Macula

Vitamin D and AMD

A study in the April issue of Archives of Ophthalmology reports that high levels of vitamin D appears to be associated with a decreased risk of developing early AMD in women younger than age 75. Women whose levels were the highest had a 59 percent decreased chance of developing early AMD. Once AMD was present vitamin D did not appear to have any effect on the condition. In women 75 years and older, higher levels were associated with a “borderline statistically significant increased risk.” Vitamin D food sources in the sample were milk, fish, fortified margarine and fortified cereal.

Avastin Safety Report

The Wall Street Journal and Marketwatch featured articles on the safety of Avastin.  Johns Hopkins University did an analysis of the Medicare patient claims database and reported that the use of Avastin for AMD showed a statistically significant increased risk for mortality and stroke as compared to Lucentis.  They cautioned that this analysis of 78,000 patients did not include information on smoking, lipid levels and blood pressure levels, all factors in mortality and stroke risk.

 

Stem Cell Therapy for AMD a Step Closer

Research on stem cell therapy for AMD is advancing according to a study conducted at the Georgetown University Medical Center. For the first time, researchers were able to create retinal cells from a patient's own stem cells (human induced pluripotent stem cells). These stem cells can then generate tissues and cells for transplantation. Work must still be done to figure out how to program the cells to function as native retinal pigment epithelium (the cells that die off and lead to AMD).

 

AMD Risk Update

Ophthalmology Management’s AMD Update states that it's estimated that 30% of Americans older than 75 years of age have AMD and that by 2020 approximately 3 million Americans will experience advanced AMD. Studies show that a family history of AMD increases one’s risk for developing AMD. Complement factor H and other complement factors appear to be responsible for the inherited risk. Knowledge of the polygenic basis of AMD has provided a foundation for genetic testing and gene therapy.

 

Possible Cause of Dry AMD Found

Researchers at the University of Kentucky have discovered one possible cause of dry macular degeneration.  The reduction of the Dicer enzyme in the retina is found in patients with geographic atrophy (a condition that causes death of retinal cells).  This is caused by an accumulation of a toxic type of RNA, which under normal circumstances would be degraded by the Dicer enzyme.  A reduced Dicer enzyme cannot control the toxic RNA and therefore the retinal cells die.  The U of K researchers, led by Dr.

Omega 3 Fatty Acids and AMD

A study of over 38,000 women who participated in the recently completed Women’s Health Study indicates that regular consumption of fish is associated with a decreased risk of AMD.  These women did not have AMD at the beginning of the 10 year study and there were 235 cases of confirmed AMD at the end of the study.  Results showed that “regular consumption of DHA and EPA and fish was associated with a 35% to 45% lower risk of visually significant AMD.”  A higher intake of omega 3 fatty acids is significant in the primary preve

Radiotherapy for AMD

Renewed interest in the efficacy of radiation therapy for neovascular AMD has prompted the initiation of large randomized clinical trials for epimacular brachytherapy.  In the past, trials for external beam techniques did not produce definitive results. This new technique provides more specific targeting of radiation to specific damaged areas with less collateral damage.  Epimacular brachytherapy has shown promising results in two pilot studies, the CABERNET trial taking place in 45 sites in the US, and the MERLOT trial in the United Kingdom.

Fenretinide for Dry AMD

Data from a phase 2 trial of fenretinide showed a reduction in the incidence of wet age-related macular degeneration in patients with geographic atrophy, the advanced form of dry age-related macular degeneration.  Alexander M. Eaton, MD, an investigator in the trial, said, “We are hopeful that the complete analysis will further validate these findings as fenretinide could slow vision loss in the millions of Americans who face blindness because of this disease.” The drug reduces VEGF, the proteins that cause growth of leaky vessels in the retina.

Avastin and Lucentis Deemed Safe by Study

Avastin and Lucentis appear to be safe as far as the risk of cardiovascular problems are concerned.  A study at Duke University School of Medicine analyzed the medical records of 146,942 patients treated for AMD in 2005-6. Patients receiving bevacizumab or ranibizumab did not have an increased risk of death, stroke or heart attack compared to patients receiving other treatments.

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Accessability Becoming Standard Fare For Many Electronics

Technological advances in electronic devices, such as the iPad and iPhone 4, both from Apple, are increasingly targeted towards visually impaired people. Both devices have a zoom feature, a white on black option, and a screen reading feature that are easily controlled with your fingers by touching the screen. They also have special features for those with hearing impairments. Most computers also come with special features for visually impaired people, and the Apple Computer models are particularly comprehensive and easy to use.

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