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Saturday, 22 December 2012

Fear of falling ‘may isolate older adults‘



A study has found that between 40% and 50% of older adults with eye disease limit their activity due to a fear of falling. The researchers warn that this may put these individuals at risk for social isolation and disability. 
Led by Ellen Freeman, from the University of Montreal in Qu├ębec, Canada, the research team recruited 93 patients with AMD, 57 with Fuchs corneal dystrophy, 98 with glaucoma and 97 with normal visual acuity and visual field to examine whether patients with eye disease report limiting their activity due to a fear of falling as compared with a control group of older adults with good vision. 
Overall, 40% to 50% of patient with eye disease reported activity limitation due to a fear of falling compared with only 16% of controls.
The Fuchs group was most likely to report activity limitation due to fear of falling, followed by the glaucoma group and the AMD group.
“Although this compensatory strategy may protect against falls, it may also put people at risk for social isolation and disability,” write the authors in the journal Investigative Ophthalmology and Visual Science.

Glaucoma patients show silent reading difficulties



People with glaucoma have difficulty with out loud and silent reading, a group of American researchers has found. The group says that the greatest impact was observed during sustained silent reading, and suggest that this may be due to reading fatigue.
 
For the study, which is published in the journal Investigative Ophthalmology and Visual Science, the investigators compared the reading speed of glaucoma patients with bilateral visual field loss to that of normally sighted individuals (controls).
 
They found that the out loud reading speed of glaucoma patients was about 6-7% slower than controls, while sustained silent reading speed was 16% slower.
 
Furthermore, glaucoma patients were two times more likely to decrease their reading speed my 0.5 words per minute or more during sustained silent reading than controls. “It appears that persons with glaucoma fatigue during silent reading resulting in slower reading over time,” conclude the researchers.
 

Thursday, 20 December 2012

Study finds fall in cataract care


More than half of NHS trusts are rationing treatments including cataract operations according to the latest report from the National Audit Office - Progress in making NHS efficiency savings (December 13).
It found that 56 per cent of primary care trust clusters reported they had introduced or raised eligibility criteria for at least one common elective procedure. Cataract patients may have to wait until their eyesight deteriorates to a greater degree before having surgery. Cataract procedures carried out in 2011-2012 dropped 1.9 per cent on 2010-2011.
The report found that eligibility was tightened for clinical reasons in most cases, but 11 per cent of clusters reported doing so mainly on financial grounds.


Global study reveals burden of vision loss

Successful treatment of blinding eye conditions has led to a lower prevalence of eye diseases than might be expected given the growth in population worldwide.
The finding is among the results of the largest review ever undertaken into global vision impairment and blindness, led by Professor Rupert Bourne of Anglia Ruskin University's Vision and Eye Research Unit in collaboration with 79 ophthalmologists and optometrists.

The review forms part of the Global Burden of Disease Study, funded by the Bill and Melinda Gates Foundation and published in a special issue of The Lancet(December 13). The study shows that, since 1970, men and women worldwide have gained more than 10 years of life expectancy but now spend more years living with injury and illness.

Visual impairment accounts for 21m years lived with disability (YLD) or 2.7 per cent of the overall global total. The largest cause of YLDs from visual impairment is 'other vision loss', primarily from trauma, occupational and idiopathic conditions. Uncorrected refractive error is second, while cataracts are the third largest contributor.
Professor Bourne said: 'The overall increase in the number of people suffering from blindness and vision loss is due to the huge population explosion that has occurred during the last couple of decades. However, the Global Burden of Disease findings actually show that this increase is not as large as one would expect given the increasing life expectancy in the world's population over this time.
'The age-standardised prevalence, which takes into account the changes in life expectancy, of blindness and visual impairment, decreased globally between 1990-2010. This points to the successful intervention in treating cataracts and other forms of blindness and infectious diseases such as trachoma.'
The work will be used to distribute resources and support VISION 2020: The Right to Sight, the global campaign to eliminate avoidable blindness.
● Access The Lancet issue here: http://www.thelancet.com/themed/global-burden-of-disease

Time of CL replacement 'important'



For patients using continuous wear or extended wear contact lenses, replacing lenses at night has no beneficial effect on ocular events compared with monthly lens replacement, a study has found.
However, morning lens replacement significantly reduced the overall rate of adverse events compared with monthly replacement.
The authors of the study say that contact lens wearers on an extended wear or continuous wear schedule “should be advised to minimise lens handling before sleep to reduce the risk of complications.”
 
A total of 215 individuals were dispensed with silicone hydrogel lenses on a 30-night continuous wear schedule. They were either advised to replace their lenses daily each night before sleeping (n=178 eyes) or each morning after waking (n=252 eyes). Neophytes were required to complete one week of daily wear before commencing continuous wear. A control group (n=191 eyes) was also included in the study. These individuals replaced their lenses monthly.
 
Led by Jerome Ozkan, University of South Wales, Australia, the team observed a significant reduction in adverse events when lenses were replaced each morning compared with being replaced monthly. They found no such effect when they examined those who replaced their lenses each evening.
 
Interestingly, when the researchers assessed the handling-related lens contamination of unworn lenses they isolated the bacterium Staphylococcus aureus from the lenses of 35% of the individuals.
 
“Replacing lenses at night had no beneficial effects perhaps because the benefit of a fresh lens at night might be partially negated by contamination of the contact lens caused by lens handling before eye closure,” suggest the researchers. “Contact lens wearers on an extended wear or continuous wear schedule should be advised to minimise lens handling before sleep to reduce the risk of complications.”

Study shows regular aspirin use may increase AMD risk



Regular aspirin use may increase a person’s risk of developing AMD, according to a study published today (December 19) in the journal JAMA.
The results showed that adults who used aspirin regularly 10 years before the study had a statistically significant increase in the risk of incident late and neovascular AMD.
 
Aspirin is widely used for relief of pain and for cardioprotective effects. However, many ophthalmologists have expressed concern about aspirin use and the risk of AMD. 
 
To investigate further, the researchers examined the association of regular aspirin use with incidence of AMD using data from nearly 5,000 individuals aged between 43 and 86 years. Over a 20-year period, the participants underwent eye examinations every five years. Regular aspirin use was defined as using aspirin at least twice a week for more than three months. 
 
The researchers found that aspirin use five or 10 years prior to the retinal examination was not associated with incident early AMD.
 
However, they found that regular aspirin use 10 years prior to the retinal examination was associated with an increase in risk of incident late and neovascular AMD.

Tuesday, 18 December 2012

Global data on visual impairment published



The results of a systematic review of all published, and several unpublished, sources of global data on vision impairment and blindness, from 1980 to January 2012, were published in a special issue of The Lancet journal this week.The study found that visual impairment accounts for 2.7% of the overall global years lived with disability (YLD).
 
The largest global cause of YLDs from vision impairment is ‘other vision loss’ which makes up 29.5% of the total, primarily from trauma, plus occupational and idiopathic conditions. Second was uncorrected refractive error, which accounts for 26.5% of vision impairment, while cataracts are the third largest contributor at 22.4%. Glaucoma and macular degeneration together explain 10.7%.
 
Professor Rupert Bourne (pictured) of Anglia Ruskin University’s Vision and Eye Research Unit led the research group, which involved collaboration between 79 ophthalmologists and optometrists.
 
“The overall increase in the number of people suffering from blindness and vision loss is due to the huge population explosion that has occurred during the last couple of decades,” he said. “However, the Global Burden of Disease findings actually show that this increase is not as large as one would expect given the increasing life expectancy in the world’s population over this time.
 
“The age-standardised prevalence, which takes into account the changes in life expectancy, of blindness and visual impairment, decreased globally between 1990-2010. This points to the successful intervention in treating cataracts and other forms of blindness and infectious diseases such as trachoma.”
 
The findings form part of the Global Burden of Disease Study 2010 – the largest systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries and health risk factors.
 

Supplementation 'improves macular pigment in early AMD'


Supplementation with lutein and zeaxanthin significantly improves macular pigment in patients with early AMD, according to research published in the journal Ophthalmology.
 
It suggests that supplementation with these carotenoids could halt disease progression, the researchers say.
 
The study involved 108 patients, aged between 50 and 79 years, with early AMD. 
 
Participants were randomly assigned to receive lutein 10mg per day, lutein 20mg per day, lutein 10mg per day plus zeaxanthin 10mg per day, or placebo for 48 weeks.
 
Macular pigment optical density (MPOD) increased significantly in the 20mg lutein group and in the lutein and zeaxanthin group. Furthermore, the changes in MPOD from baseline to 48 weeks correlated negatively with baseline MPOD in all treatment groups. 
 
The researchers conclude that further studies are needed to evaluate the effect of these carotenoids on the incidence of late AMD.

Saturday, 15 December 2012

NGOs tackle age-related sight loss



Three non-government organisations (NGOs) have come together to tackle the burden of age-related sight loss in Europe.
 
AMD Alliance International (AMDAI), World Blind Union (WBU) and the International Agency for the Prevention of Blindness (IAPB) Italy have launched a campaign today (December 13) to ‘disarm a European time bomb of age-related macular degeneration (AMD) sight loss.’ 
 
The organisations will provide tools for healthcare practitioners and local organisations which will help them raise awareness among the general public and plan appropriate interventions.
 
“We all have a role in preventing AMD and other eye diseases,” said Narinder Sharma, CEO of AMDAI. “The toolkit we are launching today at our Regional EU meeting in Rome should, in the first place, help local organisations and healthcare practitioners develop awareness-raising initiatives for older people who are at a higher risk of developing AMD, but also their friends, relatives and carers.” 
 
The initiative comes amidst a wider campaign of the European Forum Against Blindness which is seeking to raise these issues with the European Institutions and governments to reduce the incidence and burden of preventable blindness in Europe.
 
“In 2013 we will launch a Call to Action to EU policy makers as we believe that this problem is neglected at the moment,” said Ms Sharma. 
 
The toolkit can be found at www.amdalliance.org/wbu

Friday, 14 December 2012

Stem cell technique


Researchers from the University of Sheffield have developed a technique to help in the grafting of stem cells onto the eye. It is hoped that the technology will be used to treat damage to the cornea.  

The study authors made a disc of biodegradable material which can be fixed over the cornea, using a combination of techniques known as microstereolithography and electrospinning. The disc is loaded with stem cells which then multiply, allowing the body to heal the eye naturally.
 
The researchers designed the disc so that it contains pockets to house and protect the stem cells. These pockets mirror the niches found around the rim of a healthy cornea and can help cells to group together and act as a useful reservoir of daughter cells so that a healthy population of stem cells can be retained in the eye.
 
“One advantage of our design is that we have made the disc from materials already in use as biodegradable sutures in the eye so we know they won’t cause a problem in the body,” said professor Sheila MacNeil. “This means that we should be able to move to early stage clinical trials fairly quickly.”
 
Dr Frederik Claeyssens added: “We believe that the overall treatment using these discs will not only be better than current treatments, it will be cheaper as well.”
 

Wednesday, 12 December 2012

Rapid eye movements delayed in glaucoma patients


Rapid eye movements are significantly delayed in patients with glaucoma, results of a study published in Eye and Brain show.

 

The findings may shed light on why glaucoma patients are at an increased risk of falls and car accidents.
 
The researchers used head-mounted devices to measure saccadic (rapid) eye movements of individuals with and without glaucoma. They found that people with early, moderate or advanced glaucoma had significantly delayed rapid eye movements compared with individuals without the condition.
 
Lead study author and ophthalmologist, Neeru Gupta, said: “Now that we know that eye movement reaction times are delayed in people with glaucoma there is an opportunity to understand the effects of glaucoma on daily activities of living that most of us take for granted, such as walking up and down stairs, driving, navigating and reading.
 
“Further studies are needed to determine pathological processes implicated in delayed initiation of saccades, and to assess whether alterations of saccades affects daily activities in glaucoma patients.”

General Optical Council agrees to review corporate registration


Satirical newspaper Private Eye has accused Specsavers of using 'unregistered opticians' to test eyes and prescribe glasses.

The accusation was made in the November 16-29 edition of the paper and claimed that over 500 of the multiple's practices were not registered with the General Optical Council.

The article, the second that has attacked Specsavers' corporate registration status (News 28.09.12) also claimed the multiple had run rings around 'useless watchdogs' who had failed to address its regulatory failings.

Reacting to the new allegations, a spokesperson for the multiple said: 'All individual Specsavers' opticians are registered with the GOC and customers can rest assured that their eyes are tested and their glasses prescribed by fully qualified and registered practitioners. Specsavers is the largest employer of registered optometrists and dispensing opticians (around 3,500) in the UK.'

The GOC responded to the story by revealing that it would be conducting an internal review of corporate body registration in March, having already raised the issue with the Law Commission previously.
In its response to the Law Commission, the GOC said its current business regulation framework had limitations which meant significant parts of the business sector were not subject to regulation and described its framework as 'light touch' when compared to other regulators.
It added that it was aware that the current system could also create confusion for business owners, individual registrants and the public.

The GOC's internal review will be formed of independent research, due to take place in January, as well as its own legal advice. The results will be passed on to the Law Commission for consideration.
It has asked registrants from a variety of practice settings and sizes to participate in the research. Travel expenses and a small fee to compensate for time out of practice will be paid.
Those wishing to take part can contact acting communications manager Simon Grier on 0207 307 3478.

Tuesday, 11 December 2012

Vision Care for Homeless People opens Birmingham centre



Lord Mayor of Birmingham John Lines recently opened the city's new Vision Care for Homeless People (VCHP) centre situated within homeless charity SIFA Fireside.


Pictured (above) with the charity's managing director Harinder Paul, Lines witnessed first hand how VCHP provides eye examinations and glasses as a first step for those who need help to reintegrate into society. Charity chair Elaine
Styles said: 'Charity starts at home and we are delighted to bring this new facility to SIFA Fireside. It is particularly relevant at this time of the year when we are all thinking about giving.' Donations to the charity can be made at its website www.visioncareforhomelesspeople.org

People needed for research project


Researchers at Kingston University are calling for people with visual impairments to participate in a new study.


 
The research project, funded by Moorfields Eye Hospital and University College London, aims to determine the distance at which visually impaired people can see the minimum contrast difference between two surfaces.
 
The work is due to start immediately and will be completed in nine months time.
 
The University is looking for people who are able to travel to Moorfields Eye Hospital (near Old Street tube station) in London.
 
If you are interested in the project, contact Alessio Corso () or Hilary Dalke ().

Moorfields establishes new patient support service



Moorfields has launched a new integrated patient support service which aims to assist patients coming to terms with sight threatening diseases, treatment and visual impairment. 
 
The service offers counselling, emotional and psychological support, practical advice and information on services outside the hospital.
 
Charitable funds from a number of organisations have made the new service possible, which includes four eye clinic liaison
officers, two nurse counsellors and a Certificate of Visual Impairment team. 
 
While the new eye clinic liaison post, which will be based in Northwick Park and Ealing hospitals, has been funded by Friends of Moorfields and Action for Blind People, the nurse councillor position is supported by the Marie-Louise Von Motesiczky Foundation. 
 
Moorfields director of nursing an allied health professionals, Tracy Luckett, said: “Moorfields has long recognised the importance of offering psychological, emotional and proactive practical support and advice to patients who often find them having to deal with devastating news about their sight conditions. We have offered a number of services in the past at several of our sites but are now able by integrating all our patient support services under one manager and – with the help of charitable support from a number of organisations – to offer a one stop shop approach for liaison and advice purposes.”

Friday, 7 December 2012

NICE reject intravitreal implant for diabetic macular oedema



The UK National Institute for Health and Clinical Excellence (NICE) has not recommended a fluocinolone acetonide intravitreal implant (Illuvien, Alimera Sciences, Alpharetta, Georgia, USA) for individuals with diabetic macular oedema who do not respond to existing therapies.
The decision was made on cost implications, with NICE's independent Appraisal Committee concluding that the most plausible incremental cost-effectiveness ratio (ICER) for the implant compared with current available treatments was at least £ 47,600 (US$ 76,350; € 58,677) per quality-adjusted life year (QALY).
QALY's take into account disease burden in addition to the quality and quantity of life lived.
Andrew Dillon (NICE, London, UK) said in a press release that the Committee is aware of the "significant impact" that macular oedema can have on those with the condition and their carers.
"However, when NICE recommends any drug or treatment, we have to be sure that it is both clinically and cost effective, because money has to be diverted from elsewhere in the health service to pay for it."
Fluocinolone acetonide intravitreal implant is a corticosteroid with anti-inflammatory and antivascular endothelial growth factor properties, explains the NCIE final appraisal. Only patients with diabetic macular oedema who have not responded to laser photocoagulation or other therapies should receive it.
In addition to the cost implications, NICE also maintains that the manufacturer of the implant has not taken into account the potential negative side effects of the treatment, which include cataract, increased intraocular pressure, floaters, retinal detachment, and glaucoma, and the associated costs of these comorbidities.
The manufacturer provided further evidence to the Committee involving a subgroup of individuals who had already undergone operation for cataract removal, and had been fitted with an intraocular lens. The results indicated further benefits of treatment in this population since a known adverse event was in effect, removed, maintained the company.
However, the most plausible ICER for this group was £ 29,700-50,600 (US$ 47,640-81,160; € 36,611-62,375) per QALY gained, and therefore the technology was not recommended in this population either.
"The Committee concluded that the evidence provided did not show that the benefits fluocinolone intravitreal implant provides to patients justify the price the NHS [National Health Service] is being asked to pay," concluded Dillon.
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Macular Disease Society Renamed


Members of the public are reported to find the word ‘disease’ so off-putting that a national charity has removed it from its name. 

The Macular Disease Society will be known as the Macular Society with immediate affect. The news comes following research which reported that many patients thought the word disease suggested contagion. 
Chief executive of the charity, Helen Jackman commented: “Many members have been telling us for years that they disliked the word ‘disease’. Our research suggested that some people felt it was so negative it may even put them off using our services, or joining us. Members already often left it out when talking about the Society, suggesting that they didn’t even like saying the word.”

New treatment for AMD licensed.

A new injection for the treatment of wet AMD has been licensed for use in the EU. 
 
Eylea, which is also known as Vegf Trap Eye, works in a similar way to current treatment with Lucentis, but its effect is reported to last longer. 


 
Developed by Bayer, the treatment will now be appraised by NICE and, if approved, could be made available on the NHS.
 
Welcoming news of the licensing, chief executive of the Macular Disease Society, Helen Jackman (pictured), said: “We hope that this new treatment for wet AMD will be good news for patients if it means people can keep their vision with fewer injections.” 
 
A recent survey by the charity found that 80% of eye clinics are failing to meet the recommended monthly follow-ups for re-treatment of wet AMD patients with Lucentis. 
 
Ms Jackman added: “Many elderly patients find frequent hospital appointments extremely hard. We also know that eye clinics are struggling to cope with the number of patients needing treatment. This could be putting patients’ sight at risk so a treatment which is needed less often would be welcome.” 
 
Expressing concern that with the number of people affected by AMD set to rise by one third by 2020, Ms Jackson said that even the new treatment may not be enough to relive the pressure in eye clinics. “We urgently need more investment in AMD services if the NHS is to meet demand for these sight saving treatments,” she added.
 


Tuesday, 27 November 2012

Partially sighted 87-year-old jailed for killing pensioner in horror crash after lying about his poor eyesight to keep his driving licence


A partially sighted 87-year-old who lied about his eyesight to keep his driving licence has been jailed after killing a pedestrian in a horror crash.
Peter Cole, of Abridge, Essex, hit Ambrose Skingle, 86, in Theydon Bois while driving his red Fiat.
Following the horrific crash, Cole was seen looking at his mobile phone with glasses and a magnifying glass.
At Chelmsford Crown Court yesterday, Judge Anthony Goldstaub QC jailed Cole for 18 months.


Sent down: Partially sighted pensioner Peter Cole was jailed at Chelmsford Crown Court (pictured) for killing a pedestrian in a crash after he lied about his eyesight to keep his driving licence
Sent down: Partially sighted pensioner Peter Cole was jailed at Chelmsford Crown Court (pictured) for killing a pedestrian in a crash after he lied about his eyesight to keep his driving licence


He told him: 'You were visually handicapped and its clear you should not have been driving but took the risk.'
Mr Skingle suffered a broken back in the accident on January 17 and died at Princess Alexandra Hospital, Harlow, less than a month later.
Prosecutor, Richard Stevens, said that, although it played no part in the crash, Cole also drove with a concrete block in the driver’s footwell to help him control the pedals.

He said: 'Mr Skingle was crossing the road after going shopping in Tesco’s having looked both ways before setting off and before crossing the middle white line.
'Cole was driving at not less than 25mph and he braked before there was a collision at a speed of 8.5mph. His reaction time was 1.5 to 5 seconds. 
'A block of concrete 8-10 inches was in the driver’s footwell - viewed as dangerous - although there is no suggestion it played any part in the accident. 
'Should not have been driving': Judge Anthony Goldstaub (pictured) jailed Cole for 18 months and banned him from driving for six years
'Should not have been driving': Judge Anthony Goldstaub (pictured) jailed Cole for 18 months and banned him from driving for six years

'However, afterwards the defendant could be seen using a magnifying glass to look at his mobile phone very close to his face while wearing glasses.
'A Specsavers official said that in June 2009 he had received ‘strong advice not to drive any more.’ In September the following year he told her he did not drive. He suffered cataracts in both eyes.
'He was found to have applied for a driving licence in 2004, 2007 and 2010 stating he had no relevant medical condition and was able to read number plates. 
'After he was arrested, he was only able to read a number plate from seven and three quarter metres - less than half permitted distance.
'Mr Skingle died from bronchial pneumonia and a fractured spine and was described as "fit and healthy for his age" .When interviewed, Cole said: "I’m like a man in the desert who needs a camel to get from A to B."
Graham Brown, mitigating, said: 'Obviously this fatal accident has brought about the premature death of Mr Skingle who has left a family in grief. One could not fail to be moved by his daughter’s statement.
'Mr Cole is truly remorseful after what he’s done - he said he would have been better not to have survived his heart attack in December 2011. He told his daughter after the accident.'
However, Mr Brown added that if Cole had reacted two tenths of a second earlier the accident would have been avoided.
He said that Cole had declined an operation for cataracts after receiving a 'negative assessment of success' but has since successfully undergone surgery for them after receiving 'different advice'.
Mr Brown added: 'It was the wrong decision to make. He decided if he didn’t use the car he would be isolated.'
Before sentencing yesterday, Cole had pleaded guilty to causing the death by dangerous driving.
The judge, who also banned Cole from driving for six years said that in passing sentence he had born in mind the impact of prison on some-one of Cole’s age.
Judge Goldstaub commented as he passed sentence that both men served in the forces during World War Two - Cole in the RAF and Mr Skingle in the Navy - and both went on to have technical jobs. Both, he said, were 'quiet, decent men with close families'.


Read more: http://www.dailymail.co.uk/news/article-2237186/Partially-sighted-87-year-old-jailed-killing-pensioner-horror-crash-lying-poor-eyesight-driving-licence.html#ixzz2DQkZpGE9
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UK first for new eye treatment trial

A Team of Manchester eye specialists have treated the first two patients in a new trial of radiotherapy for the eye disease wet are-related macular degeneration AMD


Wet AMD affects 250,000 people in the UK alone


The radiotherapy is delivered by a non-invasive robotic device called IRay® Radiotherapy System which uses low-level radiation, similar to a dental x-ray. Patients treated with the IRay device sit at the machine with their chin on a chin rest. A contact lens is placed on the surface of their eye, and a robot tracks any eye movement via the lens and maintains stability. This allows a controlled dose of radiation to be precisely delivered into the eye on the macula.
The team, led by Mr Tariq Aslam, Consultant Ophthalmologist at Manchester Royal Eye Hospital and Honorary Senior Lecturer at The University of Manchester, conducted an initial clinical trial of IRay in 2011. This trial, called INTREPID, combined radiation therapy with the standard AMD treatment of injections into the eye. The number of injections needed within the treatment group was reduced by 32%, compared to people receiving the standard treatment of a monthly injection into the eye. Certain patients achieved an even higher reduction in injections of up to 50%. 
The Manchester team then worked with the developer of IRay, US-based company Oraya Therapeutics, to make the device even easier to use and to further reduce treatment times for patients and clinical staff. They are now running a clinical trial over the next few months with 10 patients using the enhanced IRay workflow alongside injections.
Patients only need one session of IRay treatment, which potentially can reduce or even remove the need for the regular injections. 
AMD affects thousands of people and is the leading cause of blindness in the UK for people over 65 years of age. Wet AMD is an aggressive form of the disease, affecting 250,000 people in this country, and if left untreated can quickly lead to loss of central vision.
“Treatments such as this under clinical trial conditions represent a significant logistical challenge and Iain McLean, our research manager, and Ekaterina Varimezova-Georgieva, our research co-ordinator, were instrumental to achieving the treatments,” said Mr Aslam.
“This novel therapy has to be co-ordinated with the timing of the patients’ standard treatment and the availability of Oraya’s specialist engineers, who come over from the US to provide technical support. Both Manchester patients were delighted to have been given this novel therapy, which showed significant improvements to standard AMD care in earlier randomised studies.”
Mrs Stella Chandler from North Manchester is one of the first two patients treated with IRay in this new trial. She said: “I joined the trial as I was driven by optimism about the potential benefits of the treatment in my own case, and also because this research could help other people. Having regular injections into one or both eyes is a traumatic process, so anything that reduces the frequency of the injections will be a positive result.”
Local funding support helped the trial to take place in Manchester. Debbie Vinsun, Greater Manchester Comprehensive Local Research Network (GM CLRN) senior manager, said: "Congratulations to Tariq and the ophthalmology team at the Royal Eye Hospital. They have used National Institute for Health Research GM CLRN funding to support staff with different skills, such as a photographer, nurses and a co-ordinator, to ensure that patients in Greater Manchester are getting access to treatments which are not only cutting edge but show promising improvements to the current treatments."
Mr Aslam added: "IRay is an exciting new technology that targets one of the most common causes of blindness in the UK. If the initial results are borne out in this further trial, then a majority of patients will have something to look forward to - an easily administered, one-off treatment that maintains or improves vision, and fewer injections into their eye."
Ends

Notes for editors

The INTREPID study is the first sham-controlled double-masked trial to evaluate the effectiveness and safety of a one-time radiation therapy in conjunction with as-needed anti-VEFG injections for the treatment of wet AMD. The results of the study were presented during the EURETINA Congress in Milan in September 2012. 
The National Institute for Health Research is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).
Central Manchester University Hospitals NHS Foundation Trust is a leading provider of specialist healthcare services in Manchester, treating more than a million patients every year. Its eight specialist hospitals (Manchester Royal Infirmary, Saint Mary’s Hospital, Royal Manchester Children’s Hospital, Manchester Royal Eye Hospital, University Dental Hospital of Manchester and Trafford Hospitals) are home to hundreds of world class clinicians and academic staff committed to finding patients the best care and treatments. (www.cmft.nhs.uk)
Oraya Therapeutics, Inc. is a privately-held company developing innovative and non-invasive therapies for diseases of the eye. Founded in 2006, Oraya is funded by Essex Woodlands Health Ventures, Synergy Life Science Partners, Scale Venture Partners and Domain Associates.
The University of Manchester, a member of the Russell Group, is one of the largest and most popular universities in the UK. It has 20 academic schools and hundreds of specialist research groups undertaking pioneering multi-disciplinary teaching and research of worldwide significance. According to the results of the 2008 Research Assessment Exercise, The University of Manchester is one of the country’s major research institutions, rated third in the UK in terms of ‘research power’. The University had an annual income of £809 million in 2010/11. (www.manchester.ac.uk)

The Institute for Bioengineering of Catalonia (IBEC) has renewed an agreement with the pharmaceutical company Ferrer and the universities of Valladolid and the Basque Country to work on the development of a stem–cell based therapy to regenerate the ocular surface.


Over ten million patients suffer from bilateral blindness due to pathologies that cause the cornea to become opaque. The researchers have been working on a method to reconstruct the ocular surface using bone marrow stem cells, which are cultured on a scaffold that reproduces the eye tissue and then implanted in the patient.

The IBEC’s role in the project has been to develop functionalized biomaterials that support and stimulate the growth of the stem cells to allow re-epithelisation of the damaged cornea. The scaffolds can be sutured to the patient’s eye where they serve as a temporary support to deliver the stem cellsto the eye surface so that it can be regenerated. This part of the research is being carried out by the IBEC’s Biomaterials, Biomechanics and Tissue Engineering Research Group, whose founding trustees are the Universitat Polit├Ęcnica de Catalunya · BarcelonaTech (UPC), the University ofBarcelona, and the Government of Catalonia.

After six years of work, led by the University of Valladolid’s Institute for Applied Ophthalmobiology, during the coming four years (the period covered by the new agreement), the researchers are planning to assess the robustness of the testing procedure, which has so far yielded promising results, with the ultimate goal of introducing the therapy into clinical practice.

The new agreement falls within the scope of the Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), with which the research centres participating in the project are associated.

The impact of central corneal thickness on intraocular pressure among Ethiopian glaucoma patients: a cross-sectional study

Raised intraocular pressure (IOP) is the only causal risk factor for glaucoma that can be therapeutically manipulated to change the course of the disease process. Though Goldman applanation tonometry (GAT) is the "gold standard"for IOP measurement, readings of IOP with GAT are affected by central corneal thickness (CCT).

The aim of this study is to determine the impact of CCT on IOP among Ethiopian glaucoma patients. 

Methods: It was a multicenter cross-sectional study and all glaucoma patients visiting their respective eye clinic during the study period were included. A total of 199 randomly selected glaucomatous eyes from 199 patients aged 18 years and above were employed.

The CCT was measured by OcuScan(R) RxP Ophthalmic Ultrasound and IOP was measured with Goldmann applanation tonometer. Linear regression and bivariate correlation analysis were carried out and level of significance was taken at 5%. 

Results: The mean IOP was 19.46(+/-7.05) mmHg and mean CCT was 508.07(+/-33.26) mum.

The mean IOP for primary open angle glaucoma (POAG), ocular hypertension (OHT), normal tension glaucoma (NTG), pseudoexfoliative glaucoma (PXG) and primary chronic angle closure glaucoma (PCAG) patients was 19.22 mmHg, 21.39 mmHg, 14.33 mmHg, 33.25 mmHg and 14.75 mmHg respectively. The mean CCT values were 502.24 mum (POAG), 524.32 mum (OHT), 500.75 mum (NTG), 579.00 mum (PXG) and 530.25 mum (PCAG).

Age of the patient and glaucoma surgery had an influence on corneal thickness. A positive relationship was found between CCT and IOP (p <0.001). 

Conclusions: The mean CCT of Ethiopian glaucoma patients is thin in comparison to other ethnic groups and patients with OHT have thicker corneas than POAG patients.

Hence determination of CCT for each patient is necessary in the up-to-date glaucoma management.

Author: Yeshigeta Gelaw
Credits/Source: BMC Ophthalmology 2012, 12:58