Tuesday, November 30, 2010

Glucose Control May Influence Outcome Of Ranibizumab Treatment For Diabetic Macular Edema.

Diabetic macular edema.Image via Wikipedia

According to a study published in the Journal of Diabetes and its Complications, glucose control influences the outcome of ranibizumab treatment for diabetic macular edema.

This retrospective study enrolled 65 eyes of 65 patients with persistent DME treated with intravitreal ranibizumab injection. The main outcome measures were the change in best corrected visual acuity (BCVA), the central subfield macular thickness (CSMT) recorded with optical coherence tomography (OCT), and its correlation with the serum hemoglobin A1c values (HbA1c).

Researchers found that serum levels of glycated hemoglobin (HbA1c) showed a negative correlation with the change in central subfield macular thickness (CSMT) after intravitreal injection of ranibizumab.
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Monday, November 22, 2010


For only the second time, the FDA has approved a test in people of a treatment using embryonic stem cells -- this time for a rare disease that causes serious vision loss. This was covered on the front page of the Business Day section in NY times.

Researchers at the California-based Advanced Cell Technology explained that their experiment will focus on Stargardt disease, which affects only about 30,000 Americans. But the company hopes the same approach will work for similar and more common eye disorders like age-related macular degeneration, which affects millions.

The current study will involve injecting 50,000 to 200,000 cells known as retinal pigmented epithelial cells in the hopes that they will replace those ravaged by the disease.
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Friday, November 19, 2010

Image by Chealion via FlickrMulti Coloured Brain II

According to a study published Nov. 14 in the journal Nature Neuroscience, a brain area that plays an important role i vision is divided into compartments that respond separately to different colors" and come with preference for different orientations, such as horizontal or vertical.

Working with monkeys, Vanderbilt University researcher discovered not only that the V4 area of the brain plays a role in visual object recognition, but also that there is significant segregation of color/brightness and the shape processing regions.

Anna Roe, professor of psychology and co-author of the new research, said "Our study showed that in V4, which is a brain area that plays a role in visual object recognition, there is significant segregation of colour/brightness and shape processing regions".
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Wednesday, November 10, 2010

Incredible Associations!

Corneal arcus. Photograph of patient's eyes sh...Image via Wikipedia
When i saw the headline Corneal arcus `associated with eye pressure' I did a double take!

There was a recent publication in the November issue of Archives of Ophthalmology, one of the JAMA/Archives journals, showing that corneal arcus was present in the right eyes of 57.9 per cent of people with elevated eye pressure. Renyi Wu, M.D., Ph.D., of the Singapore Eye Research Institute, and colleagues examined the prevalence and consequences of corneal arcus among 3,015 individuals age 40 to 80. Participants underwent an interview and eye examinations, including corneal measurements, assessment of intraocular pressure and identification of corneal arcus using a slitlamp.

Here is the best part: "There is no known explanation for the association of corneal arcus with higher intraocular pressure," the authors write.

If there was some link between lipid deposition localized to the cornea and IOP, I can see the point, but do you?
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Thursday, November 04, 2010

Genentech Offering Secret Rebates


An article in today's NY Times reports that Genentech has begun offering secret rebates to eye doctors as an apparent inducement to get them to use more of the company's expensive drug Lucentis [ranibizumab] rather than a less costly alternative.

Doctors can earn up to tens of thousands of dollars in rebates each quarter if they use a lot of Lucentis and if their usage increases from the previous quarter, according to a confidential document outlining the program that was obtained by the New York Times. The rebates are considered a form of volume discount, and have been offered for some other drugs, but "some doctors said they had ethical concerns about the arrangement.

Genentech, which is owned by the Swiss company Roche, said in a statement, “Rebate and discount programs are a common business practice across the industry, including in the field of ophthalmology.” The company said it had such programs for other drugs and that they “help reduce the cost of our medicines for hospitals, pharmacies and doctors.”
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Wednesday, November 03, 2010

Retinal Implant Restores Some Sight To Three Blind People.



A bionic eye has restored sight to the blind in groundbreaking tests, according to research published in the Proceedings of the Royal Society B, which describes how the implant allowed two blind men and a woman to see shapes and objects for the first time since losing their sight to retinitis pigmentosa.

Professor Eberhart Zrenner, of Germany's University of Tuebingen, and colleagues at private company Retina Implant AG initially tested their sub-retinal chip on 11 people.

The Daily Mail points out that "the device...consists of a very thin microchip, just 3mm by 3mm in size and packed with 1,500 light sensors designed to replace those in the retina lost to disease.


David Head, chief executive of the British Retinitis Pigmentosa Society, said that it was exciting news but that it was early days.
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Tuesday, November 02, 2010

Optum health Vision = Failure

As a new entrant to the business world 2 yrs ago, I was told that the best way to generate patient flow is to be signed on as many insurance panels as possible. That surely turned out to be great advice as more than 80% of the folks that walk through my door are driven by listing on the insurance company's website.
Most folks do not understand the unique nature of optometry and insurance plans.

Vision Insurance is separate from your Health Insurance and is sometimes called a "carve-out". It's usually from a different insurance provider and covers an annual eye exam for eyeglasses prescription. Most Vision Insurance has either a moderate allowance for a set of glasses or a fixed dollar amount for contact lens care. Only very rarely are both eyeglasses and contact lenses paid for by your insurance in the same enrollment year. The contact lens coverage typically includes professional evaluation and a supply of contacts.

Medical Insurance covers you for anything that has a medical diagnosis. This would include visits for an eye infection, corneal foreign body removal, sudden onset of flashes and floaters, dry eye problems, and chronic or acute allergy issues. Your Medical Insurance would also cover progress evaluations to monitor cataracts, glaucoma and other recurring issues.

Anyways, one such insurance company is Optumhealth - used to be called Spectera. Their name change might indicate their need to morph! I have consistently had poor service from them. They claim that
"Our members pay no more than $40 for an annual eye exam and save 20% on glasses"
We, as provides get shafted and are paid nothing! The contract insists that I mail all the lab work to their contracted labs and they are riddled with errors! When I write in to express my desire to cancel the contract, I get no response for months! When I call to speak to the manager they take a message and these calls are not returned.... Why are they in business?

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Monday, November 01, 2010

Lifestyle Factors Play Key Role In Controlling Diabetes And Preventing Complications.

For patients with type 2 diabetes, "basic lifestyle factors," like diet and exercise, can play a key role in controlling the disorder and preventing serious complications, such as blindness, nerve disorders, and kidney failure.

In fact, with consistent blood sugar control and careful attention to cholesterol and blood pressure levels, most type 2 diabetics can keep the disease in check. And, adopting a low-fat, low-calorie diet and regular exercise to trim 5% to 10% of one's body weight is enough to prevent type 2 diabetes from developing or to bring diabetics' blood sugar, cholesterol, and other key markers within healthy limits.

People with type 2 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugar from becoming extremely high or low. Meal planning includes choosing healthy foods, eating the right amount of food, and eating meals at the right time. You should work closely with your doctor, nurse, and registered dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your daily lifestyle and habits, and should try to include foods that you like.

Here is a fantastic resource to read through....
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Essilor announces new lens


Essilor of America, Inc. announced that it has launched the first personalized lenses available in the United States designed to accommodate the specific physiology of certain ethnic populations.

Essilor’s research and development analysis of more than 200,000 patients in the areas of optics, physiology and how people use their eyes and wear their frames revealed that five out of six wearers in Asian populations have different measurements from the average values for pantoscopic tilt, wrap angle and vertex distance. The company then used these data to develop patented technology that personalizes lenses for Chinese and Indian eyes and is now offering Varilux Physio Enhanced Azio, Essilor Azio Single Vision and Varilux Physio Enhanced India lenses as the first of its new ethnic lens products.
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