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Volume 14, Number 18

17 June 2009

• AMD marker may revolutionize diagnosis and prevention
• FDA approves capsular tension ring
• Phase II study on low-dose bromfenac for dry eye shows positive results
• ASORN, Local Eye Site announce partnership
• Children with intermittent eye deviation more likely to develop mental illness
• Estimates suggest 4% of older men have dry eye disease
• AAO promotes 'UV Safety Awareness Month'

AMD marker may revolutionize diagnosis and prevention

A team of researchers led by Jayakrishna Ambati, MD, at the University of Kentucky (Lexington, KY, USA) has discovered a biological marker for neovascular age-related macular degeneration (AMD), the leading cause of blindness in older adults, according to a recent press release from the University of Kentucky. The marker, a receptor known as CCR3, has shown potential for both the early detection and preventive treatment of AMD. The results were reported in an article published online in Nature on 14 June. "This is a major paradigm shift in macular degeneration research," said Dr. Ambati, a professor of physiology, professor and vice-chair of ophthalmology and visual sciences, and the Dr. E. Vernon and Eloise C. Smith Endowed Chair in Macular Degeneration at the UK College of Medicine. "With CCR3, we have for the first time found a unique molecular signature for the disease. This brings us closer than we have ever been to developing a clinical diagnostic tool to discover and treat the disease early, before vision is lost." Researchers in the Ambati laboratory discovered that CCR3—a molecule also implicated in inflammatory processes—is expressed on the surface of CNV vessels in humans but is absent from normal vascular tissue. "CCR3 chemokine receptor is known to be a key player in the allergic inflammation process, but Dr. Ambati's studies have now identified CCR3 as a key marker of the CNV process involved in AMD. If researchers can determine why CCR3 is expressed in the CNV of AMD patients, they could further understand AMD disease progression," said Grace L. Shen, PhD, director of the ocular immunology and inflammation program at the National Eye Institute.

FDA approves capsular tension ring

The Henderson Capsular Tension Ring (FCI Ophthalmics, Marshfield Hills, MA, USA) has been granted regulatory approval by the US Food and Drug Administration (FDA).
The Henderson Ring is a special design of the popular capsular tension rings (CTRs) manufactured by Morcher (Stuttgart, Germany). The Henderson Ring is an open C-shaped loop made of a single piece of polymethyl methacrylate (PMMA). Like standard capsular tension rings, the Henderson stabilizes the capsular bag before, during and after cataract surgery. The Henderson Ring features eight equally spaced indentations spanning the circumference of the ring creating a sinusoidal shape, FCI said. The main advantage of this ring is that the new indentations allow for easier nuclear and cortical material removal while still maintaining the desired stretch of the capsular bag. The Henderson Ring was designed by Bonnie Henderson, MD (Ophthalmic Consultants of Boston, MA, USA).

Phase II study on low-dose bromfenac for dry eye shows positive results

A proof-of-concept Phase II study of a low-dose formulation of bromfenac for the treatment of keratoconjunctivitis sicca has shown "positive results", developer Ista Pharmaceuticals, Inc. (Irvine, CA, USA) said in a press release. The study achieved statistical significance in the primary endpoint of the objective sign of conjunctival staining (lissamine green test) as compared with baseline. The study also achieved statistical significance on the objective sign of corneal staining (fluorescein test) as compared with baseline. Patients also achieved statistically significant improvements in subjective symptoms measured by the Ocular Surface Disease Index (OSDI) and improvement in patients' most bothersome ocular symptoms, Ista said. The study enrolled 38 patients who exhibited signs and symptoms consistent with moderate dry eye disease. All patients received low-dose bromfenac bilaterally twice a day for 42 days. Patient baseline scores were recorded prior to the first treatment with low-dose bromfenac and were compared with baseline at Day 14, Day 42 and Day 52. Results revealed statistical significance for low-dose bromfenac vs. the patients' baseline scores starting as early as Day 14 and sustained through Day 52, 10 days post-treatment. Adverse events were uncommon, and there were no serious ocular or systemic adverse events, according to Ista.

ASORN, Local Eye Site announce partnership

The American Society of Ophthalmic Registered Nurses (ASORN) and Local Eye Site (LES) will work together "in a collaborative effort to raise the awareness of their organizations while continuing to provide unparalleled support to eye care professionals and foster excellence in patient care," according to a news release. "Our collaboration with Local Eye Site is an exciting opportunity to share ASORN's mission of advancing education for the ophthalmic team," said Eileen Beltramba, RN, president of ASORN. "By partnering with Local Eye Site, we can share educational resources and provide our members with additional tools to help in their workplace." ASORN was founded to foster excellence in ophthalmic patient care while supporting ophthalmic teams through individual development, education and evidence-based practice. LES helps eye care practices around the country raise their online awareness, recruit qualified talent year-round and improve patient care through its model of leveraging online communication and two-way job recruitment process.

Children with intermittent eye deviation more likely to develop mental illness

Children, especially boys, diagnosed with intermittent exotropia appear more likely to develop mental illness by young adulthood than children without strabismus, according to a news release from Archives of Ophthalmology. "Intermittent exotropia occurs in approximately 1% of developmentally healthy children in the United States and, given its predominance over esodeviations among Asian populations, it may be the most prevalent form of strabismus worldwide," the authors said. Jeff A. McKenzie, BA, and colleagues at Mayo Clinic, Rochester, MN, USA, analyzed the medical records of 183 children younger than 19 in Olmsted County, MN, USA, who were diagnosed with intermittent exotropia between 1975 and 1994. For each patient, the researchers identified one control child who was the same age but did not have a diagnosis of any type of strabismus. Both groups were followed to an average age of 22. During the 20-year study period, 97 of the children with intermittent exotropia (53%) were diagnosed with a mental health disorder, compared with 55 controls (30.1%)—meaning that patients with the condition had an increased risk of developing a psychiatric illness. Mental health disorders were diagnosed in 63% of boys (41 of 65) and 47% of girls (56 of 118) with intermittent exotropia, compared with 33% of boys (22 of 66) and 28% of girls (33 of 117) in the control group. "Additionally, males with intermittent exotropia had a greater use of psychotropic medication, psychiatric emergency department visits, psychiatric hospital admissions, suicide attempts and suicidal ideation than controls, and females with intermittent exotropia had more suicidal ideation than controls," the authors wrote. They added that further research will still be necessary to determine if interventions for intermittent exotropia can decrease or alter the future development of mental illness.

Estimates suggest 4% of older men have dry eye disease

A large cohort study of men has estimated the prevalence of dry eye disease in men to be around 4%, according to a news release from Brigham and Women's Hospital (BWH), where the research took place. Debra A. Schaumberg, ScD, OD, MPH, and colleagues estimated the prevalence of and examined risk factors for dry eye disease among 25,444 US men who participated in the Physicians' Health Study I and II. The men were asked if they had ever been diagnosed with dry eye disease and also whether they had symptoms, including dry or irritated eyes. Overall, 765 men (3%) reported being diagnosed with dry eye, 6.8% experienced at least one symptom (dryness or irritation) constantly or often and 2.2% reported both symptoms constantly or often. The total age-standardized prevalence of dry eye disease among men 50 and older was estimated to be 4.34%. Men 75 years and older were more likely to have the condition—prevalence increased from 3.9% among men age 50 to 54 to 7.7% among men age 80 and older. High blood pressure, benign prostatic hyperplasia and the use of medications to treat depression, hypertension or hyperplasia were also associated with an increased risk of dry eye disease.
"The present study estimates that approximately 1.68 million men 50 years and older are affected with dry eye disease in the United States," the authors wrote. "There is a predicted growth to 2.79 million US men affected by dry eye disease in 2030." The research, published in the Archives of Ophthalmology, was supported by National Institutes of Health grants and the Joint Clinical Research Center, Massachusetts Eye and Ear Infirmary and Schepens Eye Research Institute, Boston, MA, USA.

AAO promotes 'UV Safety Awareness Month'

The American Academy of Ophthalmology (AAO; San Francisco, CA, USA) has dedicated June to UV (ultraviolet light) Safety Awareness Month and through its EyeSmart campaign is reminding Americans of the importance of protecting the eye from the sun's harmful rays, according to a statement from AAO. The group also wants to remind the public of the importance of protecting eyes from indoor UV light when using tanning beds.
"Tanning beds can produce UV levels up to 100 times what you would get from the sun, which can cause very serious damage to the external and internal structures of the eye and eyelids," said Michael Kutryb, MD, ophthalmologist in Edgewater, FL, USA, and clinical correspondent for the AAO. "Corneal burns, cataracts and, in rare instances, retinal damage can occur." It is critical that people wear the properly designed goggles for use in tanning booths to protect their eyes.

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