Author Interviews, Cost of Health Care, JAMA, Macular Degeneration, Ophthalmology, Telemedicine / 02.04.2017

MedicalResearch.com Interview with: John Wittenborn Senior research scientist NORC's Public Health Analytics University of Chicago MedicalResearch.com: What is the background for this study? What are the main findings? Response:The emergence of anti-VEGF treatment for wet-form AMD (choroidal neovascularization) has had a dramatic impact on preserving vision for many Americans. However, community-based studies show that most patients are not diagnosed with wet-form AMD until they have already lost a significant, and largely unrecoverable amount of their vision.  Early detection of wet-form AMD is key to effective treatment and the preservation of vision. The ForeseeHome telemonitoring technology provides patients with a means to check their own eyes on a daily basis to detect the earliest signs of vision loss from wet-form AMD. This is a novel technology that has the potential to improve visual health outcomes for AMD patients.  A prior clinical trial (the AREDS-2 HOME study) demonstrated that this technology can detect wet-form AMD earlier, and with less vision loss than standard care alone. However, that is exactly where that study ended as it reported no cost information nor follow-up. Since the end of this study, the device has been cleared by the FDA and approved for reimbursement by Medicare for certain higher risk patients, but no study has yet considered the long-term implications of adoption of this technology. In our analysis, we use a computer simulation model to essentially estimate what will come next, after patients realize earlier detection of wet-form AMD by utilizing home monitoring. Basically, we follow simulated patients from the time they begin monitoring for the rest of their lives, recording the likely impacts of home monitoring on patients’ long term outcomes including visual status, costs and quality of life. We find that home telemonitoring among the population indicated for reimbursement by Medicare would cost $35,663 per quality adjusted life year (QALY) gained.  Medicare would expect to incur $1,312 in net budgetary costs over 10 years for each patient who initiates monitoring.  However, Medicare patients may expect to achieve lifetime net savings when accounting for the chance of avoided vision loss and its associated costs later in life.
Author Interviews, NIH, Ophthalmology, Stem Cells / 06.02.2017

MedicalResearch.com Interview with: [caption id="attachment_31736" align="alignleft" width="180"]Ben Mead, BSc, MRes, PhD Section of Retinal Ganglion Cell Biology Laboratory of Retinal Cell and Molecular Biology National Eye Institute, National Institutes of Health Bethesda, Maryland 20892 Dr. Ben Mead[/caption] Ben Mead, BSc, MRes, PhD Section of Retinal Ganglion Cell Biology Laboratory of Retinal Cell and Molecular Biology National Eye Institute, National Institutes of Health Bethesda, Maryland 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Retinal ganglion cells (RGC) in the back of the eye transmit visual information to the brain, via long thread-like extensions called axons, which make up the optic nerve. Loss of these cells is the leading cause of irreversible blindness and can occur through trauma or degenerative diseases, such as glaucoma or optic neuritis. While no treatment yet exists to directly protect RGC from death, mesenchymal stem cells, a type of stem cell isolated from adult bone marrow, have shown therapeutic efficacy in various animal models and are currently undergoing clinical trials. In this study, we aimed to isolate exosomes, which are small, membrane-enclosed vesicles secreted by bone marrow stem cells (BMSC) and that we believe are associated with the therapeutic effect of BMSCs. Injecting these exosomes into the eyes of animals following an optic nerve injury, was associated with significant neuroprotection of RGC, as well as preservation of RGC function. The protective effects of exosomes appeared to be through their delivery of microRNA, molecules that interfere with or silence gene expression.
Aging, Author Interviews, Genetic Research, JAMA, Macular Degeneration, Ophthalmology / 08.12.2016

MedicalResearch.com Interview with: dr-anneke-i-den-hollanderAnneke I. den Hollander, PhD Department of Ophthalmology and Department of Human Genetics Donders Institute for Brain, Cognition, and Behaviour Radboud University Medical Center Nijmegen, the Netherland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age-related macular degeneration is caused by a combination of genetic and environmental factors. Rare genetic variants in the complement system have been described in AMD, but their effect remains largely unexplored. In this study we aimed to determine the effect of rare genetic variants in the complement system on complement levels and activity in serum. MedicalResearch.com: What are the main findings? Response: Carriers of CFI variants showed decreased FI levels, carriers of C9 Pro167Ser had increased C9 levels, while C3 and FH levels were not altered. Carriers of CFH and CFI variants had a reduced ability to degrade C3b, which for CFI was linked to reduced serum FI levels.
Author Interviews, FDA, JAMA, Ophthalmology / 02.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30144" align="alignleft" width="200"]Malvina Eydelman, M.D. Division Director; Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health FDA. Dr. Malvina Eydelman[/caption] Malvina Eydelman, M.D. Division Director; Division of Ophthalmic and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health FDA. MedicalResearch.com: What is the background for this study? Response: In October 2009, the FDA, the National Eye Institute (NEI), and the Department of Defense (DoD) launched the LASIK Quality of Life Collaboration Project (LQOLCP) to help better understand the potential risk of severe problems that can result from LASIK. The project aimed to develop a tool to determine the percent of patients who develop difficulties performing their usual activities following LASIK, and to identify predictors for those patients. At the time we developed our project, there was a limited amount of valid scientific data on certain patient-reported outcomes (PROs) related to LASIK. A PRO is a report of a condition experienced and reported by the patient, not the health care provider. Most LASIK studies used tools, such as questionnaires, to assess visual symptoms, but only after the surgery. The Patient-Reported Outcomes with LASIK (PROWL) studies in the LQOLCP assessed visual symptoms both before and after their LASIK surgery to identify changes over time. The studies also measured the impact symptoms directly had on performing usual activities, which had not previously been done.
Author Interviews, Neurological Disorders, Ophthalmology, Pediatrics / 23.11.2016

MedicalResearch.com Interview with: [caption id="attachment_29930" align="alignleft" width="167"]Marius George Linguraru, DPhil, MA, MB Principal Investigator Associate Professor of Pediatrics and Radiology George Washington University School of Medicine and Health Sciences Children’s National Health System Washington, DC Dr. Marius George Linguraru[/caption] Marius George Linguraru, DPhil, MA, MB Principal Investigator Associate Professor of Pediatrics and Radiology George Washington University School of Medicine and Health Sciences Children’s National Health System Washington, DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Neurofibromatosis type 1 (NF1) is the most common cancer predisposition syndrome affecting the central nervous with an incidence of one in 3,000 births. Nearly one in five children with NF1 develops an optic pathway glioma (OPG), a low-grade tumor of the anterior visual pathway (i.e., optic nerves, chiasm and tracts). These tumors are not amenable to surgical resection and can cause permanent vision loss ranging from a mild decline in visual acuity to complete blindness. Only half of children with NF1-OPGs will experience vision loss, typically between 1 to 6 years of age. The other half will never lose vision or require treatment. All previous studies have consistently demonstrated that the change in NF1-OPG size is not related to the clinical outcome. For example, the optic pathway glioma size may be stable or even decrease, yet the vision will decline. Alternatively, the OPG size may increase, yet the clinical outcome remains stable or even improves. As no imaging or clinical features can identify which children with NF1-OPGs will ultimately lose vision, clinicians struggle to follow these children and decide when to intervene. We used quantitative imaging technology to accurately assess in magnetic resonance imaging (MRI) the total volume of OPGs in NF1. We also determined the retinal nerve fiber layer thickness in these children, a measure of axonal degeneration and an established biomarker of visual impairment. The results were outstanding, as we showed for the first time that the volume of an optic pathway glioma is indeed correlated with the likelihood of vision loss in children with Neurofibromatosis type 1.
Author Interviews, Ophthalmology, Technology / 20.11.2016

MedicalResearch.com Interview with: Dr. Andrew Bastawrous, Ophthalmologist Rolex Awards for Enterprise United Kingdom Dr. Bastawrous’ smartphone-based portable eye examination system, Peek Vision, allows patients in low resource setting, to be screened for vision problems and eye diseases, enabling accurate diagnosis and treatment. MedicalResearch.com: What is the background for Peek Vision? What are the main findings of your work with this system? Response: Mama Paul has been blind for almost 20 years, most of her time is spent within the safety of her tiny home. It is basic, but in her mind’s eye she can still picture where the door is, her son - Paul, lives next door and is always willing to help. Losing sight is the sense most people fear losing most. I am severely visually impaired, I am also fortunate to have perfect vision when wearing corrective glasses or contact lenses and privileged to be in the profession of ophthalmology where centuries of research and practice have brought us to a time when so much of blindness is now curable or preventable. There is no feeling like it: when the eye patch comes off someone who hasn’t seen for years, the sheer wonder as they take in their surroundings and their anticipation to see faces that have become voices and places that have become memories. Back in 2011, as I pondered and planned for the challenges that lay ahead of us in Kenya, I had the continual thought that there must be an easier way to reach people, a way that is less expensive, less resource hungry and therefore could be used on a much wider scale. In Kenya, and much of Africa, more people have access to a mobile phone than they do clean running water. It had to be possible to harness this connectivity.
Author Interviews, JAMA, Ophthalmology, Pediatrics, Technology / 11.11.2016

MedicalResearch.com Interview with: Krista 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? Response: Amblyopia is one of the most common causes of monocular impairment in children, affecting 1 or 2 children in every US classroom. Patching of the fellow eye has been used for decades to improve visual acuity in the amblyopic eye. But patching does not always restore normal vision and does not teach the two eyes to work together. A novel technique originally designed by Drs Robert Hess and Ben Thompson at McGill University that works to reduce interocular suppression by rebalancing the contrast between the eyes has shown promising results in amblyopic adults. Dr Eileen Birch at the Retina Foundation of the Southwest worked with Dr Hess to adapt this contrast re-balancing approach to an iPad game platform suitable for children. Her research showed that the games were successful in improving visual acuity in amblyopic children as well. However, these initial games were rudimentary and resulted in low compliance.
Author Interviews, Ophthalmology, Pediatrics / 14.10.2016

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.
Author Interviews, Ophthalmology, UCLA / 10.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28685" align="alignleft" width="120"]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 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. 
Author Interviews, Cost of Health Care, Ophthalmology, Pharmacology / 06.10.2016

MedicalResearch.com Interview with: [caption id="attachment_28618" align="alignleft" width="166"]Aleksandra Rachitskaya, MD Assistant Professor of Ophthalmology Retina Service, Department of Ophthalmology Cole Eye Institute Cleveland, OH 44195 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.
Author Interviews, Brigham & Women's - Harvard, Infections, JAMA, Ophthalmology / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28049" align="alignleft" width="133"]Dr. Daria Van Tyne, PhD The Gilmore Lab Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts 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.
Author Interviews, Ophthalmology / 13.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27898" align="alignleft" width="142"]Dr. Cecelia Lee 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.
Author Interviews, Ophthalmology, Pharmacology, Technology / 08.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27727" align="alignleft" width="138"]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 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.
Author Interviews, CDC, Ophthalmology / 23.08.2016

MedicalResearch.com Interview with: [caption id="attachment_27239" align="alignleft" width="140"]Dr. Jennifer Cope MD, MPH Medical Epidemiologist CDC 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.
Author Interviews, Ophthalmology, Stroke / 15.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26986" align="alignleft" width="128"]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 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.
Author Interviews, Genetic Research, JAMA, Melanoma / 11.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26912" align="alignleft" width="150"]Ulrich Pfeffer, PhD Laboratory of Molecular Pathology Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino–IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy Dr. Ulrich Pfeffer[/caption] Ulrich Pfeffer, PhD Laboratory of Molecular Pathology Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino–IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The melanoma of the eye or uveal melanoma is well controlled by radiotherapy or surgery but very aggressively growing metastases often develop and therapy has only marginally improved in decades. On the other hand, uveal melanoma is probably the best studied cancer in absolute: we know its development in great detail and we can make very precise prognosis. An important piece of information that is lacking is the effect of a chromosomal alteration, amplification of a part of chromosome 6, that is often encountered in a subset of uveal melanomas that show features of bad prognosis but actually perform better. Many have guessed that the immune system or more generally, inflammation might protect uveal melanomas with this alteration from progression to metastasis. Therefore we have set out to analyze a candidate gene, the putative immunomodulatory BTNL2, that is located on chromosome 6. We found highly variable expression of this gene in uveal melanoma samples where it is expressed by tumor cells and by infiltrating immune cells. The type of infiltrate is strongly associated with the risk to develop metastases. We also analyzed genetic variants of BTNL2 in 209 patients but we could not find a significant association with uveal melanoma risk.
Author Interviews, JAMA, Lifestyle & Health, Ophthalmology / 05.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26717" align="alignleft" width="132"]Paul Dinneen Loprinzi, PhD Health, Exercise Science and Recreation Management University of Mississippi 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.
Author Interviews, Ophthalmology / 30.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25708" align="alignleft" width="160"]Marianne Price, Ph.D. Executive Director Cornea Research Foundation of America Indianapolis, Indiana 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.
Author Interviews, Ophthalmology / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25610" align="alignleft" width="205"]Jeffrey R. Willis, MD, PhD University of California Davis Eye Center Sacramento, CA 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.
Anesthesiology, Author Interviews, Ophthalmology, Surgical Research / 04.06.2016

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.
Author Interviews, Brigham & Women's - Harvard, Ophthalmology, Technology / 17.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24430" align="alignleft" width="200"]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 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.
Author Interviews, Ophthalmology / 13.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24353" align="alignleft" width="133"]Prof. Dr. med. Hans Hoerauf Direktor der Augenklinik Universitätsmedizin Göttingen Göttingen 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.
Artificial Sweeteners, Author Interviews, Brain Injury, JAMA, Neurological Disorders, Ophthalmology / 12.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24260" align="alignleft" width="148"]Dr. T. Dianne Langford PhD Associate Professor, Neuroscience and Neurovirology Lewis Katz School of Medicine Temple University 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.
Author Interviews, JAMA, Ophthalmology / 12.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24306" align="alignleft" width="164"]Dr-Boxer-Wachler.jpg 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.
Author Interviews, Herpes Viruses, Ophthalmology / 13.04.2016

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.
Author Interviews, Ophthalmology, Vitamin C / 25.03.2016

MedicalResearch.com Interview with: [caption id="attachment_22861" align="alignleft" width="151"]Christopher J. Hammond, MD, FRCOphth Departments of Ophthalmology & Twin Research King's College London St. Thomas' Hospital London UK 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.