Theratears Nutrition - Pflugfelder confirms Omega 3 beneficial in Dry Eye patients

According to a study published in the journal Cornea, daily supplementation with a combination of omega-3 fatty acids for six months improves ocular irritation symptoms and halts the progression of inflammation characteristic of moderate-to-severe dry eye,.

Stephen Pflugfelder, professor of ophthalmology and James and Margaret Elkins chair at Baylor College of Medicine in Houston, Texas and his team evaluated the effect of a supplement containing both gamma-linolenic acid (GLA) and omega-3 polyunsaturated fatty acids on postmenopausal patients with tear dysfunction. This research study reinforces the findings of earlier works by people such as Gilbard et al whose studies showed that an optimised mix of fish and flax oil, Theratears Nutrition, both improved meibomian secretions and reduced inflammation in Dry Eye.

A total of 38 patients were included in the study and randomly assigned to receive the supplement or a placebo for six months. Disease parameters including Ocular Surface Disease Index, Schirmer test, tear breakup time, conjunctival fluorescein and lissamine green staining and topographic corneal smoothness indexes were assessed after four, 12 and 24 weeks and compared to the start of the study.

The researchers found that the Ocular Surface Disease Index score significantly improved with supplementation and was significantly lower than the placebo after six months. The surface asymmetry index was also significantly lower in supplement-treated patients than those receiving the placebo. Supplementation was also found to suppress ocular surface inflammation.

“Prior to this study, clinical evidence showing that nutritional supplements were beneficial in treating dry eye was scarce,” said Mr Pflugfelder. “Within three months, the group treated with theOmega 3 supplement showed statistically significant improvements in irritation symptoms of dry eye, and no progression of ocular surface inflammation or corneal irregularity. The placebo group’s dry eye symptoms actually worsened over the six-month testing period.”

He added: “While the trial studied post-menopausal women, the largest group of dry eye sufferers, we think the benefits of Omega 3 supplementation should apply to other populations suffering from dry eye since inflammation is believed to be a common thread in dry eye.”

Oraya therapy reduces need for anti-VEGF injections in wet AMD

Results of Oraya Threaperutics’ INTREPID study show that a single does of Oraya Therapy significantly reduces the need for anti-VEGF injections for patients with wet AMD.

 

The study, which was published online in the journal Opthalmology this month (April 18), enrolled a total of 230 patients from 21 sites across five European countries. The investigators evaluated the effectiveness and safety of Oraya Therapy – a one-time radiation therapy – in conjunction with as-needed anti-VEGF injections.

 

The researchers reported that patients who had previously been treated with anti-VEGF for up to three years experienced a 32% reduction of injections and substantially drier retinas with Oraya Therapy compared with the control group. Moreover 25% of Oraya Therapy patients needed no further injections. 

 

Among the best responders to Oraya therapy, there was a 52% decrease in injections. 

 

“The results of the INTREPID study reported to date are encouraging for clinicians and individuals with wet AMD,” said lead investigator, Timothy Jackson, from King’s College Hospital in London. “The prospect of maintaining vision while needing fewer eye injections will appeal to any patient receiving anti-VEGF therapy, and for certain subsets in the trial there is the added advantage of an improved visual outcome.”

 

Oraya Therapeutics CEO, Jim Taylor, added: “It is rare for a new therapy to demonstrate improved patient outcomes while simultaneously offering the potential to significantly reduce treatment burden and costs.”

 

Oraya Therapy involves a low-voltage X-ray source along with advanced robotics, laser-guided positioning system and a patented methodology for eye stabilization and tracking. 

 

The procedure can be delivered in an outpatient setting, averages about 20 minutes and requires no post-treatment recovery period before resuming normal activity.

New DME drug released in the UK

A drug developed to treat chronic diabetic macular edema (DME) was made available in the UK on Monday (April 29). Announced by biopharmaceutical company Alimera Sciences, Iluvien is the first sustained release pharmaceutical product to be designed for the treatment of the sight-threatening condition. 

 

Iluvien is administered as an implant and works for up to 36 months. Injected into the patient’s eye, it delivers sustained sub-microgram levels of fluocinolone acetonide (FAc).

 

Alimera Sciences has submitted a Patient Access Scheme (PAS) to the National Institute for Health and Care Excellence (NICE), with its Appraisal Committee expected to meet on May 15 to discuss the submission. A 30-day review period is likely to follow.

 

If accepted, Iluvien would be funded for NHS use with chronic DME patients in England and Wales.

 

Dan Myers, president and chief executive officer at Alimera Sciences, said: "We are pleased that Iluvien is now available in the UK. We continue to work with NICE and are hopeful that our simple PAS will make Iluvien available to a larger group of chronic DME patients in England and Wales, who are considered insufficiently responsive to available therapies."

CL giant raises awareness of vision-related allergy issues

An estimated one in three people in the UK experience seasonal allergies in their lifetime, according to research carried out by allergyuk.org. With allergy season upon us, contact lens giant Johnson & Johnson has produced a new educational leaflet which aims to support contact lens wearers who suffer from eye allergies. 

 

There are four million contact lens wearers across the UK. Research has found that those who experience eye allergies have a higher incidence of contact lens discomfort, while symptoms can be so troublesome that it interferes with sports activities, leisure time, school performance and workplace productivity. 

 

J&J has launched the patient leaflet to coincide with Allergy Awareness Week, which takes place from April 22-28. It contains information on reducing the chance of developing problems that could affect a person’s vision and the health of their eyes, as well as how to relieve allergy symptoms such as swelling and discomfort. 

 

Director of professional affairs at J&J, Marcella McParland, said: “The good news is that there are steps practitioners can take to start new contact lens patients off with a happy first-lens experience while also minimising the number of allergy-related contact lens dropouts from current contact lens wearers in your practice.”

 

She added: “Putting in a clean, fresh lens every day minimises the potential for accumulation of allergens and irritants that can often build up with repeated use of the same pair of lenses.”

 

The guide can be accessed at www.acuvue.co.uk/allergy-guide 

Lucentis demand warning

A group of eye care charities and professional bodies have joined forces to warn that people will lose sight needlessly unless the new-look NHS prioritises eye care. 

 

As part of Vision 2020 UK, the Macular Interest Group has written to senior officers in Clinical Commissioning Groups (CCGs) across England to highlight the rise in demand for the drug Lucentis, which is used to treat a number of retinal diseases, including macular oedema.

 

Until recently the sight saving drug was solely approved on the NHS to treat wet AMD. However, in the past few months, the National Institute for Health and Care Excellence (NICE) has approved it for patients with macular oedema as a result of diabetic retinopathy. On April 11 it also approved Lucentis for those with macular oedema caused by retinal vein occlusion. 

 

It’s estimated that these subsequent approvals will increase demand for Lucentis by at least 50%, with this rising to 70% to 80% in some areas. 

 

NICE is also evaluating the use of a new drug called Eylea, which has been developed as an injection into the eye to treat the same range of diseases. 

 

When NHS changes came into effect on April 1, the Government also made preventable sight loss a public health indicator. 

 

While welcoming new access to care, the Macular Interest Group expresses fears that ‘unless CCGs commission enough services from hospital trusts, they will not be able to meet demand and patients will lose their sight unnecessarily.’ 

 

Urging CCGs to review their plans for intravitreal injection services to ensure they purchase enough supplies for their areas, the letter read: “Failure to commission or deliver the appropriate level of care will mean that people will lose their sight and place additional burden on other health and social care services.”

 

Chairman of the Macular Interest Group, Winfried Amoaku, said: “It is essential the CCGs invest in intravitreal injection services. We understand how stretched the NHS is but giving Lucentis less often than required is a waste of money and causes unnecessary sight loss.”

 

Recommendations from the Royal College of Ophthalmologists state that patients with wet AMD should wait no longer than two weeks for their first treatment, and be monitored every four weeks to determine if further treatment is required. However, research carried out by the Macular Society on behalf of Vision 2020 UK in 2012 reported that less than 50% of eye clinics were able to meet the waiting times recommended for the first treatment, while 80% failed to meet the four weekly follow ups advised.

 

Chief executive of the Macular Society, Helen Jackman, added: “Eye clinics around the country are under enormous pressure. Sight loss is devastating and all the more so when it is preventable. The Government has made preventable sight loss a priority and we ask CCGs to do the same.”

Playing Tetris could help lazy eye

Playing the popular video game Tetris has been found to be an effective way of treating lazy eye, Canadian researchers have reported. 

 

The study, performed by a team of scientists at McGill University, Montreal, discovered that the puzzle game was able to train both eyes to work together. 

 

Consisting of 18 adults, the study found that using Tetris was more effective at treating the condition than the conventional patching method, which sees the good eye covered to make the weak eye work harder. 

 

Published in Current Biology, researchers will trial the treatment on children across North America later this year. 

 

Exploring whether an alternative approach to patching would work, Dr Robert Hess and colleagues used a special pair of video goggles in the study which ensured that both eyes would work together. Nine amblyopic volunteers wore the goggles for an hour a day over the two-week period when playing Tetris. 

 

The head-mounted goggles worked by allowing just one eye to see the falling object, and the other the blocks accumulating on the ground. 

 

As a comparison, a second group of nine volunteers with amblyopia wore similar goggles, but with their good eye covered, they watched the game through their lazy eye only. 

 

At the end of the study, researchers found that those who used both eyes showed more vision improvement than the patched group. They also showed improvement in 3D depth perception.  

 

The comparison ‘patched’ group then played the game with both eyes uncovered, showing ‘dramatically’ improved vision as a result. 

 

Dr Hess believes that the treatment could be a suitable alternative to patching those with lazy eye, especially for adults whom patching tends not to be beneficial.

TV company seeks visually impaired mums-to-be

Award-winning TV documentary company Twenty Twenty is looking for first time mums-to-be with a visual impairment to take part in the filming of a documentary about pregnancy and parenting.

 

The series will follow a diverse range of parents-to-be who may have some additional needs or face challenges when having their first child.

 

The company is seeking women who are expecting their first child between June and October 2013. In addition to visually impaired expectant mothers, they also want to hear from pregnant women with mobility issues, a physical disability or restricted growth. 

 

Harriet Matthews, assistant producer for Twenty Twenty, told OT: “We want the series to challenge misconceptions and celebrate triumphs and capabilities, as well as reflecting the day to day realities of parenting.

 

“At this stage we’d just like to have informal chats with women who are currently pregnant with their first child. We can tell them more about Twenty Twenty and the series and what it would entail if they were to get involved in the series. All calls are informal with absolutely no obligation to take part.”

 

For more information contact Dominique on 0207 424 7701 or dominique@twentytwenty.tv

 

Liver transplant link to AMD discovered

People who have undergone a liver transplant are at increased risk of developing age-related macular degeneration (AMD), according to new research released on Monday (April 22).

 

Led by ophthalmologst, professor Andrew Lotery (pictured), researchers at Southampton General Hospital discovered that almost two-thirds (65%) of liver transplant patients had developed some form of the sight threatening condition, which can lead to blindness. As a result, professor Lotery has called for more emphasis to be placed on the eye health of liver transplant patients, with regular monitoring recommended and the prompt referral to ophthalmologists if AMD is detected.

 

During the three-year study, which aimed to explore the relationship between the eye disease and transplantation, the team of experts monitored 223 Western European patients aged 55 years and over who had received a liver transplant at least five years previously. 

 

Prior to the study, a mutation which causes the complement factor H (CFH) gene in the liver to produce abnormal proteins had been pinpointed as more common to AMD sufferers, possibly causing inflammation in the eye.

 

Professor Lotery said: "This study has provided us with some invaluable insights into this complex eye disease and the intriguing science behind CFH. 

 

"As a result of this project, in which we were primarily looking at whether or not fault-free genes could affect the development of AMD, we have discovered liver transplant patients have a high incidence of AMD and that was unexpected."

 

The specialists were keen to discover if receiving a new liver, without the mutation, had an effect on the development of AMD and inflammation in the eye. They aimed to determine if AMD treatment given systemically could be more effective than being administered directly into the eye. They reported that levels of inflammation in the eye remained unchanged in patients with AMD after a liver transplant, concluding that the liver is not responsible for the development of AMD and therefore AMD treatment directly into the eye was likely to be most successful. 

 

The research, which was published in the journal Ophthalmology, was funded by TFC Frost Charitable Trust and the Gift of Sight appeal.

Virtual glaucoma clinics established

A prototype programme which remotely collects the data of glaucoma patients and enables it to be viewed by specialists for diagnosis at another location has been developed by experts at Moorfields Eye Hospital. 

 

Established in partnership with the facility’s OpenEyes team, Charing System and Black Pear software, the pilot application aims to enable the creation of virtual glaucoma clinics, which will result in less frequent hospital visits for patients. It will also free up the time of glaucoma specialists’.

 

Designed for use on iPads, the system was funded by a £75,000 grant from the NHS Connecting for Health’s Interoperability Toolkit (ITK) Information Sharing Challenge Fund (ISCF). 

 

The prototype uses iPads to enable an iRIS entitled Black Pear app to capture the metrics associated with glaucoma assessments. The data is then sent from the iPad to Moorfields’ OpenEyes patient record system using ITK, where a specialist consultant can diagnose glaucoma, if required.

Fast-track stem cell treatment linked to AMD

American researchers have reported the discovery of a way to isolate retinal pigmented epithelial (RPE) cells as early as 14 days after the onset of differentiation. The dysfunction of RPE cells is thought to be a cause of AMD.

 

Published in the journal Stem Cells Transitional Medicine, researchers at the University of California said that in the past techniques used to generate RPE from human pluripotent stem cells have been time consuming and inefficient. 

 

Commenting on the discovery, James Thomson, the first researcher to isolate human embryonic stem cells, said: "RPE cells are required for visual function and are a reasonable candidate for use in cellular therapy to treat AMD. This study shows that it is now possible to produce homogeneous cultures in a shorter period of time."

 

Led by Drs Dennis Clegg, Peter Coffey and David Buchholz, the study was based on earlier reports that neural retinal progenitors could be generated through the application of a handful of factors.

 

Dr Clegg added: "As RPE and the neural retina arise from a common progenitor pool, we sought to determine whether this protocol could be altered to direct pluripotent stem cells to RPE with a similar efficiency. 

 

"Through the combined use of the retinal inducing factors IGF1, Noggin, Dkk1 and others added at specific times, we found that pluripotent stem cells could be directed to RPE, also with an efficiency of about 80% – and it only took 14 days."

Glaucoma app launched

An app has been established which simulates the vision of a patient suffering with glaucoma and for the first time allows other patients and health care professionals to experience the condition through their own eyes.

 

Developed by MSD UK, in partnership with Moorfields Eye Hospital and the International Glaucoma Association (IGA), the app is available to download via iTunes. 

 

Consultant ophthalmologist and glaucoma specialist at Moorfields Eye Hospital, Nick Strouthidis, said: "Many people with glaucoma won't realise that there is a problem until the disease is advanced, which can lead to irreversible blindness in some patients. Fortunately though, early detection and effective treatment can prevent such serious outcomes. It is essential that doctors, optometrists and specialist nurses involved in glaucoma care engage and empower their patients. We anticipate that this unique educational tool will be highly effective."

 

Clinicians are encouraged to show the app to their patients and their carers to demonstrate the effects of glaucoma on vision. 

 

Moorfields Eye Hospital hopes that the app will increase patients' understanding of the disease, but also result in increased awareness of the condition amongst the public. 

 

Deputy chief executive of the IGA, Russell Young added: "The rising popularity of tablets and smartphones in the UK means that patients and their families are increasingly in the driving seat in glaucoma management. This new free simulation app has the potential to ensure better awareness of this under recognised and tragic condition, and we urge people to download it today."

 

The app can be downloaded by visiting https://itunes.apple.com and searching for Glaucoma SIM.