Archive for September, 2010
Does cataract surgery increase the chances of retinal problems?
09.29.2010
Dr. Krawitz prefers the Alcon Infiniti phacoemulsification instrument for performing his cataract surgeries.
Cataract surgery is one of the most important processes with respect to maintaining eye health. With remarkable advances in technology accompanied by an optically demanding aging population, cataract removal has become more frequent and less arduous. However, research has shown that patients with retinal conditions may be prone to postoperative complications following cataract surgery. Cataract removal is vital in these patients because the presence of a clouded lens impedes a physician?s visualization and management of the retina. In a report from Dr. Samer Farah in the 2010 issue of the American Academy of Ophthalmology’s Eyenet Magazine, the associations between preexisting retinal disease and the effects of cataract surgery were examined.
Several retinal conditions and their relationships to cataract surgery were scrutinized. Recent studies have revealed that cataract surgery may exacerbate diabetic retinopathy, a common retinal condition in diabetic patients. Not only did cataract surgery increase the progression rate of the disease in subjects with a preexisting level of retinopathy, but it has also been associated with new occurrences of the condition. Patients with history of retinal vain occlusions (RVOs) are also susceptible to complications resulting from cataract surgery, primarily in the form of postoperative cystoid macular edema (CME). The risk of CME is also prevalent in patients with epiretinal membrane. With respect to age-related macular degeneration (AMD), results have been less conclusive. Due to the diversity of the disease, no accurate relationship has been established between AMD patients and postoperative retinal problems.
The most common cause of retinal complications following cataract surgery is vitreomacular traction caused by movement of the vitreous. However, other mediating factors have been investigated. A particular study showed that patients with a high aqueous humor level of VEGF at the time of surgery were more prone to postoperative macular edema. As a result, anti-VEGF treatment via intravitreal bevacizumab is being used to prevent the onset of this condition. Other options for postoperative retinal care include the use of topical nonsteroidal anti-inflammatory drops (NSAIDS) and AREDS nutritional supplements. For AMD patients, physicians may choose to insert an ultraviolet light-blocking intraocular lens, for UV light is commonly thought to exacerbate AMD. Of course, these patients are also advised to wear sunglasses or hats as further means of protection after the operation.
Certainly, cataract surgery is necessary to improve visual acuity, especially for patients with retinal diseases so that their conditions can be monitored without obstruction.? However, physicians must be wary that certain preexisting retinal diseases can make a patient more prone to complications following cataract removal. Hopefully, understanding the risk factors and employing certain methods of preventative treatment can minimize these postoperative effects.
Brian Krawitz
Staff Writer
New Hope for Acid burns to the eye…
09.28.2010Every year, thousands of people suffer chemical burns to their eyes resulting in blindness.? A recent study of patients who received adult stem cell transplants found that the patients had their vision restored.
The astounding results showed that the treatment worked completely in 82 of 107 eyes and partially in 14 others with the benefits lasting up to 10 years so far. One successful stem cell recipient has near-normal vision despite his eyes being severely damaged more than 60 years ago.
The stem cell transplants would not benefit people who have damage to the optic nerve or suffer from macular degeneration. People who are completely blind in both eyes would not be able to take advantage of the therapy either since the procedure requires that some healthy tissue be available for transplant.
Adult stem cells differ from embryonic stem cells. Adult stem cells are found throughout the human body. Embryonic stem cells require the destruction of the human embryo when harvested. Since the adult stem cells come from the patients’ own bodies, there is no need for anti-rejection drugs.*
Andrea Schumann
Staff Writer
Choose your spouse wisely, or else the kids will all grow up near-sighted.
09.24.2010Researchers have identified a gene linked to myopia in Caucasian people from varying regions of the world. Several unique spellings of DNA? code near the RASGRF1 gene had a strong link with focusing errors in vision. RASGRF1 is critical to retinal function and visual memory consolidation.
While most cases of myopia are not severe, about 2 to 3 percent are pathological cases and include retinal detachment, macular bleeding and premature glaucoma. All of these can eventually lead to blindness.
This discovery could potentially lead to treatment for myopia otherwise known as nearsightedness. The eye is an ideal organ for gene therapy because of its small size and self-contained area. This allows the therapy to stay inside the eye in a concentrated volume. Since the eye is easy to access, physicians are more able to study the effects of treatment over a period of time. The retina and other structures within the eye can be illuminated and tested with techniques that are not invasive. It is hoped that this discovery will enable researchers to prevent myopia which is the most common cause of visual impairment.
Andrea Schumann
Staff Writer
One blood component increases risk of developing macular degeneration. Find out which test to ask for.
09.23.2010
C-Reactive Protein
Age related macular degeneration (AMD) is a prevalent eye disease that gradually destroys sharp, central vision by attacking the macula.
In a recent study by Dr. Joanna Sedden and others published in the August 2010 issue of the professional journal, Ophthalmology, it was shown that the presence of a particular protein and genetic variants might make individuals more susceptible to this condition. Genetic variants CFH and ARMS2/HTRA1 gene regions as well as high-sensitivity C-reactive protein (CRP) levels were investigated. AMD patients, defined as either having large drusen, geographic atrophy, or neovascular disease of the retina, were examined alongside a control group that showed minimal maculopathy. Serum samples from each subject were taken to measure the levels of CRP, and DNA was also examined to code for the presence of the gene variants in question.
The results show that individuals with AMD are more likely to have higher levels of C-reactive protein, especially for those who are in the advanced stages of the disease. In addition, individuals possessing the genetic variants CFH and ARMS2/HTRA1 were associated with more severe retinal damage. These factors appear to be independent, as CRP was associated with AMD while simultaneously controlling for genotype, and AMD was more prevalent in genetically susceptible individuals (those possessing the particular genetic variants) while CRP levels remained steady.
Although further testing will help us more thoroughly interpret these results, it appears that certain ingrained biological factors contribute to the rise of AMD. CRP protein and particular genetic variants may make individuals more vulnerable to age-related macular degeneration.
Brian Krawitz
Staff Writer
Our favorite Irish lass sends us an update about her macular degeneration.
09.23.2010
Elsie Gerner's Beautiful View
Elsie
