News my parents would never have imagined!

Scientists have produced monkeys with genetic material from two mothers, an advance that could help women with some inherited diseases have healthy children but that would raise a host of safety, legal, ethical and social questions if attempted in people

Researchers at Oregon Health amp; Science University developed a way to replace most of the genes in the eggs of one rhesus macaque monkey with genes from another monkey. They then fertilized the eggs with sperm, transferred the resulting embryos into animals' wombs and produced four apparently healthy offspring.

According to Bloomberg News, "defective mitochondria are passed only from mother to child, not from the father." Data indicate that nearly one in 4,000 births produce babies with defective mitochondria. At present, there is a technique that allows doctors to assess the egg cells of women with mitochondrial diseases and pick the healthiest ones to use with in vitro fertilization procedures. Still, some women do not have any "adequate egg cells," a fact that inspired the Oregon team to devise a way to "replace defective DNA in the mitochondria

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Fashion eyeglasses for children

Nebraska's Journal Star reported that eyeglasses are no longer the fashion don't for kids they once were, as wearers and manufacturers have realized they can be another accessory used to make a style statement.imatthews.com, Fashion eyeglasses for children, Aug 2009

You should read the whole article.

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Gene Therapy Creates a New Fovea

Gene therapy for an inherited form of blindness shows promise, a U.S. study shows.

According to a study published in the Aug. online edition of Human Gene Therapy and in a letter to the editor in the Aug. 13 issue of the New England Journal of Medicine, experimental gene therapy appeared to improve vision in three patients with Leber congenital amaurosis. In this condition an abnormal protein in sufferers' photoreceptors severely impairs their sensitivity to light. "It's like wearing several pairs of sunglasses in a dark room," says Artur Cideciyan, a researcher at the University of Pennsylvania in Philadelphia, who oversaw the trial

For the study, researchers from the University of Pennsylvania injected a gene encoding a functional copy of a light-sensitivity protein into a small part of one eye of three patients, all in their twenties and blind since birth. Three months after treatment, all three patients showed substantial improvements in their ability to detect light. Notably, one year after treatment, one patient discovered that she could read an illuminated clock in the family car for the first time in her life.

The authors suggested that the brain can adapt to new sensory capacity, even in people who have been blind since birth

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Alzheimer's Patients have difficulty perceiving certain kinds of visual contrast

Memory loss in Alzheimer's disease conceals dramatic changes to vision which may make people seem less mentally competent than they actually are.

Researchers are now testing whether they could improve the lives of people with Alzheimer's by helping them see better, using low-tech interventions such as colored dinner plates, oversize change purses, and special bingo cards. The scientists believe that small changes, such as making sure patients can see a light switch or the edge of a stair, could have important consequences for their independence and quality of life.

Researchers from Dr Alice Cronin-Golomb's lab at Boston University have discovered that Alzheimer's patients have difficulty picking up on certain kinds of visual contrast. Unfortunately, the vision loss does not show up on a typical eye exam. So the problem may be blamed on memory, when it really is eyesight. A new rule of thumb may be that if you want a person with Alzheimer's to be able to see something, use bold contrasting colors.

One of the BU group’s collaborators, Grover C. Gilmore, dean of the Mandel School of Applied Social Sciences at Case Western Reserve University, has found that healthy adults were able to identify letters faster than Alzheimer’s patients. Normally, such a delay might be chalked up to memory problems. But when he increased the visual contrast, he found that the difference between the two groups disappeared.

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The First Practice Academy

I just returned from a 2 day workshop called the The First Practice Academy.
This was a workshop held in Atlanta, GA. The sponsors were Ciba Vision and Essilor of America.
The entire event was aimed at a new business owner. I was one among over a 100 young doctors of optometry eager to listen to leaders in the industry. These leaders are individuals who started small themselves and grew into multi location, multi million dollar practices.
It was an amazing event - very inspiring and filled with great insights. I can't think of any other profession where this takes place. I have always been convinced that optometry is a very generous profession and this only went to further cement that opinion.
The speakers were Laurie L. Sorrenson, Amir Khoshnevis, Kelly Kerksick, Carole Burns, Mark Wright.

I want to thank the main sponsors for giving me an opportunity to be there...

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AARP says requiring road tests for seniors only is discriminatory

The CBS Evening News  reported that the number of Americans 65 and older expected to nearly double over the next 20 years and there are growing concerns about aging drivers behind the wheel. New Hampshire is one of only two states with mandatory road tests for seniors.
CBS correspondent Randall Pinkston explained, “In New Hampshire...every car and truck driver 75 or older must retake the road test to renew their driver's license”. Pinkston also pointed out that, while 15 percent of the nation's drivers are over 65, only 11 percent of them are involved in fatal crashes. But, starting at 65, their risk of accidents for every mile driven spikes up. By age 80, elderly drivers are as likely as 17-year-olds to have fatal crashes. Currently, Massachusetts is considering legislation to require older drivers to take road tests before renewing their licenses. Pinkston added, But, the American Association of Retired Persons, the AARP, says road tests only for older drivers are discriminatory, that health, not age is the decisive factor.

A similar bill is proposed in North carolina

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UIW School of Optometry to receive funding for San Antonio eye care clinic

University of the Incarnate Word (UIW) School of Optometry - (what a strange name for a school!) is in line to receive $250,000 from the government to help pay for a new eye-care clinic on San Antonio's East Side.

The school would use the money to provide eye exams and vision services to under-served residents in East San Antonio. The planned eye care clinic is slated to open in the spring of 2010. Funding for the project was included in the Labor, Health and Human Services, Education Appropriations bill, which recently passed the US House of Representatives, but still must still pass the US Senate

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Genetic Link To Age-related Cataracts Uncovered

Researchers from Case Western Reserve University have identified the EphA2 gene, which is associated with the formation of age-related cataract, a leading cause of blindness.



The gene encodes an enzyme that plays a role in the repair of damaged proteins in the eye. Expression of the EphA2 gene decreases with age, which means damaged proteins can clump together and cause the eye lens to become cloudy, resulting in obscured vision, according to the study in the July 31 issue of the journal PLoS Genetics

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BLOOD STEM CELLS PROGRAMED TO BECOME VISION CELLS

Florida researchers were able to program bone marrow stem cells to repair damaged retinas in mice, suggesting a potential treatment for one of the most common causes of vision loss in older people.

The success in repairing a damaged layer of retinal cells in mice implies that blood stem cells taken from bone marrow can be programmed to restore a variety of cells and tissues, including ones involved in cardiovascular disorders such as atherosclerosis and coronary artery disease.

In a paper slated to appear in the September issue of the journal Molecular Therapy, scientists describe how they used a virus carrying a gene that gently pushed cultured adult stem cells from mice toward a fate as retinal cells. Only after the stem cells were reintroduced into the mice did they completely transform into the desired type of vision cells, apparently taking environmental cues from the damaged retinas.

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Ozurdex Implant Approved for Macular Edema

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An injectable eye implant approved by the U.S. Food and Drug Administration Thursday is the first product sanctioned to treat the eye disorder macular edema when it is caused by blockage of the retinal vein.

The Ozurdex eye implant treats macular edema by delivering a high concentration of the corticosteroid dexamethasone.

Macular edema occurs when the eye's macula -- a part of the retina -- swells because of fluid accumulation from leaking or blocked retinal veins. In a news release, device maker Allergan, Inc. said retinal vein occlusion is a significant cause of vision loss and the second most common disease of the retinal veins, behind diabetic retinopathy.

The implant, which is biodegradable, was evaluated in a pair of clinical studies involving about 1,300 people.

The treatment, to be injected in a physician's office, is expected to be available later this year

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ALLERGAN RECEIVES FDA APPROVAL FOR ACUVAIL

The FDA has approved Allergan Inc.'s Acuvail (ketorolac tromethamine ophthalmic solution) 0.45%, an advanced, preservative-free formulation of the NSAID ketorolac indicated for the treatment of pain and inflammation following cataract surgery. According to the company, Acuvail is formulated at pH 6.8, enabling deionized drug delivery on the corneal surface, and contains carboxymethylcellulose, which enables the drug to adhere to the ocular surface and enhances patient comfort. The company expects Acuvail to be available to physicians and patients in the United States in September 2009.

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Ocular Surface Temperature and Lipid Layer Thickness

The aim of this study was to establish the relationship between ocular surface temperature (OST), tear film stability as assessed by noninvasive tear break-up time (NIBUT) and subjective evaluation of the lipid layer thickness in a young, asymptomatic, sample group (n=29). NIBUT and tear lipid layer structure were evaluated through a slit-lamp mounted Tearscope Plus. A self-calibrating infrared thermography camera was used to record two OST values (one immediately post-blink and one immediately pre the subsequent blink).

The most common lipid layer pattern observed was the amorphous pattern (48.3%). Differences between post- and pre-blink OST values were observed. Significant differences of pre-blink OST values were observed between the closed marmoreal group with that from the amorphous and flow groups. There were no differences of NIBUT values between each lipid layer thickness.

A non-significant tendency for higher OST in eyes with increased NIBUT was observed. This study suggests that higher OST values could be associated with thicker tear lipid layer in normal subjects. The lack of significant results in relation with tear film stability may be due to only normal subjects were included.

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NASA Study of Cataract in Astronauts

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The NASA Study of Cataract in Astronauts (NASCA) is a 5-year longitudinal study of the effect of space radiation exposure on the severity/progression of nuclear, cortical and posterior subcapsular (PSC) lens opacities. Participants include 171 consenting astronauts who flew at least one mission in space and a comparison group made up of three components: (a) 53 astronauts who had not flown in space, (b) 95 military aircrew personnel and (c) 99 non-aircrew ground-based comparison subjects. Continuous measures of nuclear, cortical and PSC lens opacities were derived from Nidek EAS 1000 digitized images. Age, demographics, general health, nutritional intake and solar ocular exposure were measured at baseline. Astronauts who flew at least one mission were matched to comparison subjects using propensity scores based on demographic characteristics and medical history stratified by gender and smoking (ever/never).

The cross-sectional data for matched subjects were analyzed by fitting customized non-normal regression models to examine the effect of space radiation on each measure of opacity. The variability and median of cortical cataracts were significantly higher for exposed astronauts than for non-exposed astronauts and comparison subjects with similar ages. Galactic cosmic space radiation (GCR) may be linked to increased PSC area and the number of PSC centers. Within the astronaut group, PSC size was greater in subjects with higher space radiation doses. No association was found between space radiation and nuclear cataracts.

Cross-sectional data analysis revealed a small deleterious effect of space radiation for cortical cataracts and possibly for PSC cataracts. These results suggest increased cataract risks at smaller radiation doses than have been reported previously.

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Increase in ocular melanoma rates to use of tanning booths.

NBC Nightly News reported about the tanning bed industry. "While the risk of skin cancer is well known, [a] dire warning...compared the effects to cigarette smoking and arsenic. Chief medical editor Nancy Snyderman, MD, explained that according to the World Health Organization, an exponential increase in skin cancer can be linked to the use of indoor sun and tanning booths. For people who start using the booths before the age of 30, their risk goes up 75 percent."
        The Tampa Tribune reports that the declaration by the WHO's International Agency for Research on Cancer (IARC) that tanning booths emitting ultraviolet radiation are carcinogenic simply echoes what dermatologists say they've suspected for years. The declaration, published in the August issue of The Lancet Oncology, ranked tanning beds right up there with tobacco smoke and mustard gas. Dermatologist Neil Alan Fenske, MD, of the University of South Florida, pointed out that for some time, tanning beds that use ultraviolet rays were suspected of causing skin cancer. He stated that the members of the American Academy of Dermatology have been fighting this battle for a number of years, adding that patients who have received abundant amounts of light via tanning beds have developed extraordinary numbers of skin cancers.
        The Detroit Free Press reports that IARC made its announcement after finding enough evidence in people and mice that UVA and UVB rays damage skin-cell DNA, sometimes in cancer-blocking genes. The damage may result in three types of skin cancer: the less dangerous basal and squamous cell skin cancers and melanoma, explained dermatologist Darius Mehregan, MD, of Wayne State University. The Free Press notes that the American Academy of Dermatology had no comment on the international decree, and calls to the Indoor Tanning Association were not immediately returned.
        According to MedPage Today , citing evidence from case-control studies and a meta-analysis, the IARC monograph working group 'raised the classification of the use of UV-emitting tanning devices to Group 1, 'carcinogenic to humans.' In addition, the working group also cited case-control studies showing 'consistent evidence of an association between the use of UV-emitting tanning devices and ocular melanoma.' In fact, the IARC reclassified all forms of ultraviolet radiation as a single carcinogenic entity. Historically, mutations caused by exposure solar radiation had been attributed to UVB, but the same mutation was identified in UVA-induced skin tumors in mice. In its update, the IARC moved UV radiation as a whole into the highest-risk category, eliminating distinctions between UVA, UVB, and UVC.
        The Philadelphia Inquirer quoted John Overstreet, executive director of the Indoor Tanning Association, as saying, Because tanning beds produce the same UV light as the sun, overexposure and abuse of our product -- just like overexposure to sunlight -- is associated with an increased risk for some types of skin cancer.
        USA Today faults industry promotion of questionable health benefits of tanning. USA Today editorializes, Despite mounting evidence linking tanning beds and cancer, the Indoor Tanning Association, which represents the industry, has shamelessly promoted questionable health benefits instead. In fact, its most recent campaign has been to convince people that tanning beds are beneficial because they are a source of Vitamin D. A few years ago, the tanning industry encouraged now-disproven claims that the mainly UVA ultra-violet rays emitted by sun beds do not do the same damage as the sun's. In 2008, its director termed assertions of a link between tanning beds and melanoma 'irresponsible.' USA Today argues, It's the industry that appears irresponsible, much as Big Tobacco once was as it tried to refute science. The paper calls for better education about tanning dangers, along with stronger warnings and action against misleading health claims.

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River blindness can be stopped by drugs: WHO

River blindness may be eradicated through long-term ivermectin use.



New studies, published Tuesday in the journal PLoS Neglected Tropical Diseases, suggest river blindness can be wiped out with a long enough course of ivermectin. The World Health Organization (WHO) said the studies demonstrated that treatment with the drug ivermectin stopped further infections and transmission of the disease in three areas of Africa in Mali and Senegal.

The drug ivermectin, developed in 1987 by Merck, kills the larvae of the parasite that causes the disease, but not the adult worms, so scientists thought treatments were needed every six months or year to keep it under control. Researchers found, however, that after 15 to 17 years of regular treatment, only a few infections remained after treatment was stopped in...three test areas, leading them to conclude that river blindness can be wiped out with a long enough course of ivermectin. AFP notes that main funding for the studies came from the Bill & Melinda Gates Foundation.

BBC News reports that currently, at least 37 million people are infected with the disease, which causes sufferers to lose their sight and also to develop painful skin complaints. River blindness is endemic in many parts of Africa, primarily in poor, rural communities. The disease is caused by a parasite that is transmitted to people through the bite of the black fly. The worms spread through the body and when they eventually die, our immune system reacts fiercely. That reaction destroys living tissue -- especially the eye. While doctors have known for years that drugs can control the disease, they now believe it can be eliminated.

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Half a brain girl recovers vision

According to research published in the Proceedings of the National Academy of Sciences, researchers from the UK's University of Glasgow say they have solved the mystery of how a girl with half a brain has near perfect vision in one eye.

The 10-year-old girl was born missing the right side of her brain, whose job it is to map the left field of vision. Magnetic resonance imaging scans showed that the girl's brain rewired itself during development when she was still  in utero. In spite of having some seizures as a toddler, which were successfully treated, and slight weakness on her left side, the girl has had a normal medical history, attending school and taking part in regular activities. Amazingly, her left and right field vision is almost perfect in one eye.

Dr Lars Muckli, of the university's Centre for Cognitive Neuroimaging, said: "The brain has amazing plasticity but we were quite astonished to see just how well the single hemisphere of the brain in this girl has adapted to compensate for the missing half.

"Despite lacking one hemisphere, the girl has normal psychological function and is perfectly capable of living a normal and fulfilling life. She is witty, charming and intelligent."

Scans revealed that retinal nerve fibers carrying visual information from the back of the eye which should have gone to the right hemisphere of the brain diverted to the left.

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Intra-oral device helps blinded Marine to discern shapes.

Washington Post reports that a special 'lollipop,' a device that uses the tongue to stimulate the visual cortex and send sensory information to the brain, is helping Marine Cpl. Mike Jernigan, who lost both of his eyes in a roadside bomb attack in Iraq, to discern shapes.

The intra-oral device, or IOD...is an inch-square grid with 625 small round metal pieces that is connected by a wire to a small camera mounted on a pair of sunglasses and to a hand-held controller about the size of a BlackBerry. Images are sent by the camera to the IOD, which transmits a low-voltage pulse to Jernigan's tongue. With training, Jernigan has learned to translate that pulse into pictures.

Optometrist Amy Nau, OD, who is researching the effectiveness of the device at the University of Pittsburgh, explained, It's kind of like Braille that you use with your fingers. Dr. Nau added, Instead of symbols, it's a picture, and instead of your fingertips, it's your tongue. The IOD, called the BrainPort vision device...is manufactured by Wicab.

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Glaucoma biggest cause of blindness in New Zealand

Glaucoma NZ chairwoman Helen Danesh-Meyer has highlighted the biggest cause of blindness in New Zealand. It is estimated that 68,000 people have glaucoma in New Zealand. The Dominion Post has an excellent article highlighting this issue.

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Glaucoma surgeries up while Medicare reimbursement down

According to a study published in the July issue of the Archives of Ophthalmology, the number of glaucoma surgeries is on the rise, but Medicare reimbursement for the procedures has been decreasing.

For the study, researchers from Exponent, Alcon Research, and the Bloomberg School of Public Health analyzed Part B Medicare data for 100,000 beneficiaries from 1997 to 2006. The team found that from 1997 to 2001, there was an overall decrease in both the number of procedures and the amount of annual payments, but there was an increase in the number of procedures in the following years, reaching a total of 414,980 in 2006. The investigators attributed the increase to advancements in technology and a change in calculating the global period for reimbursement purposes.

The authors also noted that payments for trabeculectomies decreased over time, while annual payments for newer procedures, such as cyclophotocoagulation and shunt-related procedures, have increased.

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A new paradigm for understanding glaucoma has emerged

Glaucoma isn't simply an eye disease, experts now say, but rather a degenerative nerve disorder, not unlike Alzheimer's or Parkinson's disease.

While researchers still recognize high pressure within the eye as a leading risk factor for glaucoma, it is becoming clear that the condition begins with injury to the optic nerve as it exits the back of the eye. The damage then spreads, moving from one nerve cell to adjoining nerve cells.

Neeru Gupta, MD, PhD, of the University of Toronto, explained, In glaucoma, we've shown that when your retinal ganglion cells are sick, the long axons that project from the eye into the brain are also affected, resulting in changes that we can detect in the vision center of the brain. This phenomenon, called transynaptic damage, occurs in Alzheimer's and Parkinson's disease, as well.

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