Genetics And Lifestyle Interact To Increase Risk For Age-Related Blindness

The interplay between genetic predisposition and exposure to modifiable risk factors can multiply the risk for age-related macular degeneration, according to a report in the January issue of Archives of Ophthalmology, one of the JAMA/Archives journals.



Age-related macular degeneration (AMD) can cause blindness and is known to have both genetic and environmental risk factors, according to background information in the article. Researchers have previously found that a mutation in the gene for complement factor H (CFH) is associated with AMD, as is a mutation in the gene LOC387715. Because these mutations are common in the white population, it is likely that other factors--such as obesity and smoking--may modify the risk for AMD. "Elucidation of these modifying factors may increase understanding of disease pathogenesis and suggest lifestyle changes that may prevent AMD or delay the disease onset in carriers of predisposing genetic variants," the authors write.



Debra A. Schaumberg, Sc.D., O.D., M.P.H., of Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues compared 457 men and women with AMD (cases) to 1,071 controls who were the same age and sex as the cases but did not have AMD. All of the individuals were part of either the Nurses' Health Study, a large examination of female registered nurses who were between the ages of 30 and 55 years in 1976, or the Health Professionals Follow-up Study, which includes male U.S. health care professionals who were ages 40 to 75 in 1986. The participants were examined when they enrolled in the studies and completed a follow-up questionnaire every two years; average age at AMD diagnosis was 68.7 years.



Blood samples were also collected for a genetic analysis. Information about CFH was available for 437 AMD cases and 1,015 controls, while information about LOC387715 was available for 445 AMD cases and 1,041 controls. Compared with those who had two normal copies of each gene (alleles), those who had two mutated alleles of both genes were 50 times more likely to develop AMD.



Individuals who carried two mutant alleles of the CFH gene and were not obese were four times as likely as non-obese individuals with two normal alleles to develop AMD. If those individuals also smoked, their risk was 8.69 times as great as non-smoking non-carriers. If individuals were obese and carried two mutant alleles of the CFH gene, their risk increased 12 times as compared with non-obese non-carriers. For LOC387715, risk increased by 6.33 times for those with two mutated alleles who did not smoke and 22.47 times for those with two mutated alleles who did smoke. The genetic risk factors were not affected by other risk factors associated with AMD, including regular aspirin use, fruit intake, fatty acid ratios or alcohol consumption.



Because these genetic mutations are so common, some have questioned the utility of widespread screening for AMD risk, the authors write. "The existence of interactions with modifiable lifestyle factors may provide further impetus for screening individuals who are at potentially greater risk [for AMD], for example, cigarette smokers or the obese," they continue. "Knowledge of the substantial risk of AMD among individuals homozygous for either or both of these major AMD-associated variants might help motivate these individuals to stop smoking, lose weight, modify other risk factors and have regular eye examinations."

NanoViricides, Inc. Eye Drug Testing Has Begun

NanoViricides, Inc. (OTC BB: NNVC.OB) (the "Company"), reported today that testing of its topical eye drops drug candidate has begun at two different, independent facilities.


Testing of this broad-spectrum, topical, eye drug candidate by a major pharmaceutical company ("Party") is now in progress. The Company had previously announced in March that it had signed a Material Transfer Agreement with this Party. In addition, the Company is also evaluating this drug candidate against herpes keratitis of the eye at Thevac, LLC, a spin-off of the Louisiana State University (Study Director, K. G. Kousoulas, PhD).


The testing at the two facilities will independently evaluate performance of this drug candidate against several types and strains of many different viruses that cause keratitis or conjunctivitis of the eye. Cell culture studies as well as animal studies with different animal models have been planned.


"Execution of the material transfer agreement (MTA) is a step towards a potential licensing agreement," said Eugene Seymour, MD, MPH, CEO of Nanoviricides, Inc. The terms of the agreement do not allow the disclosure of the identity of the Party or the exact terms of the MTA.


HSV and some adenoviruses cause most of the cases of keratitis, a serious infection of the cornea. Importantly, HSV infection can lead to corneal scarring that may necessitate corneal transplantation. In addition, some adenoviruses cause a majority of conjunctivitis cases ("pink eye"). The remaining cases of conjunctivitis, caused by bacteria, are treatable with topical antibiotics. Currently, there are no effective treatments for viral diseases of the exterior portion of the eye.


The Company has already demonstrated strong efficacy against an adenovirus-caused external eye disease called epidemic kerato-conjunctivitis (EKC). Rapid clinical improvement in the treated animals was reported by independent researchers who tested the effects of the nanoviricides drug candidate against adenoviral EKC. Based on computer modeling, the Company believes that the broad-spectrum nature of the ligand used in this nanoviricide should enable it to be effective against HSV.


The total market for all forms of viral conjunctivitis/keratitis is estimated to be in the billions of dollars. The incidence of severe herpes (HSV) keratitis is estimated to be 250,000 cases per year in the USA. In Japan, where EKC is a reportable disease, it is estimated that there are at least one million cases per year. The number of cases of non-specific conjunctivitis (pink eye) is considered to be far greater, possibly into tens of millions in the US, and into hundreds of millions worldwide.

Source

NanoViricides

Genetic Modifier In Usher Syndrome Will Lead To Better Diagnosis

Usher syndrome (USH), an inherited condition involving both hearing and vision loss, is not a simply recessively inherited disease, a scientist told the annual conference of the European Society of Human Genetics (Saturday 12th June). Dr. Hanno Bolz, Associate Medical Director of the Bioscientia Centre for Human Genetics, Ingelheim, Germany, and active in teaching and research at the University Hospital of Cologne, will say that his team's research challenges the traditional view that USH was inherited as a single gene disorder, and shows that it may result from at least two different genetic mutations. This could lead to more accurate diagnosis of this condition, which is responsible for up to 10% of all cases of childhood deafness and 50% of all deaf/blindness in adults.



Some USH patients have only one mutant copy of an Usher gene, which in itself is insufficient to explain a recessive disease, and there is often an unexplained variability of the visual characteristics of the condition, even between close family members. Dr. Bolz's team, including scientists from Cologne University, Germany and zebrafish researchers from the University of Oregon, USA, decided to look for additional USH genes and genetic modifiers that could be involved in disease causation.



"We became interested in researching sensory diseases such as Usher syndrome because they can be very debilitating and affect people at a young age", said Dr. Bolz. "Despite extensive research into USH, there is currently no effective treatment for it."



Apart from linkage studies of recessive disease, where a particular trait or disease characteristic is traced within a family, another way of identifying genes linked to disease is to analyse genes that encode proteins which are similar to the proteins involved in the disorder being studied. Using a genome-wide database search, the team identified a gene, PDZD7, which encoded a protein with striking similarity to the proteins whirlin and harmonin, both known to be involved in USH.



"We found that some patients with only a single mutation of the gene responsible for the condition, GRP98, also had a mutant copy of PDZD7, and that this gene interacts with proteins involved in USH", said Dr. Bolz. "We were able to validate these findings in transgenic zebrafish, and to show that PDZD7 localises to cilia, thus providing further confirmation that USH is a retinal ciliopathy."



Cilia are antenna-like protuberances that project from cells and are often involved in sensory activity such as vision, hearing or smell. Genetic mutations can affect their proper functioning, and these defects in turn affect critical signalling pathways essential to cell development. As a result, cilia defects are involved in many diseases which produce multiple symptoms.



Diagnosis of USH is complicated, the scientists say. At present it is normally related to clinical symptoms, such as childhood hearing impairment and the vision disease retinitis pigmentosa in the first or second decade of life. Retinitis pigmentosa affects the layer of light-sensitive tissue in the retina and vision loss occurs as the light-sensing cells gradually deteriorate, causing blind spots which eventually merge to produce tunnel vision and sometimes total blindness.



"When hearing and visual loss are both present, the most likely diagnosis is Usher syndrome", said Dr. Bolz. "More precise genetic diagnosis is essential, but the genes are large and not easily accessible to genetic testing. However, by considering clinical data of the patient and the background of his/her family - ethnicity, for example - one can apply efficient testing strategies. For the parents of a deaf child, it would be advantageous to be aware of the retinal degeneration that will occur later on.



"Research on new Usher genes must therefore be translated quickly into genetic testing in order to aid parents to choose appropriate therapies to diminish the later consequences of the disease," he said. The decision to opt for a cochlear implant, for example, could be influenced by the knowledge as to whether the causative mutation is in a gene for isolated deafness or in a USH gene.



"We believe that our work may serve as a paradigm for the future", said Dr. Bolz. "In many recessive diseases, variability of disease characteristics is the rule rather than the exception, and in most cases this phenomenon is unexplained. With advances in new sequencing techniques that permit simultaneous analysis of several genes, we will need to interpret variants in all Usher genes in a patient, not only in one. Two hits in a single Usher gene may explain the disease in a patient, but not its variability. Our research is a step on the road to understanding that variability and to being able to provide an accurate prognosis of disease progression."



Source:

Mary Rice

European Society of Human Genetics

Inhaled And Oral Steroid Use Impacts Cataract Risk

A study conducted by the Centre for Vision Research, University of
Sydney, Australia, examines how steroid (corticosteroid) use relates
to risks for cataract,b the clouding of the eye's lens that leads to
reduced vision and blindness, if untreated.


Many people with asthma
rely on inhaled, and sometimes oral, steroids, as do people with
chronic obstructive pulmonary disease (COPD). This population-based
study, a cohort of the Blue Mountains Eye Study, followed 3,654
Australians, aged 49 years or older, five and 10 years after initial
(baseline) examinations conducted between 1992 and 1994. This
timeframe was needed to assess the long-term impact of steroid use on
cataracts, which develop slowly over years. Based on their findings,
the researchers suggest that more judicious prescription of combined
inhaled and oral steroids may decrease cataract risk for asthma
patients.



"Our findings could mean that combined steroid use, when it results
in high cumulative dosage over relatively long periods, increases
risks for two types of cataract," said lead researcher, Jie Jin Wang,
MMed, PhD, Centre for Vision Research. "When clinicians prescribe
both steroid forms, the cumulative, combined dose should be
considered. Also, recent clinical trials indicate that combined
steroids are not more effective than inhaled steroids alone in
treating asthma." He added that further investigation is needed to
determine whether asthma plays a role in nuclear cataract
development.



Elevated cataract risks were found only in patients who, at the time
of their baseline exams, had ever used inhaled steroids, had also used
oral steroids for at least one month, and had no cataracts. Patients
at highest risk for two types of cataract were those defined at
baseline as "current users" of both steroid forms; although this was
a small group, follow up exams found that nearly all of them
developed cataracts. Of seven current user patients, five had used
either steroid form for more than five years, and four of the five
developed posterior subcapsular cataract (PSC). Three additional
current user patients developed nuclear cataracts. In nuclear
cataracts the center of the lens is obscured, and in PSC the cataract
develops in the rear area of the lens. Earlier research had
established a higher risk for PSC in oral steroids users.


April 2009 Issue of Ophthalmology.


About the American Academy of Ophthalmology



AAO is the world's largest association of eye physicians and surgeons
-- Eye M.D.s -- with more than 27,000 members worldwide. Eye health
care is provided by the three "O's" -- opticians, optometrists and
ophthalmologists. It is the ophthalmologist, or Eye M.D., who can
treat it all: eye diseases and injuries, and perform eye surgery.

Source
American Academy of Ophthalmology

Prospects Grow For Blindness Recovery, Australia

Prospects for recovery of lost vision have brightened with the release of new scientific findings showing that the use of gentle near infra-red light can reverse damage caused by exposure to bright light, up to a month after treatment.


The Vision Centre's Dr Krisztina Valter and doctoral researcher Rizalyn Albarracin have successfully demonstrated recovery of vision cells in the retina following near infra-red treatment applied after damage was sustained.


Their advance has raised hopes for the development of a practical, low-cost and painless treatment for damaged eyes - including for patients suffering from dry macular degeneration (dry AMD), now the most common cause of blindness in developed countries.


The finding, made using an animal model, builds on the evidence the team has established showing that pre-treatment of eyes with near infra-red can help to minimise damage caused by bright light and enhance recovery.


"Macular degeneration is responsible for around a half of the cases of blindness in Australia. The dry form, for which there is still no cure, accounts for 80-90 per cent of cases," says Dr Valter, of The Vision Centre and Australian National University. "Our research shows clear evidence of recovery of vision cells from light damage, a good model for what happens in dry AMD."


"Given the very high costs of blindness to any economy, it is encouraging to know that there is a simple, affordable technology in prospect which could help to reduce it."


Ms Albarracin said that treating the retina with just a few minutes exposure to soft near-infra-red light a day for less than a week had produced a remarkable recovery in damaged photoreceptors (vision cells) which ordinarily would have died.


"You only have one set of vision cells, so if you lose them they can never be replaced. When they are damaged or stressed, they shut down and gradually die or kill themselves. You get a horrible 'hot spot' of dying cells in your retina, which gradually spreads out in a sort of domino effect until your vision is gone," she explains.


"We have found that treating the cells before, during or even after light damage raises their protective factors and resistance to stress, and slowly allows their vision function to return. The retina looks really sick - but then it just bounces back. It's almost a kind of a resurrection."


Since only a few people know in advance they may suffer vision damage from bright light and can be pre-treated, knowing that near infra-red treatment soon after injury also causes the cells to heal well is an important step towards developing a practical therapy for people who are losing their sight either from injury or slow-onset conditions.


The technique could potentially be used to treat a wide range of forms of vision loss, including dry AMD, retinitis pigmentosa, inflammation of the retina and some diseases of the optic nerve, the researchers say.


"We're using an array of small LEDs (light emitting diodes) that have been tuned to produce near infra-red light at a particular wavelength. These are fairly cheap, making a potential treatment very affordable - especially when you consider the overall costs of blindness," Dr Valter says.


She says that the evidence yielded by the latest research is now so persuasive that the team could move to human trials this year, if they can secure a clinical partner.


"Near infra-red therapy is very benign and involves no discomfort to the patient. It is already approved by the US Food and Drug Administration for use in sports medicine, for hair loss and so on - so developing a novel therapeutic application for the eyes is likely to be less complex and protracted than, say, developing a new drug," she adds.


Their paper "Photobiomodulation protects the retina from light-induced photoreceptor degeration," by Rizalyn Albarracin, Janis Eells and Krisztina Valter appears in the latest issue of the journal Investigative Ophthalmology and Vision Science


The Vision Centre is funded by the Australian Research Council as the ARC Centre of Excellence in Vision Science.


Source:

The Vision Centre

Australian First To Save Sight

A new system of storing eye tissue, to be launched on Tuesday 14 February at the Lions Corneal Donation Service (LCDS), will help save the sight of hundreds of Victorians a year by extending the time between donation and needing to perform the transplant.



Thanks to the new facilities, LCDS can now store corneas at human body temperature levels (34C) for up to a whole month. Previously, corneas were held at low temperatures and had to be transplanted within one week of the donation.



Dr Graeme Pollock, Director of the Lions Corneal Donation Service, said no other corneal donation facility in Australia offered this kind of service.



"Our ability to store the corneas for longer means reduced surgery postponements and waiting time for people living with vision loss," Dr Pollock said.



Corneal recipient Dorothy O'Kane, 61, welcomed the news after initially missing an opportunity for a corneal transplant when she was on holiday in South Australia.



"If this system had been in place at that time I could have come back and the cornea would have still been there for me," Mrs O'Kane said.



Mrs O'Kane, who eventually underwent a transplant in July 2005, said the improvement in her sight was remarkable, enabling her to enjoy life to the full.



"I can even see the freckles on my grandson's nose."



The new system is being launched in the lead up to Organ Donor Awareness Week to encourage people to consider corneal donation to save the sight of others.



The Lions Corneal Donation Service will be officially opened with a press conference at 10.15am on Tuesday 14 February 2006, 7th Floor Smorgan Family Wing, The Royal Victorian Eye and Ear Hospital, 32 Gisborne St, East Melbourne (due to renovations please enter via Morrison Place).



Interviews will be available with corneal recipient Dorothy O'Kane (61) and Iola Matthews (62), who is due to undergo her first corneal transplant on Thursday.



There is also an opportunity to film an operation of a corneal transplant at the Eye and Ear hospital on Tuesday following the opening.







The Lions Corneal Donation Service, supported by the Victorian and New South Wales Lions Foundation is a division of the Centre for Eye Research Australia is housed at The Royal Victorian Eye and Ear Hospital in East Melbourne.



If you want to donate your corneas you must tell your family and register on the organ donor register. For information on donating your corneas please contact Graeme Pollock on +61 399 298 709. We urge Australia to consider giving the gift of sight and donate your corneas.



Contact: Romy Johnston

romyjunimelb.edu.au

EYE RESEARCH AUSTRALIA FOUNDATION

2009 President's Award Presented To Rohit Varma, MD

In ceremonies on January 28 at the legendary Palace Hotel in San Francisco, Glaucoma Research Foundation President and CEO Thomas M. Brunner presented The President's Award to Rohit Varma, MD. Dr. Varma is Professor of Ophthalmology and Preventive Medicine, and Director of the Glaucoma Service at the USC Keck School of Medicine.


The Glaucoma Research Foundation President's Award acknowledges exemplary volunteer leadership. Dr. Varma's recent Los Angeles Latino Eye Study (LALES), confirming that Latinos are among the highest at risk for glaucoma, is widely regarded as the definitive research on this subject. Inspired by Dr. Varma's urgent call to action, and with funding from Allergan, the Glaucoma Research Foundation last year hosted Ver Es Poder (Seeing is Empowering), a Glaucoma Awareness Day at the Delhi Center in Santa Ana. More than 200 people, including families and people of every age, lined up to hear the opening ceremony and participate in a comprehensive glaucoma screening. By the end of the day, more than 350 people had participated.


Dr. Varma's personal leadership in Ver Es Poder - giving previews of his research findings to community groups, mobilizing several Spanish-speaking physicians in his team at Doheny Eye Institute to volunteer their time in the screenings - set the highest example. His generosity of spirit not only inspired others to make glaucoma awareness a personal priority, but also showed that an entire community could rally around that cause.

Glaucoma Research Foundation

Cornea Cell Density Predictive Of Graft Failure Post Transplant

A new predictor of cornea transplant success has been identified by the Cornea Donor Study (CDS) Investigator Group. New analysis of data from the 2008 Specular Microscopy Ancillary Study (SMAS), a subset of the CDS, found that the preoperative donor cell count of endothelial cells, previously considered to be an important predictor of a successful transplant, did not correlate with graft success. Instead the study found that a patient's endothelial cell count six months post-cornea transplant is a better indicator of subsequent failure of the graft rather than the donor's cell count. These results offer an additional, reliable indicator of success that surgeons can use for monitoring patients at the six-month milestone after transplantation.


Endothelial cells form the back layer of the cornea and keep the cornea clear and prevent it from swelling. Previously it was thought that the more endothelial cells/mm2 in the donor cornea, the better, which put pressure on the eye banks to have donors with the highest count possible to distribute to corneal surgeons. However, the SMAS findings show no correlation between it and a patient's graft success rate five-years post transplant, as long as the industry standard minimum of 2,000 cells/mm2 was met. The results of this study are published in the January issue of the Archives of Ophthalmology.


"These new findings of the SMAS are excellent examples of evidence-based medicine impacting clinical practice," says Jonathan H. Lass, M.D., senior author of the study and Professor and Chair of the Department of Ophthalmology and Visual Sciences at Case Western Reserve University School of Medicine and University Hospitals Case Medical Center. "This evidence offers surgeons a broader pool of donors for their patients and will allow more individuals to donate to eye banks." The results were analyzed at the Specular Microscopy Reading Center, part of the Department of Ophthalmology and Visual Sciences at Case Western Reserve University and the University Hospitals Eye Institute.


Conceived in 1998, the CDS is a prospective cohort study that has already reported: 1) The age of the donor does not impact transplant survival after five years for conditions with moderate risk for graft failure due to endothelial dysfunction (Fuchs' dystrophy, pseudophakic/aphakic corneal edema) (Ophthalmology 2008); 2) Incompatibility of blood type between the donor and recipient also does not impact graft survival at five years (Am J Ophthalmology 2009); and 3) There was a trend toward greater endothelial cell loss (75%) in the older donor age group (over 65 years to 75 years of age) than the younger donor age group (under 65 years) (69%), but this difference did not impact graft survival at five years (Ophthalmology 2008. This NIH-funded study has been extended through 2012 in order to determine whether these findings persist for a total of ten years post-transplant.















"The more than 100 physicians and researchers involved in the Cornea Donor Study have been leading the effort to identify factors that will keep donated corneas clearer for longer," says Roy W. Beck, M.D., Ph.D., the principal investigator of the Cornea Donor Study Investigator Group and Executive Director of the Jaeb Center for Health Research in Tampa, Florida.


Additional support for CDS was provided by: Eye Bank Association of America, Bausch & Lomb, Inc., Tissue Banks International, Vision Share, Inc., San Diego Eye Bank, The Cornea Society, Katena Products, Inc., ViroMed Laboratories, Inc., Midwest Eye-Banks (Michigan Eye-Bank, Illinois Eye-Bank), Konan Medical Corporation, Eye Bank for Sight Restoration, SightLife, Sight Society of Northeastern New York (Lions Eye Bank of Albany), and Lions Eye Bank of Oregon.


About Case Western Reserve University School of Medicine


Founded in 1843, Case Western Reserve University School of Medicine is the largest medical research institution in Ohio and is among the nation's top medical schools for research funding from the National Institutes of Health. The School of Medicine is recognized throughout the international medical community for outstanding achievements in teaching. The School's innovative and pioneering Western Reserve2 curriculum interweaves four themes--research and scholarship, clinical mastery, leadership, and civic professionalism--to prepare students for the practice of evidence-based medicine in the rapidly changing health care environment of the 21st century. Eleven Nobel Laureates have been affiliated with the school.


Annually, the School of Medicine trains more than 800 M.D. and M.D./Ph.D. students and ranks in the top 25 among U.S. research-oriented medical schools as designated by U.S. News &World Report "Guide to Graduate Education."


The School of Medicine's primary affiliate is University Hospitals Case Medical Center and is additionally affiliated with MetroHealth Medical Center, the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, and the Cleveland Clinic, with which it established the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in 2002.


Source: Case Western Reserve University

U.S. Department Of Defense Supports Study Of Brain, Eye Injuries In Military Personnel

The Virginia Tech-Wake Forest University Center for Injury Biomechanics has been awarded a $2.8 million contract from the U.S. Army Medical Research and Materiel Command for phase 2 of an overall project focusing on brain and eye injuries in military personnel.
Specifically, blast induced brain trauma will be investigated using experimental and computational models. Given improvements in helmet design and body armor and the resulting reductions in penetrating injuries, including penetrating head trauma, blast-related closed head injuries have become the signature injury of most military operations.


Stefan Duma from Virginia Tech and Joel Stitzel Jr. from Wake Forest University are principal investigators on the project. Co-principal investigators are Warren Hardy, associate professor of mechanical engineering, and H. Clay Gabler, associate professor of biomedical engineering, both in the College of Engineering at Virginia Tech. "By combining the excellent faculty and capabilities at Virginia Tech and Wake Forest University, we were able to successfully compete for this funding. The Virginia Tech Transportation Institute provided the talent and resources to integrate these programs and succeed in a highly competitive funding arena," said Duma, who is professor and head of the Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences. The program will also involve new partnerships at the Radford Army Ammunition Plant, Duma said.
Design changes to the High Mobility Multipurpose Wheeled Vehicle, such as additional ballistic armor, have lead to a severe increase in rollover accidents. Specifically, rollover accidents account for 42 percent of accidents with these vehicles and over 70 percent of all fatalities suffered in these vehicles in Iraq. Performing research on the vehicle safety aspects in the military is a logical extension of the Virginia Tech Transportation Institute's current research projects.


Institute Director Tom Dingus said, "We are continuing to expand our research in the field of military personnel safety. This phase 2 award will move us even further toward determining the causes of brain and eye injuries in military personnel thereby allowing us to then development safety mechanisms for the soldiers and transport vehicles."


Stitzel, associate professor of biomedical engineering and program leader of the Virginia Tech-Wake Forest University Center for Injury Biomechanics, will lead the activities at the Wake Forest University part of the center. His team has experience developing computer models of the human body for injury prediction and studying injuries that occur in real-world scenarios. They will perform computational modeling of blast, brain, and eye injury. They will also help with development of physical surrogates to measure blast loading on the human face and head for integrating experimental and computer modeling results. "With current prototyping technologies and our experience with development of three dimensional models of human anatomy, we are positioned to do the right kinds of research to really understand this important problem," said Stitzel.















The United States military is faced with a number of significant biomechanical questions for the nearly 3 million active duty and reserve personnel who fight in this nation's conflicts. Head (brain, eye, and facial fracture), neck, and chest injuries are an ever present risk of military duty. Injuries to the head, neck, and chest can be seriously debilitating or fatal and dramatically reduce the combat effectiveness of the American soldier.


Six Virginia Tech institutes support research and creative scholarship in strategically important areas, drawing upon the university's established strengths. The Virginia Tech Carilion School of Medicine and Research Institute, the Virginia Tech Transportation Institute, and the Virginia Bioinformatics Institute. focus on national research priorities, including translational health and medical research, national security, and safe infrastructure. The Institute for Critical Technology and Applied Science, Fralin Life Science Institute, and the Institute for Society, Culture, and Environment provide additional resources to develop opportunities at the intersection of engineering, science, and medicine; target infectious disease; and advance human development and the arts.


Related Links


* Virginia Tech Transportation Institute, Center for Injury Biomechanics receive $1.5 million for research

* Center for Injury Biomechanics announces $3 million award

Source:

Virginia Tech

Black Glaucoma Patients Have An Increased Risk Of Cardiovascular Disease Death, Study Finds

Blacks who have been diagnosed and treated for glaucoma have an increased risk of death from cardiovascular disease, particularly those who receive certain eye drops for treatment of open-angle glaucoma, according to a study published in the March issue of Archives of Ophthalmology, Reuters reports. Open-angle glaucoma is the most common type of the disease and the leading cause of blindness in populations of African origin, according to study author Suh-Yuh Wu of Stony Brook University.

For the study, Wu and colleagues examined the long-term mortality rates of 4,092 blacks in Barbados who received eye exams between 1987 and 1992 as part of the Barbados Eye Studies. Researchers noted that more than 90% of Barbados residents are black, with long life expectancies and free access to health care.

At the start of the study, 300 participants were diagnosed with glaucoma, 141 of whom had received treatment. Researchers observed the participants over a nine-year period and found that 19%, or 764 participants, had died by the end of the study. There was no association between glaucoma and overall risk of death. However, participants who were previously diagnosed or treated for open-angle glaucoma had a 38% higher risk of dying from cardiovascular disease, and participants treated with timolol eye drops had a 91% higher risk of dying from cardiovascular disease. Participants with ocular hypertension at the beginning of the study had a 28% higher risk of dying from cardiovascular disease.

The authors noted in the study, "One explanation for the excess mortality found in persons with previously diagnosed open-angle glaucoma could be their longer duration of disease compared with those with newly diagnosed disease." They added, "Another explanation for an increased mortality risk could be related to the open-angle glaucoma treatment received." Researchers concluded that further investigation is needed to determine the effects glaucoma treatments have on mortality (Reuters, 3/10).


An abstract of the study is available online.


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

New Point Of View On Melanoma Of The Eye: HSP90

Ocular melanoma is rarely detected before it has grown large enough to impair vision or to metastasize. This makes it a particularly challenging disease to fight, especially since chemotherapy is not very effective.



Now, the PhD research project led by Dr. Dana Faingold may open the door for very promising new treatment options for this pathology. Her first article was featured on the cover of the February 2008 issue of Clinical Cancer Research.



"The first step in developing a medication is to determine the precise target of action," explained Dana Faingold. "In this study, we have shown that to effectively fight this malignant tumour in the vascular network of the eye, we had to target Heat Shock Protein 90 (HSP90)."



HSP90 is already a therapeutic target in many other types of cancer. In fact, this protein, which is called a "chaperone" because it guides the actions of other proteins, is at the centre of many metabolic pathways. By disrupting HSP90's functioning, it is possible to affect multiple steps in cell metabolism, for example, signalling pathways, cell cycle regulation pathways, or growth hormone receptors. This blocks many vital cellular functions, so the cancer cells become unable to reproduce and the tumour regresses.



Clinical trials are currently being conducted to determine the effectiveness of an antibiotic called 17/AAG, an HSP90 inhibitor, against malignant tumours of the skin, breast and in patients with multiple cancers. However, no one has yet studied this inhibitor's effect on ocular melanoma. "This is a pre-clinical study, which means we are examining in-vitro cell lines. Our results clearly prove not only that HSP90 is largely overexpressed in this type of tumour but also that the 17/AAG molecule is effective at reducing the growth of these tumoral cells," said Dana Faingold.



Several clinical trial stages will have to be completed before 17/AAG can be recognized as a possible treatment for melanoma of the eye. The first stage, which should begin shortly, aims at proving the effectiveness of the molecule in an animal model. This in vivo confirmation is necessary before testing for human treatment can begin.







Dana Faingold is a doctoral student in the Henry C. Witelson Ocular Pathology Laboratory of the Research Institute of the McGill University Health Centre.



This study was funded through a Henry R. Shibata Fellowship Grant from the Cedars Cancer Institute.



The Research Institute of the McGill University Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, a university health center affiliated with the Faculty of Medicine at McGill University. The institute supports over 500 researchers, nearly 1000 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge. For further details visit: muhc/research.



Source: Isabelle Kling


McGill University Health Centre

Operation Eyesight Calls For Canada To Be A Leader In Eye Health Care

Operation Eyesight Universal, a Canada-based international non-governmental organization dedicated to eliminating avoidable blindness, supports Vision2020 Canada's call for a national vision health strategy.


"Canada can be a world leader by not only having our own national vision health plan, but by encouraging developing countries to ensure that eye care is part of their national health policy," says Pat Ferguson, president and CEO of Operation Eyesight. "Avoidable blindness is a global issue. By bringing it to the attention of donor countries like Canada, we can help eliminate avoidable blindness in developing countries, where 90 percent of the world's visually impaired people live."


About 284 million people worldwide are visually impaired: 39 million are blind and 245 million have low vision.


Vision2020 Canada chair John M. Rafferty urged party leaders last Friday to make vision health a priority in Canada's current election.


Operation Eyesight has worked to eliminate avoidable blindness for almost 50 years. It currently operates in India and the African countries of Ghana, Kenya, Rwanda and Zambia-places where blindness can be deadly, especially to those who are young, old or poor. The organization works directly with medical professionals, communities and governments in Africa and India to build their capacity to provide quality eye care and sustainable community development for their own people.


Source:

Operation Eyesight Universal

Why Our Peripheral Vision May Not Be As Random As We Think

As you read this, you may notice that the word directly in front of you is clear, but all the surrounding words are hard to make out. For most people, this effect - known as 'crowding' - is not a problem. However, for the millions of people worldwide who have lost their central vision through eye disease such as macular degeneration, it can make everyday tasks such as reading or recognising friends a challenge.



Despite the fact that crowding affects more than ninety-five per cent of the visual field, we know very little about how it occurs, aside from the fact that it happens not in the eye, but in parts of the brain that deal with seeing. With far fewer neurons processing inputs from the peripheral visual field in these regions compared to our central vision, the brain simplifies these areas to represent more efficiently what is in front of us.



Researchers had previously assumed that crowding makes us worse at recognising things by making our peripheral vision more random. Now, Wellcome Trust-funded researchers at UCL (University College London) and Harvard Medical School have reported in Current Biology that this process is anything but random.



The researchers asked volunteers to look out of the corner of their eye at a small patch of random visual noise (similar to the 'snow' seen when a TV loses its signal). When the patch of noise was surrounded by striped patches all oriented in a particular direction, the volunteers reported the 'noise' to be similarly oriented. The results suggest that crowding is actually a process that makes the world appear more regular by essentially 'blending' nearby objects together.



The researchers have used a real-world example to demonstrate the effect. Taking a photograph depicting a dramatic coastal village in Cinque Terre, Italy, the researchers 'scrambled' a large number of patches throughout the image by swapping individual pixels within each region. However, when one's eyes are fixed on the centre of the corrupted image (for example, on the centrally-located brown house), these 'noise' patches disappear and the image appears relatively undamaged. This image was recently named runner-up in the UCL 'Research Images as Art' competition.



"We believe that this tendency of our brains to assume that the world is regular may have evolved because fewer cells in the brain are devoted to the edges of our vision compared to the centre," explains Dr John Greenwood from the UCL Institute of Ophthalmology. "In other words, the brain is not capable of delivering anything more than a simplified sketch using these resources."



The researchers believe that understanding crowding promises to reveal much about how the visual brain works, and will also reveal the best way to present television images, text and the internet for people with damage to their central vision, for example through eye diseases such as macular degeneration and amblyopia ('lazy eye').



With amblyopia, for example, it has been suggested that crowding in the 'lazy' eye may occur in central vision in addition to the normal crowding in the peripheral visual field. Similarly, in macular degeneration patients lose their central vision and must rely on their peripheral visual field.



"If we understand when crowding does and does not occur, then we could potentially create text and images that are less likely to cause crowding," says Dr Greenwood. "Similarly, if we can understand how things look when they are crowded, we could potentially generate text and images that could be recognised even when crowding has had an effect."



Source:

Craig Brierley

Wellcome Trust

Acquired Childhood Glaucoma More Common Than Congenital Types

Childhood glaucoma may most commonly be caused by trauma, surgery or other acquired or secondary cause, according to a report in the April issue of Archives of Ophthalmology, one of the JAMA/Archives journals. In one Minnesota county, the condition occurred in approximately one per 43,575 residents age 20 and younger.



"Childhood glaucoma is an uncommon pediatric condition often associated with significant visual loss," the authors write as background information in the article. It is categorized into three subtypes: primary glaucoma, including primary congenital glaucoma (present at or soon after birth) and juvenile primary open-angle glaucoma; secondary glaucoma, which includes other syndromes or medical conditions present at birth; and acquired glaucoma, which is the result of other processes not present at birth, including inflammation, drugs, trauma or surgery.



Elisabeth P. Aponte, M.D., and colleagues at Mayo Clinic, Rochester, Minn., reviewed the medical records of all pediatric patients younger than 20 years living in Olmstead County, Minn., who were diagnosed with childhood glaucoma between 1965 and 2004. During this 40-year period, 30 children were diagnosed, for an incidence of 2.29 per 100,000 residents younger than 20 years.



Glaucoma affected both eyes in half of the children, for a total of 45 affected eyes. There were 16 boys and 14 girls, who were diagnosed at an average age of 10.4 years.



Of these cases, 19 (63 percent) were acquired, six (20 percent) were secondary and five (17 percent) were primary. The prevalence of primary congenital glaucoma at birth was 1.46 per 100,000, a rate lower than that reported in the Spanish, British or Australian general population, the authors note. Twenty-four individuals with suspected childhood glaucoma were also identified, for an incidence of 1.9 per 100,000 residents younger than 20.



"This study provides population-based incidence rates for childhood glaucoma diagnosed during a 40-year period," the authors write. "Childhood glaucoma was found in one per 43,575 patients younger than 20 years. The most common type of glaucoma was acquired glaucoma (traumatic, surgical, uveitic or drug-induced), accounting for 63 percent of patients with glaucoma, whereas the secondary and primary forms were less common."



Arch Ophthalmol. 2010;128[4]:478-482.



Source
Archives of Opthalmology

IU Ophthalmologist And Wife Support Conference Room In Glick Eye Institute

The conference room in the Eugene and Marilyn Glick Eye Institute will be named for an IU School of Medicine ophthalmologist and his wife. Daniel Spitzberg, M.D., and his wife, Alana, are supporting the nearly 100-seat conference room on the first floor of the eye institute, scheduled for completion this spring.


"As I have traveled the country, I have had the opportunity to visit many eye institutes," Dr. Spitzberg said. "Now that the Glicks have provided the lead gift for us, I thought it would be a great idea to support the conference room - it's a place where everybody will gather to discuss ophthalmology."


Dr. Spitzberg said the opportunity to honor his alma mater while providing a space to foster education and the exchange of ideas appealed to him and his wife and prompted the support. Always excited by teaching, Dr. Spitzberg said he enjoys the opportunity to teach residents while providing care to his patients. Support for the conference room was a natural way of recognizing the importance of continuing education in a subject he loves, he said.


"Hopefully some great things can come from this," said Mrs. Spitzberg. "So many great ideas will be passed among one another in this room. And the Glicks inspired us to support this and give back to the university."


Dr. Spitzberg is a clinical associate professor of ophthalmology in the Department of Ophthalmology. His bachelor's degree, medical degree and residency all were completed at IU, along with a uveitis fellowship. Dr. Spitzberg maintained a private practice for many years, returning to the university in 2008. He currently sees patients in clinics at University Hospital, Spring Mill Medical Building and in Mooresville.


"When we started talking about this gift, he had just gone back to work at IU," said Mrs. Spitzberg. "He was just so happy. And one of the great things in life is to be able to spend it doing something you love, something that excites and stimulates you, and to be able to enjoy it. He truly enjoys his patients and the opportunity to teach."


Louis B. Cantor, M.D., chairman of the Department of Ophthalmology, said the department is grateful for the Spitzbergs' support of the new eye institute.


"This conference room space is something we will use on a daily basis, as we provide educational opportunities for medical students, residents and fellows, and for our faculty. We are looking forward to moving to the Glick Eye Institute this summer, and having this classroom space will benefit our department for many years to come," Dr. Cantor said.


The Eugene and Marilyn Glick Eye Institute is currently under construction on Michigan Street on the IU School of Medicine campus. The $20 million structure will feature two floors of lab space, allowing department researchers to work in a collaborative environment. The first floor will feature an ophthalmology clinic and an optometry shop. Additional space in the four-story building includes a mock surgery center, a library and offices and meeting rooms for faculty and staff.


The eye institute, designed by RATIO Architects, has been designed to attain silver LEED status (Leadership in Energy and Environmental Design) from the U.S. Green Building Council. It will be the first building on the IUPUI campus to have that environmental status.


The building is scheduled for completion this spring; the official IU dedication will be Aug. 19, 2011.


Source:

IU School of Medicine

Examining Diabetes Through A New Lens

Diabetics may soon be able to wear contact lenses that continuously alert them to variations in their glucose levels by changing colours - replacing the need to routinely draw blood throughout the day.



The non-invasive technology, developed by Chemical and Biochemical Engineering professor Jin Zhang at The University of Western Ontario, uses extremely small nanoparticles embedded into the hydrogel lenses. These engineered nanoparticles react with glucose molecules found in tears, causing a chemical reaction that changes their colour.



Zhang received $216,342 from the Canada Foundation for Innovation (CFI) this morning to further develop technologies using multifunctional nanocomposites.



These technologies have vast potential applications beyond biomedical devices, including for food packaging. For example, nanocomposite films can prevent food spoilage by preventing oxygen, carbon dioxide and moisture from reaching fresh meats and other foods, or by measuring pathogenic contamination; others can make packaging increasingly biodegradable.



Overall, Western was awarded $2,659,595 for 12 projects from the CFI's Leaders Opportunity Fund.



Source: Douglas Keddy


University of Western Ontario

UK Researcher Finds 'switching' Compound For Angiogenesis

LEXINGTON, Ky. (Feb. 2, 2006) − For the second time in a week Dr. Jayakrishna Ambati, UK HealthCare physician and associate professor and vice chair of the Department of Ophthalmology and Visual Sciences, announced a discovery from his lab that will affect the future of macular degeneration treatment and research.



Vascular endothelial growth factor (VEGF) is a substance that promotes angiogenesis - the formation of new blood vessels from pre-existing vessels. In macular degeneration, vessels grow through angiogenesis, destroying the cells that are required for vision. Scientists have long believed that turning off the source of VEGF would lead to halting angiogenesis and disease progression.



Ambati's lab found that while withdrawing VEGF could halt angiogenesis in some areas, it actually encouraged it in others. Upon further investigation Ambati found that this previously undiscovered anti-angiogenic effect of VEGF was mediated via activating VEGFR-1 (VEGF receptor 1) and deactivating VEGFR-2 (VEGF receptor 2). Additionally, his lab found that a compound known as SPARC (secreted protein, acidic and rich in cysteine) could influence and switch the routing of VEGF away from VEGFR-1. Thus, controlling SPARC levels appears to be key to controlling angiogenesis in macular degeneration.



These surprising findings have far-reaching implications beyond ophthalmology and into all areas of medicine because angiogenesis is also the process by which other growths spread in the body, including malignant tumors. Ambati's work has opened the door into methods of controlling angiogenesis and its effects.







Ambati's paper can be found in the current issue of the Journal of Clinical Investigation. The PDF of the full article may be downloaded from jci/cgi/reprint/116/2/422.pdf.



In striving to become a Top 20 public research institution, the University of Kentucky is a catalyst for a new Commonwealth - a Kentucky that is healthier, better educated, and positioned to compete in a global and changing economy. For more information about UK's efforts to become a Top 20 university, please go to uky.edu/OPBPA/Top20.html



Contact: Allison Elliott

allison.elliottuky.edu

University of Kentucky

EyeGate Pharma Initiates ALLUVION Phase III Study Of EGP-437 In Patients With Dry Eye Syndrome

EyeGate Pharma, a privately held venture-backed pharmaceutical company developing a non-invasive ocular drug delivery platform and ocular therapeutics, announces that the Company has begun enrolling patients in the ALLUVION (EvALuation of Dexamethasone Phosphate DeLivered by OcUlar Iontophoresis for the Treatment of Dry Eye in the Controlled Adverse EnVIrONment (CAE) Model) pivotal Phase III study of its lead product, EGP-437, for the treatment of Dry Eye Syndrome (DES). This ocular surface irritation affects millions of men and women. EGP-437 is a dexamethasone derived corticosteroid custom formulated for delivery using the EyeGate II® Delivery System.


Prior Phase II Study


As announced in June 2009, an exploratory Phase II study demonstrated significant improvements in the signs and symptoms of dry eye during and after Controlled Adverse Environmental (CAE) exposure. The CAE exacerbates the signs and symptoms of dry eye in a controlled setting. EyeGate submitted information from the completed Phase II study in dry eye patients to the FDA as part of an end-of-Phase II meeting. EyeGate is the first company to complete Phase II studies using iontophoresis technology to deliver an active compound into the eye, under an investigational new drug (IND) application.


Stephen From, President and Chief Executive Officer of EyeGate Pharma, commented, "Based on clinical data, we recognize the potential value that EGP-437 may offer patients. Thus, we are excited to initiate this important pivotal study, which moves the Company one step closer to submitting a New Drug Application (NDA). Demonstrating that iontophoretically delivered drugs offers Ophthalmologists new treatment options for patients is an important milestone for the Company."


About Dry Eye Syndrome


Dry Eye Syndrome (DES) is the most prevalent form of ocular discomfort and irritation, accounting for one in four patient visits to a general ophthalmologist. It is estimated that as many as 9.5 million people in the USA suffer from the moderate and severe forms of dry eye while millions more suffer from the mild or episodic form usually associated with adverse environmental conditions. Symptoms such as pain, light sensitivity, blurred vision, and irritation decrease the quality of life for patients and can ultimately lead to loss of function and blindness. The incidence of DES is increasing due to environmental factors, the aging population, and the increasing prevalence of co-morbid diseases such as diabetes. There is no cure for DES, and the few treatment options currently available primarily provide temporary symptomatic relief.


Source:

EyeGate Pharma

Tight necktie linked to glaucoma

Men should think twice about how tight they wear a necktie because it could increase their chances of developing glaucoma, a group of serious eye diseases.



Research reported in the British Journal of Ophthalmology on Tuesday showed that a tight necktie raises blood pressure in the eye, which is a leading risk factor in the illness that can lead to damage to the optic nerve and loss of vision.



"A tight necktie increases IOP (intraocular pressure) in both normal subjects and glaucoma patients and could affect the diagnosis and management of glaucoma," said Dr. Robert Ritch of the New York Eye and Ear Infirmary.



Ritch and his colleagues tested the IOP of 20 healthy men and 20 who suffered from glaucoma while they were wearing an open-neck shirt, before putting on a tight necktie and three minutes after loosening it.



Their results showed that 60 percent of the men with glaucoma and 70 percent of the healthy volunteers had an increased eye pressure after wearing a tight necktie.


In addition to raising the risk of glaucoma, donning a tight necktie during an eye examination could lead to a false diagnosis of the illness.



The researchers suspect that a tight necktie constricts the jugular vein, which increases blood pressure and IOP.



The risk of glaucoma, which affects about 3 million people in the United States alone, increases with age.

News From The Journal Of Neuroscience

1. Targeting of Calcium Channels to Active Zones

A. Ashleigh Long, Eunju Kim, Hung-Tat Leung, Elvin Woodruff III, Lingling An, R. W. Doerge, William L. Pak, and Kendal Broadie



This week, Long et al. describe a newly discovered Drosophila protein, fuseless, that is required for vesicle fusion. Fuseless is a transmembrane protein expressed in presynaptic membranes in retina and neuromuscular junctions. Synaptic transmission was impaired in fuseless mutants but was rescued by expression of the transgene exclusively in presynaptic cells. Although synapses appeared essentially normal in mutants, the number of synaptic vesicles was nearly double that in wild-type flies, indicating impairment of exocytosis. The amplitude of evoked excitatory junction potentials was greatly reduced in mutants, and raising extracellular calcium concentration increased the amplitude much less in mutants than in controls, suggesting that a defect in calcium entry underlies the defect in vesicle fusion. Indeed, the expression pattern of voltage-sensitive calcium channels (VSCCs) was disrupted in mutants - the channels were no longer clustered in active zones. Thus, Fuseless is necessary for proper targeting of VSCCs, which enables the localized calcium influx necessary for vesicle release.



2. Could Botulinum Toxin Be Bad for You?

Flavia Antonucci, Chiara Rossi, Laura Gianfranceschi, Ornella Rossetto, and Matteo Caleo



Botulinum toxins (BoNTs) are used increasingly to treat maladies from spasms and migraines to obesity and wrinkles. It has been assumed that the toxin remains localized at the injection site, where it cleaves proteins involved in vesicle fusion, thereby blocking neurotransmitter release. But now Antonucci et al. demonstrate that BoNT/A is retrogradely transported along microtubules, transcytosed, and taken up by afferent terminals. When BoNT/A was injected into one hippocampus in rats, it cleaved its target [synaptosomal-associated protein of 25 kDa (SNAP-25)] in the contralateral hippocampus, resulting in reduced neuronal activity. Similarly, when BoNT/A was injected into the superior colliculus or whisker pads, SNAP-25 was cleaved in the retina and facial nucleus, respectively. In the retina, BoNT/A remained active for at least 25 d after injection. Although cleaved SNAP-25 was detected only in afferents that projected directly to the injection site, it is not clear whether further transcytosis would occur over time.



3. The Mystery of REM Atonia

Patricia L. Brooks and John H. Peever



It has long been assumed that glycinergic inhibition of motor neurons is responsible for decreasing muscle tone during rapid eye movement (REM) sleep. Brooks and Peever have now overturned this hypothesis. Microdialysis of the glycine antagonist strychnine into the trigeminal nucleus of rats resulted in increased tone in facial muscle during wakefulness and non-REM sleep, suggesting that tonic glycinergic inhibition occurs during these states. Tonic inhibition immediately switched to phasic inhibition when the rat entered REM sleep, however, and although strychnine increased the size of muscle twitches, it had no effect on atonia during REM sleep. When REM ended, strychnine effects on tone reappeared. Thus it appears that contrary to assumptions, glycine decreases muscle tone in all states except REM sleep. Intriguingly, GABA antagonists and AMPA were also unable to decrease muscle tone during REM sleep, indicating that neither GABAergic inhibition or decreased glutamatergic excitation is responsible. What is responsible for REM atonia remains a mystery.
















4. Somatostatin Receptors That Regulate Epileptiform Activity

Cuie Qiu, Thomas Zeyda, Brian Johnson, Ute Hochgeschwender, Luis de Lecea, and Melanie K. Tallent



The neuropeptide somatostatin reduces the probability of seizures in part by activating the IM current through voltage-gated potassium channels. In experiments reported in this issue, Qiu et al. identified which of the four somatostatin receptors (SST1-SST4 ) expressed in the brain are responsible for antiepileptic effects of somatostatin by comparing SST2, SST3, and SST4 knock-out mice. Although each knock-out increased susceptibility to seizures induced by a GABA receptor blocker, the effect was most severe in SST4 knock-outs. Moreover, only SST4 knockouts had more severe seizures than wild-type animals when seizures were induced by a glutamate agonist. The effects of somatostatin on bursting in hippocampal cultures in the presence or absence of IM blockers indicated that SST2 and SST4 are the main receptors mediating the antiepileptic effects of somatostatin. In addition, it appears that activation of SST4 increases IM, whereas activation of SST4 reduces epileptiform activity by a still unknown mechanism.







Please click here for the current table of contents.



Source: Sara Harris


Society for Neuroscience

Omega 3 Fatty Acids Appear To Impact AMD Progression

Omega-3 fatty acids found in fatty fish such as tuna and salmon may protect against progression of age-related macular degeneration (AMD), but the benefits appear to depend on the stage of disease and whether certain supplements are taken, report researchers at the Laboratory for Nutrition and Vision Research (LNVR), Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University.


The researchers calculated intakes of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) from dietary questionnaires administered to 2,924 men and women, aged 55 to 80 years, participating in an eight-year supplement trial, the Age-Related Eye Disease Study (AREDS) of the National Eye Institute (NEI). The AREDS trial results suggest taking supplements of antioxidants plus zinc prevents progression of late-stage AMD. AREDS study participants were randomly allocated to receive either a placebo or supplements containing the antioxidants vitamins C and E and beta carotene, the minerals zinc and copper, or a combination of both.


"In our study, we observed participants with early stages of AMD in the placebo group benefited from higher intake of DHA, but it appears that the high-dose supplements of the antioxidants and/or the minerals somehow interfered with the benefits of DHA against early AMD progression," says senior author Allen Taylor, PhD, director of the LNVR at the USDA HNRCA. Taylor is also a professor at the Friedman School of Nutrition Science and Policy at Tufts and Tufts University School of Medicine (TUSM).


The antioxidant supplements did not seem to interfere with the protective effects of DHA and EPA against progression to advanced stages of AMD. Participants who consumed higher amounts of DHA and EPA appeared to have lower risk of progression to both wet and dry forms of advanced AMD. The results are published on-line ahead of print in the British Journal of Ophthalmology.


"Data from the present study also shows the supplements and omega-3 fatty acids collaborate with low-dietary glycemic index (dGI) diets against progression to advanced AMD," says corresponding author Chung-Jung Chiu, DDS, PhD, a scientist in the LNVR and an assistant professor at TUSM. "Our previous research suggests a low-GI diet may prevent AMD from progressing to the advanced stage. We hypothesize that the rapid rise of blood glucose initiated by high-GI foods results in cellular damage that retinal cells cannot handle, thus damaging eye tissues."


dGI is a scale used to determine how quickly carbohydrates are broken down into blood sugar, also known as blood glucose. Foods such as sweetened drinks, sodas and white bread are high-GI because they trigger a sharp rise and fall of blood sugar. Low-GI foods, such as whole grain versions of pasta and bread, have a milder effect on blood sugar response. Earlier data published by Taylor and Chiu suggests that daily substitution of five slices of whole grain bread for white bread out of a total intake of 250 g of carbohydrate might cut out almost 8% of advanced AMD over five years. This is readily achievable with little diet behavior modification.















Eating two to three servings of fatty fish such as salmon, tuna, mackerel, shellfish, and herring every week would achieve the recommended daily intake of DHA and EPA. However, the majority of AREDS participants and Americans eat a much lower level than recommended. "If changing dietary habits is not easy, supplementation is an option," says Chiu.


The authors stress it is still premature to conclude dietary recommendations for people with AMD and more studies are warranted. "Taken together, these data indicate that consuming a diet with higher levels of omega-3 fatty acids, antioxidants and low-GI foods may delay compromised vision due to AMD," says Taylor. "The present study adds the possibility that the timing of a dietary intervention as well as the combination of nutrients recommended may be important."


AMD is a progressive disease that attacks central vision, resulting in a gradual loss of eyesight and, in some cases, blindness. The NEI reports that AMD is the most common causes of non-remediable vision loss in Americans over 60.


The study was awarded The Association for Research in Vision and Ophthalmology


(ARVO)-American Foundation for Eye Research (AFER)/Merck Innovative Ophthalmology Research Award at the ARVO 2009 Annual Conference in May. The award is given to researchers under 45 to encourage research leading to improved quality of life for patients.


The authors received funding for this study from the following: United States Department of Agriculture (USDA), the National Institutes of Health, the Johnson & Johnson Focused Giving Program, the American Health Assistance Foundation and the Ross Aging Initiative.


About Tufts University School of Nutrition


The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight degree programs which focus on questions relating to famine, hunger, poverty, and communications, are renowned for the application of scientific research to national and international policy. For two decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies.


Source: Tufts University

Glaucoma Patients At Higher Risk Than Previously Thought Due To Increased Eye Pressure During Sleep

Some patients with glaucoma appear to have higher pressure in their eyes during sleep at night than during the day when it is usually measured, possibly putting them at higher risk for progression of the disease than previously thought, according to a study in the February issue of Archives of Ophthalmology, one of the JAMA/Archives journals.



Higher intraocular pressure, the force within the eyeball, and greater daily fluctuation in pressure may increase the risk that glaucoma will develop or worsen. Intraocular pressure is usually measured during regular physician's visits, when patients are seated, according to background information in the article. However, previous studies have found that the intraocular pressure may be higher when a person is lying down, the authors report. This is probably because the eye is level with the heart when lying down, which increases the resistance in flow of fluid in the eye and may create additional pressure, they write.



Takeshi Hara, M.D., Jichi Medical School, Tochigi, Japan, and colleagues measured the intraocular pressure of 148 patients with untreated glaucoma at the Hara Eye Hospital in Utsunomiya, Japan. They took measurements 12 times over the course of 24 hours, including every three hours during the night. Each time, they measured the pressure when the patient was sitting as well as when the patient was lying down, so that each patient had three levels: the sitting pressure, the lying pressure and the reproduced pressure, which was calculated by combining the sitting values when the patient was awake and lying values when the patient was asleep.



The researchers then calculated the peak, average and fluctuation of each of these levels. The average peak pressure for seated patients was 16 mm Hg; for those lying down, it was 18.9 mm Hg; and the peak reproduced pressure was 17.5 mm Hg. Twenty-nine (20 percent) patients had a reproduced pressure of 21 mm Hg or greater when sleeping, compared to five patients (3 percent) when only sitting results were considered.



"More than 10 percent of the patients whose intraocular pressure was less than 21 mm Hg during clinic hours when sitting only had a reproduced intraocular pressure that was 21 mm Hg or greater," the authors write, suggesting that measuring pressure only during the day does not paint an accurate picture of patients' risks. "We are convinced that diurnal intraocular pressure changes should be reproduced with consideration for the posture of the patients," they conclude.







(Arch Ophthalmol. 2006;124: 165-168. Available to the media pre-embargo at jamamedia/.)



Editorial: Understanding Pressure Changes Could Improve Treatment



Since most people spend one-third of their day asleep, it is important to understand how the intraocular pressure of those with glaucoma changes during the night, write Robert N. Weinreb, M.D., and John H.K. Liu, Ph.D., University of California, San Diego, in an accompanying editorial.



"High intraocular pressure is recognized, perhaps, as the most important risk factor for the development of open-angle glaucoma and its progression," they write. "However, many physiological and environmental conditions can affect intraocular pressure, and a single determination of intraocular pressure during regular clinic hours may not fully reveal its relationship to the optic nerve damage that accrues with glaucoma."



(Arch Ophthalmol. 2006;124: 269-270. Available to the media pre-embargo at jamamedia/.)



Contact: Takeshi Hara, M.D.

glajichi.ac.jp

JAMA and Archives Journals

Allergan Receives FDA Approval For ACUVAIL™ Ophthalmic Solution For The Treatment Of Pain And Inflammation Following Cataract Surgery

Allergan, Inc. (NYSE: AGN) announced that the United States Food and Drug Administration (FDA) has approved ACUVAIL™ (ketorolac tromethamine ophthalmic solution) 0.45%, an advanced, preservative-free formulation of ketorolac, a nonsteroidal anti-inflammatory drug (NSAID) indicated for the treatment of pain and inflammation following cataract surgery. Cataracts are a leading cause of blindness among older adults and cataract surgery is the most frequently performed surgical procedure in the United States, with more than 3 million procedures performed each year.1


ACUVAIL™ is formulated at pH 6.8, enabling deionized drug delivery on the corneal surface. ACUVAIL™ contains carboxymethylcellulose (CMC), a viscous molecule also found in Allergan's REFRESH® Brand Tears that enables the drug to adhere to the ocular surface and enhances patient comfort.


With ACUVAIL™, patients benefit from the drug's comprehensive inhibition of the COX-1 and COX-2 enzymes. Studies show that those enzymes should be blocked in order to inhibit the development of prostaglandins, which are considered to be the primary sources of pain and inflammation following cataract surgery.


"Building on Allergan's 60-year expertise in eye care, we are pleased to provide physicians and their patients with an advanced and effective NSAID option for the treatment of pain and inflammation following cataract surgery," said Scott Whitcup, M.D., Allergan's Executive Vice President, Research and Development and Chief Scientific Officer. "With its preservative-free formulation, optimized tolerability and twice-daily dosing convenience, we anticipate that ACUVAIL™ will be a valuable addition to the overall management of cataract surgery patients."


The efficacy of ACUVAIL™ ophthalmic solution was assessed in two multi-center, randomized, double-masked, parallel group comparison studies involving more than 500 patients receiving either ACUVAIL™ or vehicle. In the clinical studies, the efficacy of ACUVAIL™ was defined as complete clearance of anterior chamber inflammation measured by summed inflammation score (SOIS) and ocular pain relief following cataract extraction with posterior chamber intraocular lens (IOL) implantation. Results of these studies demonstrated that at day seven, nearly twice as many patients receiving ACUVAIL™ solution had an SOIS score of zero when compared to patients treated with vehicle (32 percent versus 17 percent). In addition, patients were shown to have a significantly higher incidence of clearing of anterior chamber inflammation at day 14 versus patients receiving vehicle (53 percent versus 26 percent). ACUVAIL™ was also shown to be significantly superior to vehicle in resolving ocular pain post-cataract surgery. On day one post-cataract surgery, the percentage of ACUVAIL™ patients with pain scores of zero was 72 percent, compared to 40 percent for patients in the vehicle group.















"As an ophthalmic surgeon, I rely on effective therapies that provide my patients with an optimal experience and improve visual outcomes," said Eric Donnenfeld, M.D., F.A.C.S., Ophthalmic Consultants of Long Island. "ACUVAIL™ is an enhanced ketorolac compound and the first preservative-free, twice-daily ophthalmic NSAID that demonstrates complete elimination of inflammation for patients undergoing cataract surgery."


ACUVAIL™ is expected to be available to physicians and patients in the United States in September 2009.


About Cataracts


Cataracts are a leading cause of blindness among older adults in the United States. The exact cause of cataracts is unknown. Most often, cataracts are part of the aging process. As people age, they are at greater risk of developing a cataract. More than 20 million Americans age 40 and older have cataracts and more than half of all Americans have cataracts by the time they are 80 years old.


A cataract is a clouding of the eye's lens, which blocks or changes the passage of light into the eye. The lens of the eye is located behind the pupil and the colored iris, and is normally transparent. The lens helps to focus images onto the retina - which transmits the images to the brain. A person's vision may become blurry or dim because the cataract stops light from properly passing through to the retina.


Risk factors for cataracts include intense heat or long-term exposure to UV rays from the sun; certain diseases, such as diabetes; inflammation in the eye; hereditary influences; events before birth, such as German measles in the mother; long-term steroid use; eye injuries; eye diseases; and smoking.


Although stronger eyeglasses or brighter lighting may help relieve symptoms of a cataract in the early stages, surgery is the only cure and the most common form of treatment. Cataract surgery is the most frequently performed surgical procedure in the United States, with more than 3 million procedures performed each year. Typically covered by medical insurance, including Medicare, the surgery is usually done as an outpatient procedure under local anesthesia. The procedure consists of an ophthalmologist making a tiny incision to remove the cloudy lens and replacing it with a permanent artificial lens.

1 Allergan Data on File

Source
Allergan, Inc.


View drug information on Acuvail.

Refractive Surgical Practices In Persons With Human ImmunodeficiencyVirus (HIV) Positivity

People who are HIV-positive are now living longer, healthier lives, thanks to antiretroviral therapy and other treatment advances, and the number of HIV-positive people seeking LASIK, intraocular lenses following cataract removal, and similar procedures is likely to grow in coming years. Ahmad A. Aref, M.D., Pennsylvania State Hershey Eye Center, Pennsylvania State University College of Medicine, and colleagues recently investigated current care practices and opinions by sending a confidential online questionnaire to members of the International Society of Refractive Surgery of the American Academy of Ophthalmology.


Of the 25 percent of surgeons who responded, 51 percent considered persons with HIV to be acceptable candidates for elective refractive surgery, but only 12.5 percent considered people with AIDS to be so. The majority of respondents (72.7 percent) who perform these procedures in persons with HIV or AIDS said they take additional precautions, such as addressing one eye at a time rather than bilaterally, scheduling the patient last in a given day, and increasing attention to equipment and staff hygiene.


"Refractive surgery care practices and outcomes in HIV/ AIDS patients need to be formally studied, with the goal of ensuring optimal vision improvement and overall patient health and safety," the authors conclude.


About the Academy-SOE Joint Meeting


The 2008 Joint Meeting of the American Academy of Ophthalmology and European Society of Ophthalmology is the largest and most comprehensive ophthalmic educational meeting in the world. It is in session November 8 to 11 at the Georgia World Congress Center, Atlanta, GA. Offerings include 277 continuing medical education courses, 179 "Breakfast with the Experts" roundtables, 95 skills transfer courses, and more than 100 hours of scientific program presentations, at no charge.


About the American Academy of Ophthalmology


AAO is the world's largest association of eye physicians and surgeons-Eye M.D.s-with more than 27,000 members worldwide. Eye health care is provided by the three "O's" - opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at aao/


Source

Mary Wade

American Academy of Ophthalmology

New OCT Applications From Carl Zeiss Meditec Support Full Spectrum Of Cataract, Refractive, Glaucoma And Retina Procedures

Advanced new optical coherence tomography (OCT) applications will be showcased this week at the American Society of Cataract and Refractive Surgery (ASCRS) meeting in San Francisco by Carl Zeiss Meditec, a leader in complete ophthalmic systems, including IOLs and disposables. The New Technology area of booth 1926 will highlight the new suite of OCT innovations along with a first-ever cinematic showing of high-definition images that have been created using 3D rendering techniques by Dr. Carl Glittenberg of Austria.


"Since we first introduced OCT technology to the ophthalmic industry nearly fifteen years ago, we have continued to invest in applications that leverage clinical and scientific advances in the field as well as features that make the technology itself more efficient and user-friendly for practitioners," said Michael Kaschke, President and Chief Executive Officer of Carl Zeiss Meditec.


New OCT Applications


The newest version of Cirrus HD-OCT 4.0 adds critical features to support cataract and refractive surgeons as well as advanced analyses for tracking change in glaucoma and managing retina disease. Cirrus 4.0 software has been released internationally and is pending FDA clearance in the US.


- Anterior Segment Imaging provides visualization of the cornea and angle with central corneal thickness measurement for glaucoma management. No external lenses are needed.


- Normative RNFL and Macular Thickness Data allows physicians to identify pre-existing glaucoma and retinal disease and to rule-out suspected glaucoma.


- Guided Progression Analysis ™ (GPA) software supports glaucoma treatment decision making by identifying statistically significant RNFL thickness changes.


- Macular Change Analysis helps physicians evaluate retinal status and response to therapy by mapping changes in macular thickness measurements.


Cirrus HD-OCT 4.0 is ideal for practices that rely on advanced technologies to identify pre-existing eye diseases, to closely monitor disease progression and to determine the most appropriate course of treatment for each patient. The new software technologies can be seamlessly integrated onto any Cirrus HD-OCT platform.


"Cirrus is a valuable tool in my practice for both my cataract/refractive surgery and glaucoma patients," said Ike K. Ahmed, MD, FRCSC, Assistant Professor at the University of Toronto and Clinical Assistant Professor at the University of Utah in Salt Lake City. "It helps me to identify potential problems in my pre-operative cataract/refractive workups and my patients more easily understand what they can expect post-operatively."


Dynamic new features for Stratus OCT, the most widely adopted OCT platform worldwide, are also now available for the first time at ASCRS 2009. The Stratus OCT 6.0 upgrade includes the following enhancements:















- Anterior Segment Imaging is also available for Stratus OCT and is currently pending 510k approval within the USA.


- Enhanced Repeat Function simplifies image registration across visits to enhance reproducibility.


- Multi-slice reports provide an overview of the entire retina on a single page, allowing clinicians to preview all B-scans at-a-glance. This functionality is especially suited for cataract pre-op assessment and it allows physicians to set appropriate post-surgical expectations with patients.


These new features for Stratus OCT, combined with GPA software, provide more diagnostic functions than ever before. Version 6.0 is especially applicable to comprehensive ophthalmologists that require a consistent, cost-effective platform to identify and monitor cataract patients with pre-existing glaucoma or retina diseases.


"Immerse Yourself in the Image" Cinematic Display


Dr. Carl Glittenberg from the Department of Ophthalmology, Rudolf Foundation Clinic, Vienna, Austria will deliver a special cinematic presentation titled, "Advantage of High Density Data in Ray Traced Stereoscopic Three-Dimensional OCT Visualization," featuring high-density clinical images that have been rendered from the Cirrus HD-OCT system. The audience will have the opportunity to view these new 3D images through Carl Zeiss Cinemizers using an iPod at the special "Immerse Yourself in the Image" viewing station.


Frost & Sullivan Award


Frost and Sullivan recently presented Carl Zeiss Meditec with the 2009 North American Market Leadership Award in recognition of the company's optical coherence tomography technology. In a recent press release,1 Frost & Sullivan acknowledged that Carl Zeiss Meditec "has developed proprietary image analysis algorithms that provide volumetric data and aid in interpreting three dimensional images in highly reproducible and quantitative fashion."


"We are honored to be recognized for our contributions to OCT and we will continue to deliver meaningful advancements to this remarkable technology," added Dr. Kaschke.


New Independent Market Research


In a new market research report compiled by Market Scope and under Carl Zeiss Meditec, population and demographic data was analyzed to identify future trends that may affect practicing ophthalmologists. According to this report, cataract/IOL Surgeries will increase by nearly 25 percent between 2008 and 2015 and combined disease intervention (including refractive, glaucoma and AMD) will increase by approximately 19 percent. Conversely, the number of practicing ophthalmologists is anticipated to remain fairly constant.


This data suggests that integrating new technologies that expedite workflow efficiencies in the practice will be necessary to support the influx of patient volume within the next five years. Please visit booth #1926 to receive a complimentary copy of the report.


Cataract Surgical Outcomes Educational Symposium


Meeting delegates are encouraged to attend the "Cataract Surgical Outcomes" symposium on Monday, April 6 at 7 pm at the Parc 55 Hotel in San Francisco to learn about the application of Zeiss technologies to achieve better patient outcomes and to identify candidates for refractive IOLs procedures.


Carl Zeiss was the first to commercialize OCT technology for ophthalmology, pioneering this market in 1995. In 2002, Carl Zeiss Meditec introduced Stratus OCT™, which became a gold standard product with more than 8,000 units in the marketplace today. The largest body of OCT clinical data, including a library of more than 2,000 peer reviewed articles, has been published about Stratus OCT™ to date. Five years later, Carl Zeiss Meditec launched Cirrus™ HD-OCT, the first in its category to deliver high-definition 3D maps.


Brief profile


Carl Zeiss Meditec AG (ISIN: DE 0005313704), which is listed on TecDAX of the German stock exchange, is one of the world's leading medical technology companies.


The Company supplies innovative technologies and application-oriented solutions which enable doctors to improve the quality of life of their patients. The Company offers complete solutions, including implants and consumables, to diagnose and treat ophthalmic diseases. In the field of Neuro/ENT surgery the Company provides innovative visualization solutions. Carl Zeiss Meditec's medical technology portfolio is rounded off by promising future technologies such as intraoperative radiotherapy.


The Company's around 2,100 employees generated revenue of about EUR 600 million in fiscal year 2007/08 (ended Sept. 30). The headquarters of Carl Zeiss Meditec are located in Jena, Germany. In addition to other subsidiaries in Germany, the Company is represented by over 50 percent of its employees at sites in the USA, Japan, Spain and France.


Thirty-five percent of Carl Zeiss Meditec's shares are in free float. The remaining 65 percent are held by Carl Zeiss AG, one of the world's leading groups engaged in the optical and opto-electronics industry. The five independently run business segments of Carl Zeiss AG operate in the future-oriented markets "Medical and Research Solutions", "Industrial Solutions" and "Lifestyle Products". Carl Zeiss AG is headquartered in Oberkochen, Germany. During fiscal year 2007/08 (ended Sept. 30) the company generated revenues of about EUR 2.7 billion. Carl Zeiss has around 13,000 employees in more than 30 countries, including more than 8,000 in Germany.


For further information please visit our website at: meditec.zeiss


1 Press release issued via PRNewswire on March 24, 2009: Frost & Sullivan Recognizes Excellence in Medical Technologies & Life Sciences.

Source
Frost & Sullivan

The Hierarchy Of Directional Interactions In Visual Motion Processing

Humans can accurately perceive a moving object's direction. We can also, however, be fooled into miss-perceiving this direction.


If one views upward motion for some 30 seconds and then subsequently looks at motion in a different direction, the latter may be grossly miss-calculated. This illusion is known as the direction after-effect.


We can also be fooled into miss-calculating the directions of two superimposed motions - direction repulsion. These two illusions react similarly to various experimental manipulations, consistent with the same neural structures driving both illusions. We devised a series of experiments demonstrating that the two illusions are driven by different neural structures.


This finding furthers our understanding of the cascade of processes underlying vision.


Proceedings of the Royal Society B: Biological Sciences


Proceedings B is the Royal Society's flagship biological research journal, dedicated to the rapid publication and broad dissemination of high-quality research papers, reviews and comment and reply papers. The scope of journal is diverse and is especially strong in organismal biology.


Proceedings of the Royal Society B: Biological Sciences

Dry Eye Research To End In Tears

University of Western Sydney researcher, Associate Professor Tom Millar has approached the problem of dry eyes from a new perspective. He re-examined the structure and function of natural tears to find new clues for creating longer lasting artificial tears.



Tears protect and lubricate the cornea and conjunctiva of the eye and help provide a clear medium through which we see.



Dry eyes occur when tears evaporate or break-up too quickly. Anyone can experience dry eyes, but the problem is more common when you stare at computer screens, wear contact lenses or after you turn 65. Hot dry conditions in summer, winter heating and taking antihistamines can also aggravate the condition.



Associate Professor Millar, from the School of Natural Sciences, says the interaction between the liquid tear and air holds the key to slowing the 'break-up time' of tears.



"At the surface of all liquids, including tears, molecules are spread very thinly," he says.



"A good example of what's happening at the micro level can be seen when you put a small drop of oil into a bowl of water. The oil spreads over the entire surface, so a little bit goes a long way.



"When we looked closely at the thin surface layer of molecules on tears - the 'tear film' - we found proteins previously thought to be confined to the aqueous portion of the tear," he says.



Further study by Associate Professor Millar revealed, for the first time, proteins at the surface also played an unexpected role slowing down the break-up rate of tears.



"Proteins on the tear film interact and behave very differently. They lower the surface tension and make tears more stable," he says.



Previously it was believed lipids - released from small holes inside the eyelids - formed an oily barrier, which protected the tears from evaporating too quickly.



Associate Professor Millar's discovery has opened a whole new avenue of research and is the culmination of 14 years of blood, sweat and literally tears.



Over the years, he has collected samples of his own tears to extract compounds needed for experiments.



Already Associate Professor Millar's research, and tears, has helped to develop a synthetic polymer, which has doubled the tear break-up time in animal trials.



"The ultimate goal is to create effective eye drops which work with your natural tears to give lasting relief from dye eyes," Associate Professor Millar says.





Contact: Paul Grocott


Research Australia

The Eyes Have It: The Eye Muscles, Those Go-Getters Of The Anatomical World - May Provide Clues To Muscular Dystrophy, Myasthenia Gravis

The eye, often called the window to the soul, may become a window to the mysteries of muscular dystrophy, a debilitating muscle disease that often leads to death in early adulthood.


Physiologists are intrigued that muscular dystrophy spares a few muscles of the body -- notably the vocal cords, some muscles of the pelvic region and the eye muscles. What is it that allows these muscles to escape the effects of this deadly disease while other skeletal muscles are so profoundly affected? At the same time, the eye muscles fall prey to diseases that do not affect other skeletal muscles. Why?


These are some of the intriguing questions that four eye muscle experts will explore at the symposium, "Ultra fast and ultra active: the strange life of the extraocular muscles." The symposium will take place at the 120th annual meeting of The American Physiological Society (APS), which coincides with Experimental Biology 2007. The session will be held at 10:30 a.m., Tuesday, May 1 in Room 147A of the Washington Convention Center.


"We think that by learning what makes these muscles unique, we will understand why they are spared by some neuromuscular diseases and targeted by others," said Francisco H. Andrade, Ph.D., who will lead the symposium. "These insights will lead, in turn, to better treatment options for these diseases."


The speakers, who are among only a handful of experts on the topic in the U.S., are Linda K. McLoon, Ph.D., a professor at the University of Minnesota, Minneapolis; Francisco H. Andrade, Ph.D. an associate professor at the University of Kentucky College of Medicine, Lexington; Henry J. Kaminski, M.D. the chairman of the neurology and psychiatry department at the St. Louis University School of Medicine, St. Louis, Missouri; and Stephen J. Goldberg, Ph.D., a professor (now retired) at Virginia Commonwealth University, Richmond. Andrade will also lead the symposium.


On the go


The extraocular muscles are the six small muscles that move each eye from side to side, up and down and on the slant. When these muscles don't work together, it can affect vision. One condition that can arise when these muscles don't work together is strabismus, a condition that affects about 5% of children and arises when the eye muscles don't work together properly. This leads to "lazy eye," in which one eye takes over all the vision duties. If strabismus is not treated, it results in functional blindness.


A defining characteristic of these tiny muscles is that they are nearly always moving, even during sleep. In fact, even when "staring" at a fixed object, the eyes keep moving over the image. Although these muscles are very small, they use a lot of energy because they are always on the go.















And that is a key to Dr. Andrade's presentation, "Always active, always hungry: the metabolic design of the extraocular muscles." The cells that make up the extraocular muscles contain more mitochondria, the energy manufacturing structures in all cells, than other skeletal muscles, such as those of the limbs. This rich population of mitochondria allows the muscles to keep moving the eye. On the other hand, this leaves the eye muscles vulnerable to diseases that target the mitochondria, such as Kearns-Sayre syndrome, a condition that gradually limits eye movements and eventually immobilizes them completely.


Dr. McLoon will discuss "Dynamic cell biology of the extraocular muscles." She looks at satellite cells, a type of cell involved in muscle growth and injury repair. The extraocular muscles are richer in satellite cells than the skeletal muscles of the limbs. There is evidence that eye muscles regenerate much faster than skeletal muscle of the limbs. This may be a key to why the eyes have a greater ability to withstand the onslaught of muscular dystrophy. Another very important aim of Dr. McLoon's research is to find new drugs to treat strabismus.


Dr. Kaminski will talk about the "Differential involvement of extraocular muscle by neuromuscular disease." His work focuses on myasthenia gravis, an autoimmune disease which disrupts communication between muscles and nerves. The illness particularly affects the eye muscles, causing drooping eyelids and double vision. Dr. Kaminski focuses on the eye's immune environment. He looks at what role this plays in the eye muscles' vulnerability to myasthenia gravis. If this process can be better understood, it could eventually lead to new treatments. His research also has implications for Graves' disease, an auto-immune thyroid disorder in which the extraocular muscles get enlarged causing the eyes to bulge out.


Dr. Goldberg will speak on "Eye muscle motor units: a petite illumination." His laboratory investigates the motor neurons of the brainstem which are involved in tongue and eye movements. (When a doctor asks a patient to follow his or her finger, the patient's brainstem functioning is being tested.) This research has applications to strabismus. When rats have strabismus, they can later recover vision in both eyes, but humans permanently lose the ability to have normal vision. This finding has been a tantalizing one for physiologists, who want to find out how rats manage to recoup their vision. The hope is to find out how this can be applied to humans.


Physiology is the study of how molecules, cells, tissues and organs function to create health or disease. The American Physiological Society has been an integral part of this scientific discovery process since it was established in 1887.


The American Physiological Society (APS) has been an integral part of the scientific discovery process since it was established in 1887. Physiology is the study of how molecules, cells, tissues and organs function to create health or disease.


www.The-APS


The APS annual meeting is part of the Experimental Biology 2007 (EB '07) gathering and is being held April 28 - May 2, 2007 at the Washington, DC Convention Center.