Download The Achiever Dec 14 - Retina Australia Victoria

THE
ACHIEVER
Retina Australia Victoria
Registration # A0002991W
SUMMER EDITION
DECEMBER 2014
R O S S H O U S E , 4 TH F L O O R
M E L B OU RN E
VIC 3000
247 - 251 FLINDERS LANE
PHONE (03)9650 5088
FAX (03) 9639 0979
Email: [email protected]
Web site: www.retinavic.org.au
INSIDE
FROM THE PRESIDENT
QUESTION TIME
I SPY WITH MY BIONIC EYE
RUNNING WITH A BLIND AMBITION
ESCOURTED VIP TOUR
CHILDREN’S BOOK
RESEARCH UPDATE:
NEW STEM CELL ROBOT
BIONIC EYE FUNDINGS BOOST
OCULAR STEM CELLS UPDATE
MACULAR ABNORMALITIES IN
ITALIAN PATIENTS WITH RP
VISUAL IMPAIRMENT IN JAPAN
VISUAL AID FOR RP
RELATION OF LIFESTYLE TO
CHANGES IN VISION
NON-DAMAGING PHOTOTHERMAL
THERAPY FOR THE RETINA
MICRONUTRITION IN AMD
ANTIOXIDANTS AND VISION
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SUPER SUMMER
EDITION
 Report on AGM
 Latest Research
Around the World
News
from
 Two interesting new Books
Merry Christmas
and Best Wishes
for 2015!
MYTH BUSTER, CHRISTMAS JOKE
AND LAST WORD
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PP: 33 1088/00015
From the President - Leighton Boyd
We are rapidly approaching the end of 2014 which has been another very busy year
for the staff and volunteers at Retina Australia (Vic). We have continued to support our
members, and potential members, through: peer support; participation in Telelinks;
providing information; the regular distribution of this newsletter; and raising funds for
Research.
RETINA AUSTRALIA (VIC) AWARDS
These annual awards were introduced last year to recognise the significant
contribution of individual members, and others, to the work of Retina Australia (Vic). At
this year’s AGM, Board Member Mary-Anne Carmody presented a Certificate of
Appreciation to Mark Boyd for his voluntary services and contribution to Retina
Australia (Vic), and his work as convenor of the Bendigo and Districts Support Group
for many years.
Congratulations Mark. Thank you for your many years of support and dedication to the
work of Retina Australia (Vic).
2014 ANNUAL GENERAL MEETING
This year our guest speakers were Dr Alice Pebay and Dr Alex Hewitt from the Centre
for Eye Research Australia. Alice and Alex spoke about Stem Cell Research, giving a
very clear “layman’s terms” explanation of what stem cells are, and the difference
between embryonic and adult stem cells. They also talked about their work in creating
biopsies from skin cells of people with inherited retinal disease, which in turn will help
them learn about the disease and assist them to diagnose the specific form of inherited
retinal disease the patient has.
Both Alice and Alex were quite excited about their work, which in collaboration with
researchers worldwide has the potential to revolutionise treatments for people with
inherited retinal disease. Alex stated that currently about 60% of the retinal disease
genes are known and he believes that within five years at least 80% will be known.
Alex also mentioned that the team had recently received a large philanthropic donation
to establish a semi-automated or robotic system, in place of the current manual system
completed by an individual laboratory assistant, to assist with maintaining the cells
they are working on. This will instantly create an opportunity to rapidly increase the
number of cells being investigated simultaneously, the results of which will contribute
to the increase of global knowledge of inherited retinal disease genes.
Alice and Alex also briefly mentioned some of the world-wide studies and spoke about
the many clinical trials that are being undertaken. They specifically spoke about trials
relating to Lebers Congenital Amaurosis in the USA, and the research work in Japan
where skin cells are being transferred into eye cells and then injected into the region
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behind the eye as a possible treatment. Both researchers strongly believe that
treatments for monogenic inherited eye disease will be established within the next five
years but that more complex inherited diseases will take much longer.
Alice and Alex concluded their presentation by mentioning that shortly they will be
seeking volunteers with inherited retinal disease to provide a skin sample from which
they will extract cells which will subsequently be studied to determine what type of cells
occur for the many different types of inherited retinal disease. They hope to work
closely with the Australian Inherited Retinal Disease Register & DNA Bank in Perth to
source participants. More information will be provided to Retina Australia (Vic)
members in due course.
At the AGM, we also elected the office bearers and members of the Board who will
serve for the next twelve months. Those elected were as follows:
President
Vice-President
Treasurer
Secretary
Board Member
Board Member
Board Member
Leighton Boyd
Rick Clarke
Graham Owen
Rosemary Boyd
Chris Edwards
Mary-Anne Carmody
Dianne Ashworth
Subsequently Graham resigned his role as Treasurer and Chris Edwards has taken
over this important role. I would like to take this opportunity of thanking Graham for his
contribution over many years to this role and for his willingness to assist with the
general work in the Retina Vic office each week. I would also like to thank the other
members of the Board for volunteering their time to assist me in providing support for
our members and information for members of the community at large.
We currently have two vacancies on the Board and are seeking interested members
who would be willing to assist us in the management of our organisation. The Board
meets on average eight times per year. It would be good to share the workload by
having a full complement of Board members. If you wish to find out more about what
this role entails, please do not hesitate to phone me on 0417 566 899.
If any member would like a copy of the 2013-2014 Annual Report, which was
distributed at the AGM, please contact the office.
RETINA AUSTRALIA ANNUAL GENERAL MEETING 2014
This AGM was held in Perth on Saturday 18 October 2014. The directors of Retina
Australia are as follows:
RA (ACT)
Jan James; John Barlow
RA (NSW)
Betty Ghent; Robert Craft
RA (Queensland)
Anne Housego; Marg Veltheim
RA (SA)
Philippa Cooper (Treasurer); Orm Cooper
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RA (Victoria)
RA (WA)
Individual Member
Leighton Boyd (Vice-President); Rosemary Boyd(Secretary)
Murray Witham; Jeremy D’Souza
Graeme Banks (President)
The Australian President Graeme Banks, and each of the State Presidents, presented
their reports which outlined what activities each organisation has been undertaking
during the previous financial year. The audited financial reports were also presented
and accepted. The general business discussed included:
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Consideration of the future role of Retina Australia
Retina Australia Youth representation
Australia Congress: 23-25 October 2015
Retina International Congress 2018: New Zealand
RETINA AUSTRALIA NATIONAL CONGRESS 2015
This triennial Congress will be held in Melbourne at the Ibis Hotel in Therry Street on
23-25 October 2015. Planning is well underway, with many renowned researchers
being invited to make presentations about their work. The program should be very
interesting and informative. More information will be circulated as the planning unfolds
but it would be great if you could put these dates in your diary now and spread the
word to others.
RETINA INTERNATIONAL CONGRESS 2018
This event will be held on 9-11February 2018 in Auckland, New Zealand. Retina
Australia’s triennial Congress will not be held in 2018. However, all members and
interested people will be invited to attend this international congress. Opportunities to
meet and socialize with eminent researchers and members from Retina groups from
across the globe do not come up often in our part of the world.
So don’t miss out, put the dates in your diaries, and plan to be in Auckland at this time.
OFFICE CLOSURE
As is our usual practice, the office will be closed during the Christmas, New Year and
January holiday period. This allows our office staff and volunteers to have a wellearned break and enjoy time with their families. This year, our last day in the office will
be Thursday 18 December 2014 and we will reopen again on Tuesday 20 January
2015 at 9.30am. During this time, I can be contacted on my mobile phone, 0417 566
899, and any mail, or messages left at the office will be attended to.
IN CONCLUSION
Thank you all very much for your continued support and assistance. I hope that you all
have a wonderful Christmas and a happy New Year and are able to take the time to
celebrate this special time with family and friends.
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Question Time
with Cathy Plueckhahn
In this edition, Cathy Pleuckhahn has kindly
volunteered to respond to our 10 questions.
Would you like to share your story? Have
you had personal experiences or gained
insights you would like to share? Everyone
has a story to tell!
Please consider
volunteering for Question Time or writing a
personal piece to feature in an upcoming
edition of The Achiever in 2015!
4. Who inspires you?
People who have faced adversity in
life and have never given up on their
dreams or aspirations. I truly admire
the late Nelson Mandela. Other
people who have inspired me are
Moira Kelly and singer Andrea
Bocelli.
5. What makes you angry?
So much injustice and inequality in
this world that could be easily
avoided. On a lighter note,
sometimes AFL umpires with some
decisions make me angry.
1. What’s your earliest memory?
As a young girl heading to
Sandringham Beach for the day with
my parents. At the time it was a long
trip from Essendon in the Austin A30.
2. What’s your idea of a good time?
Going for brisk walks around the Tan,
Melbourne Botanical Gardens or
Albert Park Lake. I also enjoy going to
the Football to watch my favourite
team Essendon play. Never without
my walkman radio of course.
3.What’s
your
ideal
holiday
destination?
My love for the beach continues.
Holidaying at a tropical beachside
resort, just relaxing with family and
friends enjoying the sunshine and
going for a swim.
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6. What’s the hardest thing
you’ve ever done?
As a consequence of having RP,
loss of a lot of my independence
after giving up my licence to drive a
car. Until that time, it is not realised
what a great privilege it is to drive.
7. What’s the best thing you’ve
ever done?
Being a wife and mother to three
beautiful boys. I am so proud to see
these boys develop and achieve so
much in their individual lives.
8. What do you like about Retina
Australia (Vic)?
It is reassuring and comforting to
know there is an organisation like
Retina Australia. Not only to support
research but be available to anyone
who
needs
help,
assistance,
information or just a chat in a time of
need.
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9. If you could change one thing
about the world, what would it be?
The people who make up our
governments and influential leaders to
have a greater focus on integrity,
character, values and morals so the
next generation and beyond have role
models to look up to and follow.
10. What’s the most important
thing you’ve learnt about life?
To make the most of every
opportunity that life brings. Don't
take family, friends or things for
granted and always have a spirit of
thanksgiving and gratitude.
I Spy with my Bionic Eye by Dr Dianne Ashworth
I am very pleased and proud to present my
book, I Spy with my Bionic Eye. My story
begins on 22nd May 2012 when I was waiting for
surgery as first research participant in the
Australian prototype bionic eye trials. Being first
meant no one really knew what to expect. Of
course with all the pre-clinical work that had
been done before my surgery, everyone hoped
all would go to plan. And it did!
This book is an adaptation of my journal, as I
share eighteen months of my participation in the
research. It includes switch on, a term used to
describe the first time the device is switched on,
drawings of what I saw when the device is
activated and how testing in our weekly
psychophysics sessions unfolded, as well as
using the camera to see and moving about
using a semi-portable unit.
Di speaking at the
book launch
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As such, this book provides insight into the brilliance of
Aussie science! But it is oh so much more. In it, I open
my life up to share with the reader, too. Being diagnosed
with retinitis pigmentosa in my mid-twenties was certainly
one defining moment, one that changed its course. After
my husband deserted me, I raised my two sons as a
single mum, studied, volunteered and worked. During
the middle of my participation in the bionic eye trials, I
even completed a PhD. If you are interested in obtaining
a copy, so far I Spy with my Bionic Eye is available online
from Dorrance (the publisher), Amazon and Google
Books. You can buy it at Angus & Robertson and
Booktopia in paperback and also purchase an e-book. If
you do get to read it, I hope you enjoy.
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Runner with a Blind Ambition
Albion resident, David Connolly, and his friend, Newport resident, Tom Bevan,
participated in the Melbourne Marathon’s half-marathon on October 12. During the 21
km race, Mr Connolly led the blindfolded Mr Bevan along with a tether to keep them
joined. The pair practised at Selwyn Park in Albion with a blindfold and tether before
the half-marathon, in which they were accompanied by about 30 other runners to raise
awareness of disability in sport.
Their participation also saw them raise funds to create participation opportunities for
adults with vision impairment to play Blind Football (soccer). Mr Connolly and Mr
Bevan are co-founders of the Social Goal, which has joined forces with Blind Sports
Victoria to establish the Blind and Vision Impaired Football Project.
“People are always intrigued about these two guys strapped together and one with a
blindfold,” Mr Connolly said. “It’s an important part of raising disability awareness and
we are only too happy to stop and chat to people about what we are doing. “Tom puts
a lot of trust in me leading him in the right direction, only on a couple of occasions have
I forgotten to mention a curb or crack in the pavement.”
Mr Connolly said Social Goal has already established a junior vision impaired football
program in Melbourne’s north and were about to start an adult Blind Football skill
development program at the Docklands. “These projects are the first of their kind in
Australia,” he said. “Together we want to rewrite the story of disability and sport in
Australia. We’re dreaming big – of an affiliation with Football Federation Australia, an
inclusive blind football league, a national team and a [Paralympic Games] gold medal
in 2020.”
Blind football is an internationally recognised sport played at the
Paralympics, with players locating a special ball by its rattling sound.
“The blindfolded run is a fantastic way of raising disability awareness and, most
importantly, challenging public perceptions of what people with a disability can do,” Mr
Bevan said.
Source: Edited from Brimbank Leader, 23 September 2014, and The Weekly Review Maroondah, 1 November, 2014.
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Escorted Vision Impaired Tour to Queenstown,
New Zealand
Depart Perth Sunday 24th May 2015 and returning Saturday,
30th May 2015. (6 Nights/7 Days)
“Travel Tree has been successfully designing and escorting
vision impaired tours for a number of years, specifically for
Australian vision impaired persons.
Traditionally the tours have been to South East Asian
destinations, but this year Queenstown New Zealand has
been selected to ensure participants from all around Australia
have easy access to the tour. There are many activities
included in the itinerary to make sure there is plenty to do, but
also to allow some downtime for shopping, resting and the
opportunity for some optional activities.
Start planning, look for your sighted companions, and join me
on this wonderful journey.” George Booth: Tour Escort.
Package Pricing: Per Person Share Twin $2,875
Single Room (sole occupancy) $3,380
Trip Includes:
• Economy class airfare Perth to Queenstown and return flying QANTAS.
• Current airline taxes and charges
• 6 nights’ accommodation Novotel Queenstown
• Full buffet breakfast daily
• Roundtrip airport transfers Queenstown
• Activities: Twin challenge Shotover and rafting on the great Kawarau River/Lunch
and wine tasting at Gibbston Valley Winery/Spectacular cruise on the Sprit of
Queenstown across Lake Wakatipu to MT. Nicholas Station/4WD drive tour Discovery
tour and lunch at Arrowtown./Queenstown to Cromwell with lunch in Clyde at the Post
Office Restaurant / Skyline Gondola & Restaurant dinner.
• Services of escort in New Zealand (subject to 20 persons participating on the tour
from Australia).
Not Included:
• Meals other than stated above
• Telephone calls and alcohol
• Travel Insurance (All participants must have travel insurance)
• Passport cost
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Note:
• Passports must have 6 months’ validity from arrival back into Australia
• All vision impaired persons must have a sighted companion. (If required, people can
register and Travel Tree will endeavor to arrange a sighted companion to share).
Payments
A deposit of $350.00 per person is required within 7 days of confirmation of tour and
the balance around 6 weeks prior to departure. Full terms and conditions will be
advised at time of enquiry.
For bookings and information contact Maxiema Lager on (08) 9382 5044 or
[email protected]
Along Came Henry: A Guide Dog Story for Children
‘Along Came Henry’ is a beautifully illustrated and charming story of
the transformation for BCA member Bev Larsson, after she met her
guide dog Henry.
Bev wrote the book because she says that “people don’t always
understand that her guide dog is different from a pet”. When Henry
has his harness on he is working. He has had stringent training to
become a guardian for Bev and when he is on the job, that is what
he is focusing on. But Bev says some humans can’t resist.
‘Henry is such a good looking animal, he is gorgeous. I often hear “Oh aren’t you
gorgeous”, and I say “Thank you, what about the dog?” laughs Bev.
Bev says that apart from being so handsome he has qualities that make him loveable
on many levels.
‘He has got a beautiful personality’, says Bev. ‘He has a lovely temperament, he’s
thoughtful, kind, considerate and he’s bright. He really looks after me.
Bev has a background managing child and family health services so she is
knowledgeable about children in the age group the book is aimed at.
The book makes a wonderful addition to any children’s book collection, school or
library. For further information on how to purchase the book, go to
http://guidedogs.com.au/home
Extracts of this story thanks to Guide Dogs Australia.
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Australia’s New Stem Cell Robot
The Centre for Eye Research Australia (CERA)
has opened the Automated Stem Cell Facility
and brought Australia’s unique new stem cell
robot to life. The Federal Minister for Industry,
the Honorable Ian Macfarlane MP, joined Peter
Clemenger AM, and members of CERA’s Vision
Regeneration program, Principal Investigator
Neuroregeneration, Dr Alice Pébay, and
Principal Investigator Clinical Genetics, Dr Alex Left to right: Dr Alex Hewitt, Hon Ian
Hewitt, to switch on the robot.
Macfarlane, Peter Clemenger and Dr Alice
Pebay, pictured next to the stem cell robot
CERA purchased the automated system after a generous donation from Peter and
Joan Clemenger who are passionate in their support for eye research. Mr Macfarlane
said the robot is the first of its kind in Australia and a significant new asset for
Australia’s research community to build on our nation’s knowledge base of eye
research. Using adult stem cells, sourced from the skin cells of patients, CERA
researchers produce eye cells for disease modelling which allow for new drug
therapies to be developed.
The automated system can tirelessly maintain the stem cells required for the study of
macular degeneration, glaucoma, and other eye diseases leading to vision loss. Dr
Hewitt said that with the push of a button the Automated Stem Cell Facility is now a
powerful ally in the fight against eye disease.
“Thanks to the generous donation from Mr and Mrs Clemenger, we can now get
working on producing patient-specific, individualised stem cells from a larger number of
people, which will certainly expedite our research and shorten the time required for
clinical translation,” Dr Hewitt said. “We can make a real impact as we work toward
our goal of preventing blindness and restoring sight.”
Dr Pébay said that her team of researchers is excited about the prospect of working
with the samples delivered by this new approach. “It’s very difficult to get tissue
samples from within the eye so the stem cells obtained by reprogramming skin
samples in larger quantities will give us more to study than ever before,” Dr Pébay
said.
Mr Clemenger, who pressed the button that set the robot in motion, said he was proud
to be involved with CERA and wished researchers the best of luck with their new
automated research assistant. “Hopefully this will make real progress to eliminating
eye disease and blindness in my lifetime, as well as encouraging other researchers
from around the world to collaborate with CERA here in Melbourne using this world
class facility,” Mr Clemenger said.
Source: Eye-News, CERA, September 2014
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Funding Boost for Bionic Eye Testing
Researchers and clinicians working on the bionic eye at the Centre for Eye Research
Australia (CERA) have received a major funding boost thanks to a significant $1.2
million grant from the National Medical and Research Council (NHMRC). The project
will now move outside the lab and into the lives of patients with the aim of using the
bionic eye to restore vision to patients who have become blind as the result of eye
disease, particularly retinitis pigmentosa.
The funding will enable a select group of patients to take the bionic eye home for the
first time and report back on what they see. Lead researcher, Dr Penny Allen, said
road testing the bionic eye in the home environment will put it to practical use and kick
off an exciting new research phase. “The NHMRC grant will allow us to test a fullyimplantable device, which will include a patient-worn vision processor for use at home,”
Dr Allen said. “With the funding we can monitor patients, track their progress and see
how the device handles in the outside world. The next step is crucial because we’re
dealing with environmental factors that are hard to replicate in the lab and the
information we gather will help to refine the devices for everyday use.”
Director of Bionic Vision Australia, Professor Anthony Burkitt, said the funding is a
significant investment in one of the most important research projects in Australia. “I
am delighted the NHMRC has decided to fund the further safety and efficacy testing of
the bionic eye in patients over the next three years,” Professor Burkitt said. “This
NHMRC funding will enable a fully implanted version of the device with an increased
number of electrodes to be tested in patients, bringing us one step closer to restoring
vision to people with profound vision loss. With this funding we can now see the device
becoming available to patients through commercialisation in the not too distant future.”
Source: CERA and bionicvision.org.au
Ocular stem cells: a status update!
Stem cells are unspecialized cells that have been a major focus of the field of
regenerative medicine, opening new frontiers and regarded as the future of medicine.
The ophthalmology branch of the medical sciences was the first to directly benefit from
stem cells for regenerative treatment. The success stories of regenerative medicine in
ophthalmology can be attributed to its accessibility, ease of follow-up and the eye
being an immune-privileged organ.
Cell-based therapies using stem cells from the ciliary body, iris and sclera are still in
animal experimental stages but show potential for replacing degenerated
photoreceptors. Limbal, corneal and conjunctival stem cells are still limited for use only
for surface reconstruction, although they might have potential beyond this. Iris pigment
epithelial, ciliary body epithelial and choroidal epithelial stem cells in laboratory studies
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have shown some promise for retinal or neural tissue replacement. Trabecular
meshwork, orbital and sclera stem cells have properties identical to cells of
mesenchymal origin but their potential has yet to be experimentally determined and
validated.
Retinal and retinal pigment epithelium stem cells remain the most sought out stem
cells for curing retinal degenerative disorders, although treatments using them have
resulted in variable outcomes. The functional aspects of the therapeutic application of
lenticular stem cells are not known and need further attention. Recently, embryonic
stem cell-derived retinal pigment epithelium has been used for treating patients with
Stargardts disease and age-related macular degeneration. Overall, the different stem
cells residing in different components of the eye have shown some success in clinical
and animal studies in the field of regenerative medicine.
Source: Dhamodaran K, Subramani M, Ponnalagu M, Shetty R, Das D. Stem Cell Res Ther. 2014
Apr 22;5(2):56.
Macular Abnormalities in Italian Patients with Retinitis Pigmentosa
AIM
To investigate the prevalence of macular abnormalities in a large Caucasian cohort of
patients affected by retinitis pigmentosa (RP).
METHOD
A retrospective study was performed by reviewing the medical records and optical
coherence tomography (OCT) scans in a cohort of 581 RP patients in order to assess
the presence of macular abnormalities - that is, cystoid macular oedema (CMO),
epiretinal membrane (ERM), vitreo-macular traction syndrome, and macular hole.
RESULTS
Macular abnormalities were observed in 524 (45.1%) out of the 1161 examined eyes.
The most frequent abnormality was CMO, observed in 237 eyes (20.4%) from 133
patients (22.9%), followed by ERM, assessed in 181 eyes (15.6%) from 115 patients
(19.8%). Moreover, vitreo-retinal abnormalities were significantly associated with older
age, cataract surgery, or cataract. CMO appeared to be significantly associated with
female gender, autosomic dominant inheritance pattern, and cataract.
CONCLUSION
Macular abnormalities are more frequent in RP compared to the general population.
For that reason, screening RP patients with OCT is highly recommended to follow-up
the patients, evaluate the natural history of disease, and identify those patients who
could benefit from current or innovative therapeutic strategies.
Source: British Journal of Ophthalmology, 2014 Jul;98(7):946-50. Authors from Multidisciplinary Department of Medical,
Surgical and Dental Sciences, Eye Clinic, Second University of Naples, Naples, Italy, and Department of Surgical and
Morphological Sciences, University of Insubria, Varese, Italy.
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Causes and Prevalence of Visual Impairment in Japan
PURPOSE
To investigate the causes of visual impairment in Japan.
METHOD
The documents of 4,852 individuals with authorization of visual impairment registered
between April 2007 and March 2010 in 7 randomly selected regions were reviewed.
RESULTS
The major causes of visual impairment were glaucoma (21.0%), diabetic retinopathy
(15.6%), retinitis pigmentosa (12.0%), macular degeneration (9.5%) and chorioretinal
atrophy (8.4%). Individuals over 70 years of age were predominant for glaucoma,
those aged 50-69 years for diabetic retinopathy and those under 40 years of age for
retinitis pigmentosa. Sixty-one percent of persons affected by glaucoma were severely
handicapped. Macular degeneration increased with age especially in individuals over
80 years of age.
CONCLUSION
There was no difference in the order of major causes as compared with a previous
report in 2001-2004. It is important to establish a central database system so that the
data can be surveyed to provide more relevant information to understand current
issues for handicapped persons and develop new prophylactic and therapeutic
modalities.
Source: Wako R, Yasukawa T, Kato A, Omori T, Ishida S, Ishibashi T, Ogura Y, Japanese Journal of Ophthalmology,
2014 Jun;118(6): 495-501.
Development and Evaluation of a Visual Aid Using
See-Through Display for Patients with Retinitis Pigmentosa
PURPOSE
Patients in the early stage of retinitis pigmentosa (RP) suffer from night blindness and,
therefore, have mobility problems at night. To assist such patients with walking in the
dark, we developed a wearable visual aid utilizing a see-through display upon which
assistive images from a high-sensitivity video camera are superimposed. We
evaluated the efficacy of our new visual aid for RP patients.
METHOD
The device is equipped with a camera with a minimum illuminance of 0.08 lux and a
view angle of 53° × 40°. The experiment was conducted in a room with dimmed light
(illuminance level 0.2-1.2 lux). Eight subjects with RP were instructed to arrive at a
goal 16 m away from the starting point, both with and without the device, passing
through four 1.5-m-wide gates consisting of pairs of black square carpet pieces, white
poles, red and white traffic cones and cardboard boxes with and without the device in a
darkened room. Three gates, except for the boxes, which were nearest the goal, were
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randomly arranged along the x-axis at each trial. The number of trial failures and the
time required to walk the course were assessed as outcomes.
RESULTS
Seven of the eight subjects could walk with the aid of the device without any failure.
With the device, the number of trial failures significantly decreased in number in all
subjects.
CONCLUSION
This device enabled the subjects to see objects that could not be recognised by the
unaided eye. Our visual aid effectively assisted RP patients with night blindness.
Source: Japanese Journal of Ophthalmology, 2014 Oct 29. Authors from Department of Ophthalmology, Graduate
School of Medical Sciences, Kyushu University, Japan.
Relation of Smoking, Drinking, and Physical Activity to
Changes in Vision over a 20 Year Period
OBJECTIVE
To describe the relationships of lifestyle characteristics to changes in vision and
incidence of visual impairment (VI) over a 20-year period in the Beaver Dam Eye Study
(BDES).
DESIGN
Longitudinal, population-based cohort study.
PARTICIPANTS
A cohort of 4926 persons aged 43 to 86 years participated in the baseline
examinations in 1988-1990, and 3721, 2962, 2375, and 1913 persons participated in
follow-up examinations in 1993-1995, 1998-2000, 2003-2005, and 2008-2010,
respectively.
METHOD
Best-corrected visual acuity (BCVA) measured by a modified Early Treatment Diabetic
Retinopathy Study protocol.
MAIN OUTCOME MEASURES
Change in number of letters read correctly and incidence of VI based on BCVA in the
better eye assessed at each examination over a 20-year period.
RESULTS
The 20-year cumulative incidence of VI was 5.4%. There was a mean loss of 1.6
letters between examinations, with a 20-year loss of 6.6 letters. While adjusting for
age, income, and age-related macular degeneration (AMD) severity, being a current or
past smoker was related to a greater change in the numbers of letters lost. Persons
who had not consumed alcoholic beverages over the past year and sedentary persons
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had higher odds of incident VI than persons who drank occasionally or who were
physically active. For example, in women with early AMD and annual household
income less than $10,000, the estimated 20-year cumulative incidence of VI in those
who drank occasionally and were physically active was 5.9% compared with 25.8% in
women who had not consumed alcoholic beverages over the past year and were
sedentary.
CONCLUSION
Three modifiable behaviours - smoking, drinking alcohol, and physical activity - were
associated with changes in vision. Further evidence that changes in these behaviours
will result in less loss of vision is needed because of the expected increase in the
burden of VI due to the aging of the population.
Source: Ophthalmology, 2014 Jun;121(6):1220-8. Authors from Department of Ophthalmology and Visual Sciences, and
Departments of Biostatistics and Medical Informatics and Population Health Sciences, University of Wisconsin School of
Medicine and Public Health, Madison, Wisconsin.
NON-DAMAGING PHOTOTHERMAL THERAPY FOR THE RETINA
PURPOSE
To assess safety and clinical efficacy of the nondamaging photothermal therapy for the
macula for the treatment of chronic central serous retinopathy.
METHOD
Sixteen eyes of 16 patients with persistent central serous retinopathy (less than 4
months of duration) were treated with the PASCAL Streamline at 577-nm wavelength,
using 200-mm retinal spot sizes. Using Endpoint Management Software, the laser
power was first titrated for a barely visible burn with 15-ms pulses, which was defined
as 100% pulse energy. Treatment was then applied over the area of serous retinal
detachment and adjacent nonthickened retina, using 30% pulse energy with the spot
spacing of 0.25 beam diameter. Changes in subretinal fluid, Early Treatment Diabetic
Retinopathy Study best corrected visual acuity, and central macular thickness were
measured over 6 months of follow-up. Pre-treatment and post-treatment fluorescein
angiography and fundus autofluorescence were also assessed.
RESULTS
On average, 532 spots have been applied per treatment. No visible laser marks could
be detected by clinical observation, optical coherence tomography, fundus
autofluorescence, or fluorescein angiography. On average, 12 Early Treatment
Diabetic Retinopathy Study letters gain was achieved at 2 months and was sustained
by 6 months. Central macular thickness decreased from 350 mm to 282 mm.
Subretinal fluid completely resolved in 37% of the patients after first treatment,
whereas 44% of the patients required retreatment after 3 months because of recurrent
fluid or incomplete resolution. The remaining 19% of the patients received a second
retreatment. By 6 months, in 75% of the patients, the subretinal fluid was completely
resolved, whereas in 25%, there was some minimal fluid left.
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CONCLUSION
Photothermal therapy using 577-nm PASCAL laser
with Endpoint Management graphic user interface was
safe, and it improved visual acuity and resolution of
subretinal fluid in chronic central serous retinopathy.
Lack of tissue damage allows periodic retreatment
without
cumulative
scaring,
characteristic
to
conventional photocoagulation. This technique should
be tested in the treatment of other macular disorders
and may offer an alternative to conventional laser
coagulation of the macula and to anti-vascular
endothelial growth factor pharmacological treatments
of macular diseases.
The Pascal Streamline 577
Source: Daniel Lavingsky, MD, PhD, Daniel Palanker, PhD, Retina-The
Journal of Retinal and Vitreous Diseases, 2014.
European Survey on the Opinion and Use of Micronutrition in AMD
PURPOSE
To evaluate ophthalmologists' opinion of, and use of, micronutritional dietary
supplements 10 years after publication of the first Age-Related Eye Disease Study
(AREDS).
METHOD
Participation was solicited from 4,000 European ophthalmologists. Responding
physicians were screened, and those treating at least 40 patients with age-related
macular degeneration (AMD) per month and prescribing nutrition supplements at least
4 times per month were admitted and completed a 40-item questionnaire.
RESULTS
The surveyed sample included 112 general ophthalmologists and 104 retinal
specialists. Most nutritional supplements (46%) were initiated when early/intermediate
AMD was confirmed, although 18% were initiated on confirmation of neovascular AMD.
Clinical studies were well known: 90% were aware of AREDS, with 88% aware of
AREDS1 and 36% aware of the AREDS2 studies. Respondents considered lutein,
zeaxanthin, zinc, omega-3, and vitamins to be the most important components of
nutritional supplements, with the results of AREDS2 already having been taken into
consideration by many. Ophthalmologists anticipate more scientific studies as well as
improved product quality but identify cost as a barrier to wider uptake.
CONCLUSION
Micronutrition is now part of the routine management of AMD for many
ophthalmologists. Ophthalmologists choosing to use nutritional supplements are wellinformed regarding current scientific studies.
Source: Aslam T, Delcourt C, Holz F, García-Layana A, Leys A, Silva RM, Souied E, Clin Ophthalmol. 2014 Oct 0;8:204553. Authors from Manchester Royal Eye Hospital, University of Bordeaux, University of Bonn, Clínica Universidad de
Navarra, Spain, University Hospitals, Belgium, University of Coimbra, Portugal, Université Paris Est Créteil, France.
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Antioxidants and Vision Health: Facts and Fiction
A number of nutritional supplements containing antioxidants are advertised for better
vision health. Do they benefit the average consumer? The literature was examined for
the effectiveness of antioxidants for human eye health, and for the intricacies in
collection of such evidence. The following diseases were considered: cataract,
glaucoma, age-related macular degeneration (AMD), retinopathy, retinitis pigmentosa,
eye infections, and uveitis.
The literature indicates that antioxidant supplements plus lutein have a reasonable
probability of retarding AMD. For glaucoma, such supplements were ineffectual in
some studies but useful in others. In some studies, antioxidant rich fruits and
vegetables were also useful for protection against glaucoma. For diabetic retinopathy,
antioxidant supplements may have a small benefit, if any, but only as an adjunct to
glycemic control. In very high-risk premature retinopathy and retinitis pigmentosa,
antioxidant supplements may be beneficial but those with excess Vitamin E should be
avoided. For cataract, there is no evidence for an advantage of such nutritional
supplements. However, lubricant drops containing N-acetylcarnosine may be helpful in
initial stages of the disease. For eye infections and other causes of uveitis,
antioxidants have not been found useful.
We recommend that a diet high in antioxidant rich foods should be developed as a
habit from an early age. However, when initial signs of vision health deterioration are
observed, the appropriate nutritional supplement products may be recommended but
only to augment the primary medical treatments.
Source: Grover AK, Samson SE, Mol Cell Biochem. 2014 Mar;388(1-2):173-83. Authors from Department of Medicine,
McMaster University, Hamilton, Canada.
MYTH BUSTER
MYTH:
Eating carrots will improve your vision, especially at night.
BUSTED: Carrots along with dark green vegetables such as spinach and broccoli are
generally good for you as they’re an excellent source of vitamin A which is used by the
eye. But they will not noticeably affect your vision.
CHRISTMAS JOKE
Why is Christmas just like a day at the office?
You do all the work and the fat guy with the suit gets all the credit.
Last Word
“And now here is my secret, a very simple secret.
It is with the heart that one can see rightly; what is
essential is invisible to the eye.”
ANTOINE DE SAINT-EXUPERY, 1900 – 1944
French aristocrat, poet, writer and aviator
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