Archive for January, 2010
Risk of endophthalmitis associated with injections for wet AMD
01.18.2010Patients are frequently concerned about the benefits and risks of medical procedures. And the standard of care for the treatment of wet macular degeneration is injections of a drug into the vitreous cavity of the eye, where it hopefully causes atrophy and elimination of abnormal blood vessels that leak blood and fluid into the retina.
One of the questions is what are the risks of infection with such treatments?
A study published in the February 2009 issue of? the scientific journal, Eye, links injections of Lucentis or Avastin that are used to treat wet age-related macular degeneration with endophthalmitis.
Researchers determined there is a 1 in 1000 incidence of endophthalmitis which is an infection of the inner eye tissues in patients who receive the injections as treatment for wet AMD.
Three eyes of three patients who were identified as being diagnosed with endophthalmitis following their injections were studied. All three patients improved by the end of their follow-up period.
Researchers determined that endophthalmitis is still a potential complication of Lucentis or Avastin injections despite taking all precautions to ensure maximum sterilization techniques. The infection occurs rapidly and it is imperative that the signs of infection be recognized and treated early to prevent any vision loss.
Andrea Schumann
Staff Writer
High caloric and sodium intake associated with more severe eye disease in African-Americans
01.16.2010Diabetic African-American patients may benefit from a reduction of calories and sodium in their diets. Regulating caloric and sodium intake may reduce the development and progression of diabetic retinopathy.
The leading cause of blindness in 20 to 64 year-olds, diabetic retinopathy occurs when blood vessels in the retina are damaged by diabetes-related changes in the body. There are two causes of vision-threatening diabetic retinopathy: proliferative retinopathy and macular edema.
469 African-American patients were evaluated in the study which was published in the January issue of Archives of Ophthalmology. Patients with the greatest caloric intake at the beginning of the study were more likely to develop the vision-threatening retinopathy while those with high sodium intake were more likely to develop macular edema.
Researchers concluded that a change in diet may slow progression of diabetic retinopathy in African-American patients.
Andrea Schumann
Staff Writer
New device will aid in early detection of Age-related Macular Degeneration
01.14.2010There is an exciting development in the diagnosis of age-related macular degeneration (AMD). A new device, the AdaptDX, will allow doctors to detect the onset of macular degeneration by measuring how fast the eyes adapt to darkness. This new device is currently undergoing clinical trials here in the United States.
This device was developed upon the known dark adaptation in patients with macular disease. This is the same effect that a person experiences when coming in from bright sunlight into a dark house. Most people can recover in 30 seconds while sufferers of AMD can take minutes to recover.
The creator of AdaptDX, Greg Jackson, says that the device should arrive in ophthalmologists’ and optometrists’ office nationwide some time this year and will most likely be incorporated into the standard eye exam for those aged over 50.
The device will be able to detect if the epithelial cells within the retina are abnormal which would cause the patient to take a longer time adapting to darkness which would indicate the onset of macular degeneration.
Andrea Schumann
Staff Writer
Bifocals prove to be beneficial to children with myopia (near-sightedness)
01.13.2010Children who have rapidly progressing myopia (nearsightedness) may benefit from wearing bifocals rather than single-vision eyeglasses.
A study published in the January Archives of Ophthalmology finds that bifocals can slow the rapid progression of myopia in children.
The diagnosis of myopia has risen 66% in the United States over the past 30 years with 33% of the adult population being nearsighted.? People in East Asia have a much higher incidence of myopia with the rate being 60% by age 12. Because of this, researchers chose to study Canadian Chinese children with rapidly progressing myopia.
Researchers believe that one reason that bifocals are more effective in slowing the progression of myopia than normal lenses is because positive lenses can disrupt the equilibrium of the eye muscles? for those who already have some degree of exophoria.
Researchers cautiously recommend offering bifocals to children with rapidly progressing myopia. They urge eye care practitioners to weigh the extra cost and poor cosmetic appearance of bifocals when considering this option.
Andrea Schumann
Staff Writer
Cyclosporine is effective in treatment of Dry Eye Syndrome
01.12.2010For people suffering from severe forms of dry eye, relief may be found in the form of cyclosporine. Cyclosporine ophthalmic emulsion, or better known by its prescription name of Restasis, can increase tear production and reduce dry eye symptoms.
Choosing the appropriate medication to treat dry eye depends greatly upon the severity of the disease.? Patients with moderate to severe dry eye symptoms will benefit the most from treatment with anti-inflammatory medications such as topical cyclosporine. Patients with moderate to severe symptoms are at the highest risk of their disease worsening.
Often times, cyclosporine is used in conjunction with corticosteroids. The patient begins by taking the corticosteroid and cyclosporine concurrently for a couple of weeks and then he or she is gradually taken off the corticosteroid and continues with the cyclosporine.
People are often under the assumption that dry eye syndrome cannot progress quickly but it can significantly worsen in a year’s time so it’s important to treat affected patients quickly. Depending on the severity of the disease, patients may either need short-term or long-term maintenance therapy.
Andrea Schumann
Staff Writer
Addendum: In published studies, cyclosporine (Restasis) has been shown to have some effectiveness versus the symptoms of dry eye syndrome in 60-70% of patients. However, in our own practice, we have witnessed only 30-50% efficacy. Some of the clinical benefits of Restasis may be due solely to the emulsion mixture of oil and balanced salt solution into which the active cyclosporine is placed. This emulsion, without the medication, was so effective that it was taken off the market by the manufacturer, presumably because it adversely affected the sales of prescriptive Restasis.
Paul L. Krawitz, M.D., President
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