Wednesday 30 January 2013

Optom spots tumour during routine test

A young woman is highlighting the importance of regular eye exams after a routine test resulted in emergency surgery to remove a brain tumour. 
Amber Carter attended Haine & Smith in Chippenham after suffering sickness and severe headaches for several months.
She explained: “My GP suggested I saw an optician as I might need glasses. I was so desperate I booked an eye test with Haine & Smith straight away. The optician gave me an urgent referral to the Royal United Hospital in Bath and the next day I had an eight-hour operation to remove a benign grade 1 tumour”
Examined by optometrist Anna Lewin, who has worked for the independent for over 10 years, Ms Lewin noted that the 23-year-old’s optic nerves were swollen and referred as a matter of urgency. 
Barry Smith, co-founder of the independent, said: “Amber’s case illustrates how important it is for people of all ages to have regular eye tests. In addition to checking any deterioration in vision, a number of underlying health problems can be revealed by your optician looking at your eyes.”

B+L embarks on glaucoma drug study

Contact lens giant Bausch + Lomb has confirmed it will push forward with phase III of a clinical trial of latanoprostene bunod in the reduction of intraocular pressure (IOP) for patients with glaucoma or ocular hypertension. 
Announced in partnership with Nicox, the third phase of the study will include two separate randomised, multi-centre, double-masked clinical studies named Apollo and Lunar. They are both designed to compare the efficacy and safety of the drug when administered once daily, in addition to timolol maleate 0.5% twice daily, in lowering IOP for patients with open-angle glaucoma or ocular hypertension. 
Around 800 patients will take part in the studies, which will be performed in North America and Europe. 
B+L’s decision to go ahead with phase III of the program follows positive results in the phase IIb trial which tested 413 patients with heightened IOP as a result of the eye conditions. Researchers reported that the drug ‘consistently lowered IOP in a dose-dependent manner.’ 
Cal Roberts, executive president and chief medical officer at B+L, said: “Bausch + Lomb believes that latanoprostene bunod has the potential to become an important new treatment option for people suffering from elevated IOP due to glaucoma and hypertension. 
“We look forward to completing this pivotal research program, and hope to develop an effective new treatment option to benefit physicians and the patients they serve.”
Latanoprostene bunod has been licensed by Nicox to Bausch + Lomb. 
Chairman and CEO of Nicox, Michele Garufi, added: “Latanoprostene bunod is a nitric oxide-donating compound which was discovered in our research laboratories in Milan and is the first Nicox program licensed to a partner to enter into phase III. 
“We are pleased with B+L’s commitment to pursing this program in an area of significant therapeutic need. The whole Nicox team has contributed to this important milestone which underlines the potential of our research platform in the ophthalmic field.”

A decade in optics

The developments, challenges and successes which have taken place in optical manufacturing over the last decade have been brought together and compiled in a new book published by the FMO. 
The UK Ophthalmic Industry in the 20th Century title includes technical and political developments and highlights how they have influenced optics. 
Jointly authored by optical journalist Shelagh Hardy and past Essilor director Jacques Desallais, the book concludes with present day innovations of titanium single-piece spectacles, free-form technology and computer advancements. 
Ms Hardy commented: “Charting the history from Clerkenwell and Hatton Garden, where the industry really evolved from the jewellery trade, the book seeks to show how the industry developed. Key highlights include the influence of the NHS; the advancement from bifocals to progressives and the mid-80s move from a largely glass lens market to predominantly plastic.”

Scientists grow eye

A complete eye, with intact lens, retina and other components, has been successfully grown from somatic cells of ocular origin.
Scientists at the Institute of Advanced Studies in Education in Rajastahn have shown that ectopically transplanted ocular tissues can be made to grow into a complete eye.

The researchers took the lens of a donor tadpole, excised the epithelial cells, and implanted them into the tail of a recipient tadpole.
Within just days, the cells, in the presence of a vitamin-A containing substrate, had differentiated into a complete eye. The experiment has been hailed as showing the plasticity of differentiated ocular tissues in the presence of vitamin A.

Further species work would need to be done, but the potential for re-differentiation of transplanted ocular cells into a complete eye might offer some hope for replacement of damaged or inactive organs.

Monday 28 January 2013

Lamellar Biomedical raises £3.3m for dry eye drug development

A life sciences firm has raised £3.3m from investors to help it commercialise a drug treatment for dry eye disease.

Lamellar Biomedical raised the money from existing and new shareholders including Barwell, Scottish Enterprise and angel investors Tri Cap.
Its lead product - LMS-611 - is also aimed at radiotherapy induced xerostomia (Rix), commonly known as "dry mouth" in cancer patients.
It is also investigating its possible use in cystic fibrosis treatment.
Bellshill-based Lamellar said it was working with the Vision Sciences Unit at Glasgow Caledonian University and the Beatson West of Scotland Cancer Centre in its development programme.
Following completion of the latest investment round, Duncan Moore was elected chairman of the company.
Mr Moore is a partner at East West Capital Partners and was previously global head of healthcare equity research at Morgan Stanley.
Lamellar was founded in 2007 to develop a new class of therapies for the prevention, treatment and control of severe respiratory disease.
Funds managed by Invesco Perpetual now form the largest shareholding in the company.

The goggles that soothe dry eyes in 12 minutes

A new 12-minute treatment in the doctor’s office could help relieve the problem of chronically dry eyes. 
The procedure uses special goggles to gently warm and squeeze tiny glands in the eyelids, which help to keep the eye lubricated.
Dry eye affects around three million Britons — it’s sometimes caused by a lack of tear fluid, which is needed to moisten and clean the front of the eye when we blink. This can worsen with age.

The new device, the LipiFlow system, works by warming and compressing the eyelids to clear the meibomian glands and improve flow

It can also affect people who wear contact lenses; this is because the lens reduces the amount of oxygen reaching the eye surface.
But in around 65 per cent of cases dry eye is caused by a lack of protective oil in the tear fluid. 
This clear oil, known as meibum, prevents the watery tear film evaporating. 
The oil itself is produced in the 30-40 tiny meibomian glands in the eyelids. 
But in patients with evaporative dry eye, as it is known, the meibum becomes thick and buttery, clogging the glands. 
Without the protective oil, the tear film evaporates, leaving the eye feeling dry, gritty and sore. In extreme cases, this dryness can cause permanent damage to the front of the eye, leading to scarring or infection of the cornea (the clear front window of the eye).

Patients can use eye drops to lubricate the eye, or warm compresses to try to melt the meibum and clear the glands. 
They can also clean around the eyelids (not the eye), carefully using a cotton bud and baby shampoo to remove the fatty plug. 
There has also been some evidence to suggest that a diet rich in omega-3 fatty acids (found in oily fish) may help.
The new device, the LipiFlow system, which was launched in the U.S. around six months ago, works by warming and compressing the eyelids to clear the meibomian glands and improve flow. 
It consists of a soft plastic cup that sits over the eyeball, under the eyelids. 
The back of this cup has a small heated plate on it that presses against the eyelids. 

Dry eyes can affect people who wear contact lenses; this is because the lens reduces the amount of oxygen reaching the eye surface

A second cup then sits over the eyelids. The inner cup starts to heat up, melting the fat in the meibominan glands. 
The outer cup has two tiny paddles that gently put pressure on the eyelids every two minutes, which helps to squeeze out the abnormal thickened secretions from the gland.
The device is heated to 42c for 12 minutes and studies suggest that once the glands have been cleared, they start to produce normal fluid.
A study of 139 patients, published in the journal Cornea, showed that after four weeks patients who had been treated with the device had more healthy secretions from their glands when compared with patients who used a warm compress. 
Patients who’ve had just one treatment often experience significant improvement, claims Imran Rahman, a consultant ophthalmologist at 20-20 Vision in Manchester who has started using the LipiFlow system.
However, the treatment — at £595 per eye — is not cheap. 
But it could be considered for difficult cases, says Professor Bernard Chang, consultant ophthalmologist at Leeds Teaching Hospitals NHS Trust. 
‘Warm compresses can help unblock the glands and improve dry eye — and this device acts in a similar, but more sophisticated, way. 
'The device could be useful in hard-to-treat cases.’ 

Friday 25 January 2013

Light in womb has effect on developing eye

Normal foetal eye development in mice is related to light exposure during pregnancy, according to latest research in the US.
Scientists at Cincinnati Children's Hospital Medical Center and the University of California San Francisco (UCSF) have identified a light-response pathway that controls the number of retinal neurons, and has effects on developing vasculature in the eye.

The unexpected findings, published in Nature, were said to offer a new basic understanding of foetal eye development and ocular diseases caused by vascular disorders, in particular retinopathy of prematurity.
Professor David Copenhagen of the departments of Ophthalmology and Physiology at UCSF, said: 'Several stages of mouse eye development occur after birth. Because of this, we had always assumed that if light played a role in the development of the eye, it would also happen only after birth.'
Researchers found that activation of a light-response pathway must happen during pregnancy to activate the 'carefully choreographed programme' that produces a healthy eye.
They specifically found it was important for a sufficient number of photons to enter the mother's body by late gestation - or about 16 days into a mouse pregnancy.
Researchers also observed that photons of light activated a protein called melanopsin directly in the foetus - not the mother - to help initiate normal development of blood vessels and retinal neurons in the eye. In the experiments, mice were reared in the dark and in a normal day-night cycle beginning at late gestation to observe the comparative effects on vascular development of the eye.

Optegra launches new AMD service

Specialist eye care hospital, Optegra has established a new service to improve support for patients diagnosed with dry AMD. 
Expected to go live this month, Optegra’s Birmingham Eye Hospital will offer patients a regular monitoring service, which aims to detect any changes to their condition as quickly as possible, with treatment instigated where necessary. 
The service is the brainchild of professor Jon Gibson, a consultant ophthalmologist at Optegra Eye Hospital in Birmingham. He explained: “Many patients that we see in the NHS with dry AMD are understandably anxious to know if their condition is worsening or if they might be at risk of developing wet AMD, and ask if they can be monitored on a regular basis.
“Although currently there is no treatment available for dry AMD, many patients would like to be regularly assessed. The NHS cannot effectively offer this at present, given the other demands placed on it in busy eye clinics.”
The service consists of a one-hour appointment during which they have a thorough eye examination and autofluoresence retinal images are taken. 
Professor Gibson added: “We have realised that there is an opportunity to support our patients – both medically and emotionally – by setting up a new service where they can be jointly managed by consultant ophthalmologists at Optegra in conjunction with their own optometrists in the community, and so providing regular monitoring. As part of this process we can keep them updated about progress in new therapeutic developments for dry and wet AMD, that hopefully will proceed to effective treatment for both types of AMD in the near future.”
Following the appointment, patients will have a six-month check-up at the optometrist, followed by a 12-month review at the hospital. 
Optegra Birmingham Eye Hospital manager, Stacey Owens, said: “Professor Gibson supports a vast number of patients with AMD, and sees at first hand their concern and worries, particularly about not having an opportunity for regular monitoring. As Optegra has the latest technology available for monitoring and treating AMD, as well as leading consultant ophthalmologists available, this service is one more step to provide assessment and reassurance for our patients, as well as expert advice for any treatment options that may be available.”

Wednesday 23 January 2013

Special assessment clinic team shortlisted

The Special Assessment Clinic team at Cardiff University has been shortlisted for an award for Clinical Excellence by the National Autistic Society
The team, which provides eye care for patients who cannot communicate in the usual way, consists of Andy Millington, Mike George and Maggie Woodhouse (pictured).
They work closely with the educational services to provide guidance on visual abilities and needs for children with any form of visual impairment, and the clinic links with the Low Vision Clinic to advise on or supply magnification aids when appropriate.
The clinic also operates as a teaching clinic for optometry students at the university as well as a research resource.
Mr Millington, who led the application, said: “It is a great honour to have our work recognised by the National Autistic Society. We firmly believe that everyone has the right to enjoy high quality eye care, which will allow them to lead the kind of life that they want for themselves.”

Aspirin Warning

A recently published study suggested that Aspirin use was associated with an increased risk of developing wet AMD. However, the Macular Society is warning patients with heart disease not to stop taking prescribed Aspirin without consulting their doctor.
Helen Jackman, chief executive of the Macular Society (pictured), said: “We understand that patients will be concerned and they should discuss the risks with their doctors. 
“For patients with cardiovascular disease who are taking Aspirin, the risk of heart attack is higher than the risk of developing wet AMD. We urge patients not to stop taking prescribed Aspirin without speaking to their doctors.”

Saturday 19 January 2013

Inadequate evidence used when restricting cataract surgery

Around 50% of Primary Care Trusts across England have restricted access to cataract surgery, with the majority of these failing to use adequate clinical evidence in doing so, NHS medical director, Bruce Keogh, has told MPs. 
Speaking to a hearing of the public accounts committee last week (January 14), Sir Keogh acknowledged that: “We know that about 50% of PCTs have restricted access to cataract surgery, and we know that the bulk of policies used by PCTs have not used the best evidence to ration that care.”
Continuing, he confirmed he has raised the issue with strategic health authority medical directors, as well as medical directors on the new Commissioning Board. “I have asked for cataracts to be one area that the programme of value-based surgical commissioning works on,” he said. 
Welcoming the Committee’s focus on cataract surgery, president of the College of Optometrists, Dr Kamlesh Chauhan (pictured), highlighted the importance of overturning unfair cataract rationing policies immediately. 
“Cataract surgery is a highly effective procedure that restores people’s vision with tremendous benefits for their quality of life,” he said. “Sir Bruce’s admission that people across the country are being denied this life changing treatment on inappropriate grounds is deeply worrying and must be tackled immediately. Cataract pathways begin with optometrists so the College would be very happy to work with the NHS Commissioning Board and our partners in the vision sector to find a solution.”
Sir Keogh added: “If we can get this right, and if we can get surgeons and the commissioners into the same place for the thresholds of referral, I think we will not only improve the quality of care, but save a considerable amount of money.”

Friday 18 January 2013

'Best Friends' depicts joy of sight

The winner of Bausch + Lomb's Joy of Sight photography competition has been announced, with ‘Best Friends’ (pictured) by Sally Stratton from Cornwall, scooping the top prize.
The selected image won a Nikon D3100 SLR Pro Kit from iGadjit Cameras.
Entrants were asked to submit an original image encapsulating what sight means to them and capturing the joy it brings, to highlight the importance of keeping eyes healthy.
The contest was launched by Bausch + Lomb to raise awareness of age-related macular degeneration (AMD). The image was selected from over 1,000 entries by a panel of judges from Bausch + Lomb, the Macular Disease Society, Amateur Photographer Magazine and included OT’s deputy editor Robina Moss. 
Describing her photograph Ms Stratton said: “The image is of my late father, Arthur, with his great grandson, Jake. Even with his poor eyesight his eyes would light up whenever Jake visited.”
‘Morning Rush’ by Alf Bailey of Cheshire, ‘Ayers Rock With Company’ by Robert Spanring of Somerset, ‘Anyone for a Paddle’ by Michael William Beales of Somerset and ‘Life Begins’ by Jodie Cooling of Oxfordshire were also highly commended for their powerful and moving images.
The pictures can be seen on

Vision Express Fitness To Practise Summons

Vision Express has been summoned to appear before a GOC fitness to practise substantive hearing next month.
Allegations relate to eight practitioners. A student optometrist is alleged to have performed unsupervised sight tests, three DOs are accused of working while unregistered, three student DOs are said to have worked as DOs under student registration and one DO is alleged to have practised with lapsed registration.
'Fitness to carry on business is impaired by reason of practices or patterns of behaviour occurring within the business which you knew or ought reasonably to have known of amount to misconduct,' alleged the committee.
The last body corporate to appear before a fitness to practise committee was Boots Opticians in 2009. The multiple was fined £30,000 after the committee heard it did not take reasonable and proportionate steps to prevent a student dispensing optician dispensing to a patient under 16 years old.

Specsavers ordered to become registered with the General Optical Council

All of Specsavers' joint venture companies (JVCs) must register with the General Optical Council, the regulator has ordered.
The GOC said it had opened an investigation into the matter after it received a complaint about unregistered Specsavers JVCs and subsequently made its policy on registration of corporate bodies clear to the multiple.

'Specsavers has now agreed to make sure that all its JVCs are registered as soon as possible. We welcome this decision and have now begun to process applications from previously unregistered JVCs,' said a GOC spokesperson.
Responding to the new requirements, a Specsavers spokesperson said: 'Following clarification received from the GOC in December, Specsavers has been working towards registering each individual store company in addition to the overall parent company registration.'
The news follows a third story (News 28.09.12 and 07.12.12) in Private Eye which questioned the multiple's operating practices as a result of its registration status.
The GOC said its research project into the future of business registration (News 07.12.12) would continue as planned.
'This project has always been in our 2012/13 business plan and is not related to recent press coverage of our body corporate registers. As we noted in our response to the Law Commissions, we believe that there may be scope for the new statutory framework to contain provision for a more clear, modern and proportionate system of business regulation; the current research project is to inform our thinking in this area,' said the GOC.

Patients unaware of winter UV risk to eye

Eye care professionals have been told to remind their patients about the importance of UV protection for eyes during the winter months.
A study by Johnson & Johnson Vision Care showed 90 per cent of patients only felt exposed to UV rays in summer.

It was found that while 65 per cent were concerned about protecting their eyes from UV rays overall, just 6 per cent considered using protection on a cloudy day.
'During winter the dangers of UV still exist with 50 per cent of the UV radiation our eyes receive coming from indirect sources, such as reflections from ice and snow on the ground,' said optometrist and director at Specs of Kensington, Daska Barnett.
'Not only can UV rays pierce cloud cover, they reflect off all surfaces in any weather. New research shows eyes are particularly vulnerable to UV light exposure in the early morning and late afternoon, when people least expect it.
'As eye care professionals we should remind our patients that protection from UV rays is important to eye health.'
Reflected radiation was said to be more dangerous than direct sunlight because people were more likely to look down than up, and noted that fewer UV rays were absorbed by the atmosphere at high altitude.
'With this in mind building a dialogue with our patients is necessary - not only to educate them on the health dangers but to ensure they make an educated decision on the right product to help protect their eyes,' added Barnett.
The study also showed 74 per cent of UK contact lens wearers were not aware that contact lenses can offer UV protection, but most would be willing to pay extra for UV protection.
J&J added that the best UV protection for eyes was the combination of contact lenses with UV blockers and wrap-around goggles or sunglasses.

Wednesday 16 January 2013

Charity extends information support

The charity SeeAbility has expanded its website to offer an online information service which is dedicated to eye health care for people with learning disabilities. 
The new area  – – has been developed in partnership with Mencap and aims to improve access to eye care information for people with learning disabilities. 
There are an estimated one million adults living with learning disabilities in the UK. They are 10 times more likely to be blind or partially sighted than others, while six out of 10 will require spectacles.
The development of the new online section is the result of a study involving people with learning disabilities, support staff and High Street practitioners.
The website area includes easy read fact sheets and videos with information on eye health, while there is a female avatar, which describes what's on the screen, built in for those who are unable to read. 
A second new area –  – contains a database where optometrists can enter their practice information to enable people with learning disabilities to find a local optometrist who can test them with ease. 
Matin Thomas, information manager at the charity, said: "It is difficult for people with learning disabilities to access good, appropriate eye care.
"We worked with people who would benefit from this service to ensure that it is user-friendly and provides them and their careers with the information they need to prepare for a sight test."

About End-Stage AMD

The Implantable Miniature Telescope (by Dr. Isaac Lipshitz), about the size of a pea, is intended to improve distance and near vision in people who have lost central vision in both eyes because of End-Stage AMD. The telescope implant is surgically placed inside one eye. The implanted eye provides central vision; the other eye provides peripheral vision. To give you some interesting points on it; ·         It is a closed system magnification device.(compared to the IOL VIP which is a 2 lens system)·         The only lens of this type to be FDA approved·         It enlarges the image by 2.7 times. (compared to the IOL VIP which is 1.3x)

The more you know about End-Stage AMD, the easier it is to understand the CentraSight treatment program. End-Stage AMD is a disease of the retina. It is the most advanced form of age-related macular degeneration (AMD) and the leading cause of irreversible vision loss and legal blindness in individuals over the age of 65.
Some degeneration of the macula is normal during aging. In early, less advanced AMD, visual symptoms are generally mild and may or may not impact vision-related activities. However, advanced stages of AMD can result in severe loss of sight in the central part of vision. This is often referred to as a central vision "blind spot". This blind spot is different than the visual disturbances experienced with cataracts (clouding of the eye's lens) and is not correctable by cataract surgery or eyeglasses. Side vision, or peripheral vision, is not affected by AMD, but is too low resolution (blurry) to make up for lost central vision.
With End-Stage AMD, the macula reaches a point where central vision is lost in both eyes, making it difficult to perform everyday tasks. End-Stage AMD can develop from the dry form of AMD or the fast-progressing wet form. There are no drugs or treatments that can cure End-Stage AMD. The damage to the macula is permanent.
Normal Eye and Eye with AMD Blind Spot
AMD affects a part of the eye called the macula. The macula is the most important part of the retina. It is responsible for "straight ahead" detailed vision. The macula makes it possible to see well enough to perform everyday tasks such as reading, watching television, recognizing faces and colors, seeing objects in detail, and safely walking up stairs.
Diagram illustrating parts of the eye.
Age-related macular degeneration (AMD) is a disease of the retina in which light sensing cells in the central area of vision - the macula - can be damaged and stop sending images to the brain. In advanced AMD, this can result in permanent loss of central vision.

Tuesday 15 January 2013

DoH publishes guidance on registered a vision impairment as a disability

The Department of Health has published information on how to register a vision impairment as a disability.
If a person is registered as partially sighted or blind they will be able to access a range of benefits to help them manage their condition and the impact that it may have on their lives.
The documents published on Department’s website include a Certificate of Vision Impairment (CVI) form, which formally certifies someone as visually impaired, explanatory notes about the CVI form for consultant ophthalmologists and hospital eye clinic staff to help them manage the completion of the form, and a referral letter which can be used to request social needs assessment from the local council or a designated agency.
These documents were previously on an NHS web portal which is no longer in use. 
To access the documents or to find out more visit

Friday 11 January 2013

Essilor widens Varilux view

Essilor is launching the seventh generation varifocal design Varilux S series in a move that it described as breaking the traditional limitations of varifocal performance.The company said the lens was developed through Essilor's LiveOptics approach that gave wearers an extremely wide field of vision with minimal swim effect.

The correction was realised through two advances in optics - SynchronEyes which considered the physiological differences between the eyes to ensure maximised binocular fields of vision, and Nanoptix which re-engineered the lens structure to virtually eliminate swim effect.Essilor added that practitioners with a Visioffice Universal measuring device could advance the performance even further through Eyecode frame fitting conditions and a personalisation technique which considered the dominant eye.'These unique wearer characteristics are factored into the premium S series lens, Varilux S4D, and in doing so the practitioner improves the wearer's visual reaction time.'Professor Mo Jalie commented: 'Even people who in the past have been unsuccessful with progressive lenses should now find the new features of these lenses very easy to adapt to.'

B+L recalls eye drop batch after ink found

Bausch+Lomb has recalled some 36,000 bottles of Minims proxymetacaine hydrochloride 0.5 per cent eye drops in the UK after printer ink was found inside the containers.

The recall was issued last month by the MHRA and the Scottish Health Department, whose representative Irene Fazakerley wrote: 'B+L is recalling the batch because black particles have been identified in some packs.

Blind mice see light after cell transplant

Oxford University researchers who have transplanted cells capable of reforming the light-sensitive part of the retina in the eyes of blind mice believe the approach has relevance for treating patients with retinitis pigmentosa.The project, part funded by Oxford Stem Cell Institute and the Oxford Martin School, used mice that were blind due to complete loss of the light-sensing photoreceptor cells in their retinas. After two weeks the transplanted cells had reformed a full light-detecting layer on the retina and the mice could see, with 10 of the 12 showing improved pupil constriction in response to light.The study, published in PNAS, was led by Professor Robert MacLaren in the Nuffield Department of Clinical Neurosciences, with Dr Mandeep Singh an eye surgeon and PhD student. Dr Singh said: 'We found that if enough cells are transplanted together, they not only become light sensing but the also regenerate the connections required for meaningful vision.'Professor MacLaren added: 'Stem cells have been trialled in patients to replace the pigmented lining of the retina, but this new research shows that the light-sensing layer might also be replaced in a similar way. The light-sensing cells have a highly complex structure and we observed that they can resume function as a layer and restore connections after transplantation into the completely blind retina.'

Researchers identify genetic markers for keratoconus

Researchers have identified genetic markers that are associated with central corneal thickness and keratoconus.
Fight for Sight-funded clinical researcher, Professor Colin Willoughby (pictured), along with colleagues from Queen’s University, performed a meta-analysis on more than 20,000 individuals from Europe and Asia. 
Commenting on the findings, Fight for Sight’s director of research, Dolores Conroy, said: “Despite the visual and social impact of keratoconus, the underlying biochemical processes and pathobiology remain poorly understood. Corneal transplantation, although effective, carries inherent risk so research into alternative treatments for keratoconus is welcomed.

Wednesday 9 January 2013

Protein 'essential for healthy retina' identified

Researchers have identified a protein which is essential for maintaining a healthy retina.
Protein S was found to maintain a healthy retina through its involvement in the process of ‘pruning’ photoreceptors, also known as phagocytosis. Without such pruning, photoreceptors would succumb to toxicity and degenerate, which, if left unchecked, can lead to blindness, according to Dr Tal Burstyn-Cohen (pictured), from the Hebrew University of Jerusalem, and colleagues.
In the study, which appears in the journal Neuron, Dr Burstyn-Cohen’s team performed experiments in laboratory animals and found that Protein S, along with another protein, Gas6, are needed to activate phagocytosis of retinal photoreceptors, therefore keeping the retina healthy.
Protein S may also have implications for understanding and possibly treating other conditions in the immune, reproductive, vascular and nervous systems, as well as in various cancers, the researchers believe.

Friday 4 January 2013

Researchers identify early predictor of glaucoma

Patients with abnormally narrow retinal arteries could be at an increased risk of developing glaucoma, suggest the results of a study published in the journalOphthalmology.
The authors report that patients whose retinal arteries had been the narrowest when the study began had an almost four-fold higher open-angle glaucoma (OAG) risk than those who had the widest arteries.
“Our results suggest that a computer-based imaging tool designed to detect narrowing of the retinal artery calibre, or diameter, could effectively identify those who are most at risk for open-angle glaucoma,” said lead author of the study, Paul Mitchell, from the Centre for Vision Research at the University of Sydney. 
The researchers examined the associations between retinal vessel caliber and the 10-year incidence of OAG using data from nearly 2,500 individuals free from OAG at baseline.
Overall, 82 of the participants (104 eyes) developed incident OAG during the follow-up period. For each standard deviation increase in central retinal artery equivalent the 10-year risk for OAG increased by 77%. This association persisted even after adjustment for intraocular pressure and ocular perfusion pressure.
“These data support the concept that early vascular changes are involved in the pathogenesis of OAG,” write the study authors. “Computer-based measurements of retinal vessel caliber may therefore be useful to identify people with an increased risk of developing OAG.”
They add: “Such a tool would also need to account for blood pressure and other factors that can contribute to blood vessel changes. Early detection would allow ophthalmologists to treat patients before optic nerve damage occurs and would give us the best chance of protecting vision.”

NICE recommends Lucentis for some NHS patients

The National Institute for Health and Clinical Excellence (NICE) has recommended that Lucentis (ranibizumab) be available on the NHS for some patients with diabetes-related eye conditions.
NICE has issued a Final Appraisal Determination recommending Lucentis be approved for use within the NHS to treat people with visual impairment due to diabetic macular oedema (DMO) who have more extensive swelling of the retina. Specifically, it recommends Lucentis be used to treat those with a retinal thickness in the eye of 400mm or more at the start of treatment.
Approval of Lucentis could be one of the most significant developments in the treatment of DMO in 25 years as, before now, treatment has been limited to laser therapy. Laser therapy is not suitable for all people due to the nature of their condition and clinical studies have only shown it to stabilise vision on average.
Commenting on the decision, Ben Burton, consultant ophthalmologist at the James Paget University Hospital said: “Granting access to ranibizumab for patients with DMO, who face the very real prospect of permanently losing their vision, is great news. Up until now, most patients could only receive laser treatment on the NHS, which usually just stops their vision worsening but does not necessarily improve it. We have been able to use ranibizumab to treat people with wet age-related macular degeneration since 2007 and have seen good patient outcomes in this disease. Now that ranibizumab has been approved I look forward to seeing improved outcomes for people with this condition.”
The recommendation follows an announcement in December 2012 that Lucentis had been approved to treat people in Scotland with vision impairment as a result of DMO. The article can be accessed here.