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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

Monday, 26 November 2012

Eye health indicator details revealed



Details of how the first-ever public health indicator for preventable sight loss will be measured were released this week and have been welcomed by the eye sector. 
 
The indicator will be introduced as part of the public health outcomes framework in England next April and will monitor the major causes of preventable sight loss in adults. 
 
Public Health England, the organisation responsible for the framework, will assess how many people are registered as sight impaired or severely impaired who have lost their sight as a result of one of the three major causes of preventable sight loss – glaucoma, AMD and diabetic retinopathy. 
 
Coinciding with the update, a briefing, which explains in more detail how individual stakeholders such as optometrists, ophthalmologists, orthoptists and people within the voluntary sector working with sight loss can raise awareness of the new indicator among key decision-makers, has been released.
 
Welcoming the ‘Preventing avoidable sight loss: a public health priority’ document, which was launched on Tuesday (November 20), Anita Lightstone, programme director for the UK Vision Strategy Programme, said: “This briefing will help everyone involved with eye health to speak with one voice to highlight why this indicator is so important.”
 
Parliamentary under-secretary of state for quality, Lord Howe, commented: “Including the preventable sight loss indicator in the public health outcomes framework will be valuable in helping drive up standards in eye care.
 
“I welcome this briefing and encourage the eye health sector to use it in delivering and promoting the indicator.”
 
Ms Lightstone added: “By working together the eye health sector has ensured that preventable sight loss has been recognised by the Government as a public health priority for the first time. 
 
“This major achievement is one further crucial step on our journey to improving the eye health of the nation. We must continue to work together to ensure health and wellbeing boards, public health professionals, clinical commissioning groups and the new local eye health networks reflect this new indicator in their joint health and wellbeing strategies, their join strategic needs assessments and commissioning and service development plans.

Patient research call



The RNIB is calling for patients with cataracts or wet AMD and their carers to take part in two research projects which aim to identify what needs to be actioned to improve access to sight-saving treatments. 
For the first study, the charity is seeking 100 people with AMD and 100 carers, while the second project requires 100 patients with cataract. 
 
Those interested in taking part in either study must have been diagnosed and treated for either condition within the last three years. It can include both those who are currently being treated and those who have completed treatment. 
 
Clara Eaglen, eye health policy and campaigns manager for the RNIB, said: “The aim of the research is to examine the impact of restrictions on access to treatments and talk to eye health specialists about how services are delivered.
 
“But most importantly, the research will ask patients about the impact that these conditions – and waiting for their treatment – has on their quality of life. We want to hear from people who have good, or bad experience, of NHS treatment and care.”
 
Participants will be interviewed over the telephone by researchers.
 
Reports on each project are expected to be published in spring and will arm the charity with essential information when campaigning for PCTs to change their policies and improve access to treatments for both conditions. 
 
Ms Eaglen added: “As part of the RNIB’s Save our Sight campaign, we are fighting for the rights of people with sight loss and for better access to sight-saving treatments on the NHS. 
 
“The research will help us increase the public profile of the issues in the treatment of these conditions, increase political pressure on PCTs to remove cataract restrictions and improve the treatment outcomes and service delivery for wet AMD patients.”

Friday, 23 November 2012

New dry eye drug shows promising results in clinical trials

PHOENIX – Lifitegrast, a T-cell antagonist, has been shown to significantly improve symptoms, discomfort and ocular dryness in phase 3 clinical trials, according to a presenter here at Academy 2012.


Kelly K. Nichols, OD, PhD, FAAO, reported that lifitegrast 5% (SARcode Bioscience) was tested against placebo in more than 500 patients at nine sites.
According to Nichols, the corneal fluorescein score showed worsening in the placebo group and significant improvement in the trial arm. Symptoms of discomfort and ocular dryness also significantly improved, she said.

“This is a milestone in the development of a dry eye therapeutic that hasn’t been obtained before,” she said. “The discomfort score was significant.”
Nichols said lifitegrast is a new anti-inflammatory under development, “but you have to hold your breath; they need the results from the phase 3 to parallel what they’ve seen in the first phase 3. It’s close, but still not approved.”
Some patients experienced burning and stinging after administration, she said, but noted that the drop irritation occurred after patients were in a challenge chamber.
She explained: “Patients were challenged in a dry room for 90 minutes; they had to show worsening of signs in order to be enrolled.
“Phase 3 will look at whether or not drop instillation irritation is a common occurrence…without the challenge chamber,” she added.
Disclosures: Nichols is a consultant for, receives research support from and has stock options with SARcode Bioscience.

Wednesday, 21 November 2012

Radiation treatment 'could fight disease leading to blindness'



A new study has claimed radiation treatment can successively be used in cases of wet age-related macular degeneration (wet AMD), which leads to blindness in older adults.
Some 21 international centres including King's College London and the Manchester Royal Eye Hospital contributed to the research, which found the radiation therapy could significantly lower patients' need for injections directly into their eyes.
Dr Tim Jackson, an NHS eye surgeon who led the UK arm of the trial, said around half of those who took part in the programme experienced improved vision as a result.
"These are good results, but we would always want a further long-term follow-up to establish the safety and effectiveness of the treatment," he added.
Earlier this month, the results of the HYDRUS I clinical trial showed glaucoma patients could benefit from the development of a tiny draining device for the eye.

600,000 Ghanaians suffer from glaucoma – Nursing Officer


Majority of Ghanaians are suffering from glaucoma without knowing it, Mrs Lydia Attoh, Principal Nursing Officer, Korle-Bu has said.
Available statistics show that currently 600,000 Ghanaians have glaucoma with about 30,000 already blind.
She said people had a negative culture of not going for medical check-ups and rather preferred self medication without the optician’s advice.
Mrs Attoh said this on Saturday at an eye screening organised by the First Premium Lion, a voluntary organisation and a member of the international Lion Club in Accra over the weekend.
Majority of the people screened were said to be affected with glaucoma and other diseases, which can cause blindness. Glaucoma can damage the eyes’ optic nerve and result in blindness.
Mrs Attoh said through early detection and with proper treatment, satisfactory sight could usually be preserved indefinitely.
The Principal Nursing Officer said the eye needed a certain amount of pressure to keep the eyeball in shape so that it could work properly.
“In some people, the damage is caused by raised pressure. Others may have an eye pressure within normal limits but damage occurs because there is a weakness in the optic nerve. In most cases both factors are involved but to a varying extent,” she added.
She said certain tissues within the eye such as the lens were nourished by a fluid called aqueous humour and that if the optic nerve came under too much pressure it could be injured.
Mrs Attoh stated that Glaucoma risk factors included family history of glaucoma, myopia, diabetes and high intraocular pressure.
She said cataract is one of the world’s leading causes of blindness that affects children as well as adults and its treatment was much more difficult in developing countries.
She said many people were needlessly blind from cataract because they don’t know that it could be cured or do not have the money to visit the hospital.
She advised people to refrain from robbing the eye, staying behind computer for a longer period as well as avoid treating the eye not recommended by a doctor.
Mrs Fredrica Odie Benefo, a nurse, debunked a notion that eating of gari causes blindness and advised that people should eat balanced diet.
She commended the Club for the exercise and promised to work with any organisation that wanted to partner with them to embark on a sensitization programme.
Lions Club embarks on programmes that help the vulnerable.
Lion Atawa Akyea, a past President of the Club, said they performed volunteer work for many different community projects – including caring for the environment, feeding the hungry and aiding the disabled.
Lion Akyea said the Club was putting up an eye clinic at Korle-Bu to augment the work of other eye centres.
The exercise formed part of Lions social responsibility towards the development of the nation and also to help address the issue blindness.
Source: GNA

Optegra to introduce end-stage AMD treatment to the UK


Optegra to introduce end-stage AMD treatment to the UK

NOVEMBER 15 2012
Specialist eye hospital group Optegra has signed an agreement which will allow its surgeons to offer the first-ever FDA-approved ophthalmic telescope implant to patients at the end stage of AMD.
Optegra has partnered with American-based ophthalmic specialists VisionCare Ophthalmic Technologies to introduce the treatment option to the UK. 
The implantable miniature telescope uses micro-optical technology to magnify images which would not normally be visible in the central vision of someone with the end stages of AMD.  The images are magnified onto a part of the retina not affected by the disease, allowing patients to see the object. 
The device, which is smaller than a pea, is the only medical option which improves visual acuity by reducing the impact of the central vision blind spot. 
Gareth Steer, managing director of Optegra, said: “We are committed to being at the forefront of medical treatment options, and this latest offering really captures how we have the best surgeons available to offer the best treatments for any eye conditions.”
The treatment will initially be offered at Optegra’s Surrey, Solent and Manchester eye hospitals, and performed by ophthalmic consultants Andy Luff and Brendan Moriarty. 
“While there is no absolute cure for AMD, the symptoms of end stage AMD can be so debilitating we are confident that we can make a real difference to people’s lives by offering this new, highly advanced procedure.”
 

94-year-old man among first to get implant restoring some vision lost to macular degeneration

Don Mason had the miniature telescope placed in his right eye in May. “My vision has improved from nothing to something,” he says. 

Credit: John Murray/University Communications (Medical Xpress)




Ask most people to describe a telescope and they might imagine a large device in an observatory training its penetrating gaze into outer space. Offer Don Mason has one implanted in his right eye. He's among the first patients in the USA  to receive a pea-sized telescope designed to partially restore vision in those with age-related macular degeneration. 


"Macular degeneration damages the retina and causes a blind spot in the center of a person's field of vision," says Dr. Sumit "Sam" Garg, medical director of UC Irvine's Gavin Herbert Eye Institute. "The implantable miniature telescope projects an image onto an undamaged portion of the retina, making it possible for patients to recognize faces, read and perform daily activities." In May, he placed the 4-millimeter device in the 94-year-old Anaheim resident's right eye. "Mr. Mason came to me with years of poor vision due to macular degeneration," Garg says. "He was interested in exploring options to improve his vision and quality of life, and when presented with this option, he was excited at the possibilities." 




Mason had been a builder, traveling around the world as an operations manager based in Hong Kong and Australia before settling his family in Southern California. He worked into his late 80s, when heart trouble and macular degeneration slowed his active lifestyle. The condition had progressed to where Mason retained only peripheral vision in each eye. 

The hourlong surgery involves a small incision in the patient's cornea, removing the eye's natural lens and replacing it with the telescope. The procedure does not require general anaesthesia or an overnight hospital stay. Virtually unnoticeable to others, the telescope is implanted inside the eye and is mostly covered by the iris, the coloured portion of the eye. "I was a bit apprehensive before the operation," Mason says. "But there was no real pain; I would do it again." 


After surgery, he worked with a vision specialist from the Southern California College of Optometry each week to train his eye and brain to integrate the partially restored central vision in his right eye with the peripheral vision in his left eye. A lifelong baseball fan, Mason recalls the Angels' first games in 1961. Now, for the first time in years, he can again read the sports pages and watch games on TV. "Before the operation, I was vaguely aware the TV was on," Mason says. "I feel that this has been a vast improvement." He's also looking forward to finishing his written family history. 


Generally, Garg notes, the vision lost in advanced macular degeneration cannot be recovered. "The implantable telescope gives these patients a new option for treatment and, more importantly, the possibility of regaining useful vision," he says. Garg and UC Irvine colleague Dr. Marjan Farid are the first in Orange County to place the miniature device in the eyes of patients with end-stage age-related macular degeneration, the leading cause of blindness among older Americans.


In December 2011, Farid implanted the telescope in the left eye of an 85-year-old Irvine woman. This summer, she placed it in another patient. UC Irvine's Gavin Herbert Eye Institute is the sole facility in Orange County and among only a few nationwide to offer this new technology. Clinical trials have demonstrated that the implant increases people's independence by improving vision. It also fosters social interaction by making visible the facial expressions of family and friends. "Until now, there has been no mechanism – surgical or medical – to restore that central sight," says Farid, UC Irvine's director of cornea, cataract and refractive surgery. "These patients are now experiencing a quality of life that they've not enjoyed in many years. My original patient is seeing her son's face for the first time in more than a decade." The federal Food & Drug Administration approved the miniature telescope last year for use in patients with irreversible end-stage macular degeneration. At least 15 million Americans are affected by some form of the disease. The implant cost is covered by Medicare. The device is integral to CentraSight, a new patient care program developed by VisionCare Ophthalmic Technologies.




Centrasight is now available in the UK through Optegra http://www.optegra.com

Read more at: http://medicalxpress.com/news/2012-11-year-old-implant-vision-lost-macular.html#jCp

Tuesday, 20 November 2012

Reduced glaucoma risk in patients who take statins



People who take statins to reduce their risk of cardiovascular disease are less likely to be diagnosed with the most common form of glaucoma, according to a nationwide study of more than 300,000 patients. A University of Michigan School of Medicine research team, directed by Joshua Stein, MD, MS, found that the risk for glaucoma was reduced by eight percent in patients who took statins continuously for two years, compared with patients who did not take statins. The study, the largest to date on the topic, is published in the October issue of Ophthalmology, the journal of the American Academy of Ophthalmology.



Dr. Stein's study was sparked by growing evidence that statin use may protect the optic nerve and retinal nerve fibers, structures that are essential to good vision and are damaged by glaucoma. His team used healthcare claims data for a diverse population of Americans aged 60 and older who took statins to control high blood levels of unhealthy fats, a condition known as hyperlipidemia, between 2001 and 2009, The researchers assessed patients' risk for open-angle glaucoma (OAG). Unlike earlier studies, their analysis adjusted for patients who also had diabetes and/or hypertension to prevent distortion of the results.



Several of the study's findings suggest that statin use may be most important before glaucoma is diagnosed, or in the early stages of the disease. Dr. Stein's research may lead to new preventive treatments that could especially benefit groups at increased risk, including African-Americans, Hispanics and those with a family history of glaucoma.


Glaucoma affects more than 2.7 million Americans age 40 and older . If untreated, glaucoma causes vision loss or blindness by damaging the eye's optic nerve. The optic nerve sends signals from the retina — a layer of light-sensitive tissue at the back of the eye — to the brain, where these signals are interpreted as the images we see. Only about half of the people who have glaucoma know it, since symptoms are rarely noticed in the early stages and vision loss is very gradual in most cases.


"Statins' apparent ability to reduce glaucoma risk may be due to several factors, including improved blood flow to the optic nerve and retinal nerve cells and enhanced outflow of the aqueous fluid, which may reduce intraocular pressure," said Dr. Stein. "While more research is needed, we hope our results may contribute to saving the sight of thousands who are predisposed to glaucoma."


Dr. Stein cautioned that the study results apply only to patients with hyperlipidemia, and that further study is needed to determine whether statins also protect patients who don't have this diagnosis or have other characteristics that differ from the study population.

Drinking coffee linked to pseudoexfoliation glaucoma risk


Study findings show that heavy caffeinated coffee consumption is associated with an increased risk of developing pseudoexfoliation glaucoma among people aged 40 years or older.

coffee

Researchers found that men and women who drank three or more cups of coffee per day were at a 66% higher risk of developing pseudoexfoliation glaucoma, or suspected pseudoexfoliation glaucoma than their non-coffee drinking counterparts.

However, no association was found between consumption of other caffeinated products, such as fizzy drinks, tea, chocolate, or decaffeinated coffee, and risk of developing the syndrome.

The findings arise from a meta-analysis of two cohorts: 78,977 women from the Nurses' Health Study (NHS) and 41,202 men from the Health Professionals Follow-up Study (HPFS). All participants were at least 40 years of age, did not have glaucoma, and underwent eye examinations from 1980 (NHS) or 1986 (HPFS) to 2008.

Daily consumption of caffeine-containing drinks was assessed using validated follow-up questionnaires. Using this information, Jae Kang (Channing Laboratory in Boston, Massachusetts, USA) and colleagues examined the association between caffeinated drink consumption and incident cases of pseudoexfoliation glaucoma, or suspected glaucoma.

Writing in the journal Investigative Ophthalmology and Visual Science, the researchers report a positive association between heavier coffee consumption and risk of pseudoexfoliation glaucoma, or glaucoma suspect. The results also showed that women with a family history of glaucoma were at an increased risk.

The researchers didn't find associations with consumption of other caffeinated products, such as soda, tea, chocolate or decaffeinated coffee.


NICE issues draft guidance on treatment for diabetic macular oedema


The National Institute for Clinical Excellence (NICE) has issued draft guidance recommending Lucentis as a treatment option for visual impairment caused by diabetic macular oedema (DMO).


lucentis



It recommends Lucentis as an option for treating DMO among people with central retinal thickness greater than 400 micrometres.

People currently receiving Lucentis whose disease does not meet these criteria should be able to continue therapy until they and their clinician consider it appropriate to stop.

The guidance has been welcomed by the RNIB. Steve Winyard (pictured), head of policy and campaigns at RNIB, said: "We are pleased that NICE has recommended Lucentis for use in treating some patients with DMO as this is something RNIB, along with a number of other charities, has been calling for since last year's initial decision not to make the treatment available.

"This new recommendation by NICE may help to reduce the amount of avoidable sight loss from DMO, which is set to increase as the number of people in the UK diagnosed with diabetes continues to rise."

NICE has issued the guidance after a rapid review of the original guidance, published in November 2011, following submission of a revised patient access scheme by the manufacturer. The manufacturer also included updated analyses showing the drug's superior relative effect among a sub group of people with DMO.


University Of Bern Presents Methods for Multi-Surface Segmentation of OCT Images

Over the past several years and for the foreseeable future, development and implementation of algorithms for processing of OCT images has become a fertile area for researchers at universities and product development engineers at OCT system companies. Such algorithms can dramatically improve OCT images and extract new information, both of which can improve clinical decision making and add tremendous value and differentiation to a product line. Topical areas include removing motion artifacts from 3D data sets, fast processing and rendering of very large data sets, extracting functional information, registration of data sets from longitudinal studies, and more. Recently the University of Bern has published some interesting work on “Graph-Based Multi-Surface Segmentation of OCT Data Using Trained Hard and Soft Constraints” and provided their software for researchers. Below is a summary of their recent work.

Segmentation of Optical Coherence Tomography (OCT) datasets is an important prerequisite for the analysis of the retina. Thickness measurements of the retinal cell layers provide valuable information about the retinal structure. It provides quantitative measurements that can be used for diagnostic purposes, clinical studies and trials, and research into disease progression. As manual segmentation is extremely time-consuming, automatic methods are required.

We recently developed a graph-based method that is capable of segmenting OCT datasets of healthy eyes as well as drusen in datasets of patients with Age-Related Macular Degeneration (AMD). The advantage of graph-based segmentation methods is that the global optimal solution is found. This is coupled with the ability to segment multiple surfaces simultaneously.

The improvement over previous methods is the inclusion of additional soft constraints. On one hand, soft smoothness constraints increase the rigidity of a segmented surface, making it less susceptible to outliers such as vessel shadows and decrease the influence of noise. On the other hand, soft constraints were added in-between neighboring surfaces and act as forces that drive the solution towards a specified model. The parameters of these soft constraints are learned from training datasets and vary depending on the position in the image. In that way, true local information is incorporated into the segmentation algorithm.

Of interest to researchers is that we made our developed application publicly available. It currently supports the segmentation of OCT datasets from Heidelberg Spectralis machines and automatically segments six layers in healthy eyes and eyes of patients with AMD. Manual correction of the automatic segmentation or manual segmentation from scratch is also supported. Measurement capabilities include the standard ETDRS sectors, area and point measurements in B-scans, and average reflectivity measurements of cell layers. For more information see Article. Courtesy Pascal A. Dufour from University of Bern. To share this article click Here.