensues resulting in a broad spectrum of sequelae, including ocular discomfort and compromised vision. The result is partial or pervasive reduced quality of life for the individual along with a significant economic burden on our society. Conversely, when the ocular surface is healthy, patients feel better, see better and live better. Meibomian gland health is essential for ocular surface health. Meibomian glands secrete the oils necessary to protect the ocular surface from the negative effects of desiccating stress. Predictably, meibomian gland dysfunction (MGD) is a leading cause of dry eye disease. MGD is almost always the result of thickened and stagnated gland secretions. These stagnated secretions obstruct and/or limit the flow of functional oil into the tear film. MGD is the most common form of dry eye disease and is also known as evaporative dry eye. While management of dry eye in general can be complex, the management of MGD affords a relatively straightforward approach, which is to improve meibomian gland function by treating obstruction. Dry eye disease is pretty common – more than 340 million people suffer from it globally. Short-term management of dry eye involves improving signs and symptoms of the condition, including the use of tear supplementation and reducing ocular surface inflammation. Long-term dry eye management requires that the cause (or causes) of the condition is also diagnosed and treated. That cause is often MGD, and MGD can be successfully managed with LipiFlow®.  (more…)
Author Interviews, JAMA, Ophthalmology, University of Michigan / 16.03.2018

MedicalResearch.com Interview with: Maria A. Woodward, MD, MSc Department of Ophthalmology and Visual Sciences W. K. Kellogg Eye Center Institute for Healthcare Policy and Innovation University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Many people go to emergency departments seeking care for their eye problems. We wished to investigate which factors are associated with the involvement of ophthalmologist consultants in the care of these patients and whether any disparities exist.  (more…)
Author Interviews, Multiple Sclerosis, Ophthalmology, Pharmaceutical Companies / 08.03.2018

MedicalResearch.com Interview with: Sarah A. Morrow MD, MS, FRCPC Associate Professor of Neurology Department of Clinical Neurological Sciences University of Western Ontario (Western) MedicalResearch.com: What is the background for this study? Response: Acute demyelinating optic neuritis, which presents with loss of vision and painful eye movements, is common in multiple sclerosis (MS) occurring 50% of persons with MS. High dose (≥ 1g) corticosteroids administered through an IV became the standard of practice after the landmark Optic Neuritis Treatment Trial as IV administration. However, in that study the IV dose of corticosteroids was much higher (1 gram daily) than the oral dose (1 mg/kg). Thus, it is not clear if IV administration is still better if equivalent doses are used orally. Oral administration is much more convenient for patients and less expensive, and previous studies showed that it is preferred by patients. In this study, we asked the following question: are high dose (≥ 1000mg) IV corticosteroids superior to equivalent doses of oral corticosteroids for the acute treatment of optic neuritis? We randomly assigned fifty-five cases of acute optic neuritis to 1000mg IV methylprednisolone or 1250mg oral prednisone daily for three days and compared recovery of their vision over the next 6 months.  (more…)
Author Interviews, Emory, Genetic Research, JAMA, Ophthalmology / 24.01.2018

MedicalResearch.com Interview with: Eldon E. Geisert, PhD Professor of Ophthalmology Emory School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the late 1990s a group of doctors began a study of glaucoma patients to determine if there were phenotypes that are predictive for developing glaucoma. In this Ocular Hypertension Treatment Study (OHTS) one of the highly correlated ocular traits was central corneal thickness (CCT). The early clinical studies found that people with thinner corneas were at a higher risk of developing glaucoma. In two large studies, examining thousands of people a number of genes were identified that were risk factors for glaucoma or that controlled CCT in humans. In both cases the identified genes accounted for less than 10% of the genetic risk for glaucoma and less than for 10% of the genetic control for CCT. There was little data linking the genetic control of CCT to the glaucoma risk. Our group has taken an indirect approach to the question, using well-defined mouse genetic system to identify genes modulating CCT and then interrogating human glaucoma data to determine if these genes are associated with glaucoma risk.   (more…)
Author Interviews, Cost of Health Care, JAMA, Ophthalmology, Surgical Research, UCSF / 23.01.2018

MedicalResearch.com Interview with: Catherine L. Chen, MD, MPH Assistant Professor UCSF Department of Anesthesia & Perioperative Care MedicalResearch.com: What is the background for this study? What are the main findings? Response: Routine preoperative medical testing (such as common laboratory tests looking at a patient's blood cell counts and kidney function, or cardiac tests like an EKG) are not recommended in patients undergoing cataract surgery, but these tests still occur quite frequently among Medicare cataract surgery patients because these patients tend to be older and sicker than the general population. In the past, researchers have used a 30-day window counting backwards from the date of surgery to determine whether a given test should be categorized as a routine preoperative test. However, we know that testing often takes place outside this window and therefore, the frequency and cost of routine preoperative medical testing has generally been underreported. In our study, we used a new method to figure out how to determine the start of the routine preoperative testing period. In cataract patients, ocular biometry is a diagnostic test that is performed in anticipation of cataract surgery, and this test is only performed in cataract patients who will be having cataract surgery in the near future. For each patient, we calculated the elapsed time between the ocular biometry and cataract surgery dates to get a better idea of when to start looking for unnecessary routine preoperative testing. Our goal was to identify all the routine preoperative medical testing that occurs once the decision has been made to operate and better estimate the cost to Medicare of this unnecessary testing. In a previous study that we published in the New England Journal of Medicine, we reported a significant spike in the rate of routine preoperative medical testing that occurs in the 30 days before surgery compared to the baseline rate of testing. In our current study, we discovered that there is a second spike in testing that occurs in the 30 days after ocular biometry. In fact, even if you exclude the testing that takes place during the 30 days before surgery, there is still a 41% increase in testing rates during the interval between ocular biometry and cataract surgery over the baseline rate of testing. In addition, we found that the cost of routine preoperative testing was 47% higher when looking at the entire biometry to surgery timeframe compared to testing that occurs just in the 30 days before surgery. We estimate that the cost to Medicare of all of this unnecessary testing approaches $45.4 million annually. (more…)