Archive for the ‘Macular Degeneration’ Category

New stem cell research may cure blindness due to macular degeneration.

02.26.2010

Advanced Cell Technology, Inc. has filed a request with the FDA to test a treatment for macular degeneration. Advanced Cell would be conducting the clinical trial with the Foundation Fighting Blindness which is bound by stem-cell-harvest2National Institute of Health (N.I.H.) regulations.

A proposal by the N.I.H. would expand it’s current definition of human embryonic stem cells which would enable researchers that it finances to work with cells derived from blastomeres.

Advanced Cell pioneered the development of embryonic stem cells from blastomeres and has since learned how to convert these cells into the specific cells that form the basement membrane of the retina. Animal testing of these blastomere-derived cells has resulted in the retinal cells growing well and reproducing light-detecting rod and cone cells which resulted in the improved vision of the lab animals.

Andrea Schumann
Staff Writer

Which medications have risk of causing blindness?

02.04.2010

Prednisone, a glucocorticoid, is used to treat a number of eye diseases, some acutely (asthma suddenly out of control), some chronically (ulcerative colitis, Polymyalgia rheumatica, Giant Cell Arteritis). Despite the plethora of powerful new medications being developed, prednisone still works well to control the inflammation of a number of illnesses and diseases better than the modern alternatives. The problems arise when the side effects begin to take effect. And the side effects with prednisone are many. They include: brittle bones (osteoporosis), which can increase the risk of bone fractures and spinal pain, increased weight, elevated blood sugar, and increased risk of infection. But ocular side effects can reduce vision, and in some cases, cause blindness.

Prednisone may cause cataract formation

Prednisone may cause cataract formation

Prednisone causes the formation, in many people of a type of lens opacification known as posterior subscapsular cataracts. These cataracts, known as “PSC’s” by ophthalmologists, are particular visually debiliating because the loss in lens clarity occurs in the back of the lens, which is the optical center of the lens where all light travels before heading to the retina in the back of the eye. Symptoms include glare and haloes and difficulty reading details up close. This latter effect occurs due to the pupil constricting during reading, which forces light to travel through the most opaque portion of the cataract.

But cataracts are not the only side effect from Prednisone. Elevation in eye pressure may also occur, above and beyond the upper normal limit of 21 mm Hg. Patients may assume that taking oral predisone for only one or two months could not possibly be harmful, and their doctors are often unaware of the rapid rise in pressure to levels of 30 to 50 mm Hg that can occur in people who have diabetes, those with a family history of glaucoma, or those people who have a borderline pressure level to begin with. Approximately 10% of people are “steroid responders,” who develop elevated intraocular pressures in response to oral prednisone.

Patients often ask whether nasal or oral steroid inhalers can also raise pressure. The answer is yes, but rarely. The culprit is almost always oral steroids, or steroid eyedrops themselves.

If you listen to the commercials on television and radio, you’ll undoubtedly hear about other drugs that “can cause glaucoma,” but are really rather rare. These include all drugs with “anticholinergic side effects,” and include such common drugs as cold remedies and spastic bladder medications.

Although these are very common telephone inquiries to an eye doctor, in fact the incidence of developing glaucoma is rare.

Why?

Because these medications dilate the pupil slightly, which increases the risk of an angle closure glaucoma attack in patients with narrow anterior chamber angles, but have no effect on nearly everyone else, including those patients with the most common form of glaucoma, known as primary open angle glaucoma.

So why do the ads warn against taking the medications if you have, “glaucoma?” Read the previous paragraph and decide for yourself which saves the advertiser the most time (and dollars) in their ads.

Yep. “Don’t take the meds if you have glaucoma,” saves the advertisers money, even though it is an inaccurate statement.

There is another medication that requires frequent monitoring. Plaquenil (hydroxychlorquine) is used to treat Rheumatoid arthritis and other “autoimmune” diseases. An infrequent, but serious side effect is the loss of scattered areas of the vision that might not be detected using a simple eye chart test. The recommended test is a computerized visual field examination, which assesses for loss of tiny areas of peripheral, or “side vision.” Often seen concomitantly with the visual field loss is a retinal finding known as Bull’s Eye Maculopathy. The finding of either visual field loss or Bull’s Eye Maculopathy warrants the discontinuation of hydroxycholoroquine.

Medications that are used to treat erectile dysfunction may cause the user to see a blue haze in their vision. While alarming, however, this transient visual change does not appear to induce any permanent damage.

And finally, no discussion of ocular side effects of prescription medications would be complete without discussing prostate medications. The worst of the bunch seems to be Flomax, a drug that blocks the alpha adrenergic receptors not just surrounding the prostate, but everywhere else in the body too. I have previously written about this in greater detail on the page explaining causes of Floppy Iris Syndrome. In short, the medication causes the iris dilator muscle to relax, sometimes permanently. This results in a small pupil, again sometimes permanently. A small pupil is not in itself, a dangerous thing. But a small pupil, particularly with a floppy iris, makes cataract surgery more difficult. I perform nearly 600 cataract surgeries annually. Among that number are eye doctors who refer me their patients who have taken Flomax and are at high risk for Floppy Iris Syndrome. Despite my expertise in treating patents with Floppy Iris Syndrome, I would much prefer if the patient had not taken Flomax or another alpha adrenergic drug prior to cataract surgery.

If your doctor is considering using Flomax to treat your prostate hyperplasia, my recommendation is to go to your eye doctor first to be evaluated for cataract surgery. It is much more desirable to do the cataract surgery first, and THEN AFTERWARDS, start the Flomax regimen.

Paul Krawitz, M.D., President
Vitamin Science, Inc.

AMD patients may benefit from epimacular brachytherapy

02.03.2010

A recent study involved the use of epimacular brachytherapy to treat patients requiring continual anti-VEGF injections found that the procedure may ease the number of treatments for age-related macular degeneration (AMD).

Epimacular brachytherapy involves inserting a probe inside the eye and then directing the radiation from the probe directly to the fovea (the center of the macula).vidion

The study showed that the number of anti-VEGF injections which were required was reduced among patients. In addition, the visual acuity of the majority of the study participants was improved. 63% of patients gained visual acuity with 50% gaining five or more letters of visual acuity in 6 months.

The epimacular brachytherapy system directly delivers radiation to the targeted area in the eye. As a result, no cases of radiation retinopathy were reported in this study or in prior studies. The procedure has been performed safely in over 400 patients from around the world.

While further studies will be conducted, researchers are encouraged by the results obtained thus far.

Andrea Schumann?Staff Writer

Why do doctors tend to continue practicing what they knew last year?

01.29.2010
Burying ones head in the sand might not be the best survival behavior.

Burying one's head in the sand might not be the best survival behavior.

It comes as a shock to patients to learn that many doctors don’t keep up with the latest literature in their field. New studies come out in high quality, peer reviewed scientific journals. But physicians, as a lot, tend to be dubious of the results. And it often takes YEARS and several corroborative studies before the doctors feel comfortable enough to change their behavior. And it may still not happen unless they discuss the issue with their peers and everyone else has made the change. As a rule, doctors tend to have a herd mentality.

After 20 years in practice, I have finally recognized this. But it was my involvement with VisiVite.Com, beginning in 2001, that alerted me to this disturbing trend.

In November 2002, one full year after the National Eye Institute’s Age Related Eye Disease Study (AREDS) was published, our company presented our VisiVite vitamin formulas at the largest annual meeting of ophthalmologists in the world, the American Academy of Ophthalmology’s Annual Meeting. Nearly 30,000 ophthalmologists attended.

Only one hundred or so eye doctors (1/3 of one percent) wanted to discuss eye vitamin research with us. And among them, the comments were along the lines, “Nothing helps macular degeneration, certainly not eye vitamins.”

And mind you, this was one year after the most prestigious ocular research institution published a beautifully designed, randomized, double-blind, prospective study of thousands of patients measured over five years proving the benefits of the AREDS formulation. It took nearly 5 more years before eye doctors began routinely recommending eye vitamins to their patients with AMD.

So it continues to frustrate me, and it should frustrate you as well, to read the letter below, sent to me on January 29, 2010, about a patient’s lament that the doctor wants to stay with “what he knows.”

Where does that leave you, the patient?

My friends, you need to be your own, and best, health care advocate.

Paul L. Krawitz, M.D., President
Vitamin Science, Inc.

———————-

Dear Dr. Krawitz,

I purchased the Premier Ocular Formula 2 for my husband …he has wet AMD
in one eye & dry AMD in the other….yesterday, I showed his Retina Specialist
the info on said vitamins but he said he would rather my husband stayed with
the _________  (husband is a smoker) since it is the only one with any scientific
basis.   I have to say I was rather disappointed because I liked what I read about
the Premier Ocular 2 Formula.

Dear Mary,

Doctors are sometimes slow to come on board with the most recent research.

The Premier Ocular Formula No. 2 contains everything that ________ has, AND MORE!

Compare below:

  • Vitamin C: 452 mg in ________, 500 mg in VisiVite
  • Vitamin E: 400 IU in both
  • Zinc: 69.9 in ________, 80 mg in VisiVite
  • Copper: 1.6 in ________, 2.0 in VisiVite
  • Lutein: 10 mg in both

But…

________ has NO OMEGA 3 ESSENTIAL FATTY ACIDS! And the research
supporting their use in the prevention of AMD is strong.

And the National Eye Institute and others now know that these are CRITICAL to
prevention of AMD worsening. The proof is so strong that they are now including
the verysame Omega-3 formulation that’s in VisiVite Premier in the AREDS 2
research.

You can read more about AREDS 2 here:

http://www.areds-2.com

Ultimately you and your husband have to do what is comfortable for you and
what you think holds the best chance for preventing him from losing vision.

I’d be happy to write your husband’s doctor a personal note explaining the
benefits of VisiVite Premier Ocular Formula No. 2. if you wish.

Dr. Krawitz

Promising new treatment for dry AMD in clinical trials

01.21.2010

Acucela Inc. has announced Phase 2 clinical trials of it’s ACU-4429 for the treatment of dry age-related macular degeneration (AMD).  ACU-4429 works by decreasing the levels of toxic products in the eye thus hopefully stopping the advance of dry AMD.

More than 29 million people worldwide are affected by either “wet” or “dry” AMD. The leading cause of the loss of vision in people over the age of 50 is antioxidantsdry AMD.  90 percent of AMD patients suffer from the dry form of AMD.  Currently, there are no FDA approved therapies to treat dry AMD which will make the trials of ACU–4429 ones eagerly watched. Anti-oxidants are the only therapy available to slow or halt the progression of dry AMD

Researchers are pleased with the preclinical and early clinical data for ACU-4429. Thus far, it has demonstrated the ability to decrease toxic by-products which have had a part in the progression of dry AMD.

ACU-4429 is administered as an oral, daily pill unlike other therapies for the eyes which can involve the use of injections into the eyes.

Andrea Schumann
Staff Writer