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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 2 5 6 7 8 9 10 11 11 12 13 13 14 15 16 17 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 17 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 RATHE ACHIEVER P a g e 2 RETINA AUSTRALIA (VIC) INC. 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 RATHE ACHIEVER P a g e 3 RETINA AUSTRALIA (VIC) INC. 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: 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. RATHE ACHIEVER P a g e 4 RETINA AUSTRALIA (VIC) INC. 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. RATHE ACHIEVER 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. P a g e 5 RETINA AUSTRALIA (VIC) INC. 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 RATHE 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. ACHIEVER P a g e 6 RETINA AUSTRALIA (VIC) INC. 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. RATHE ACHIEVER P a g e 7 RETINA AUSTRALIA (VIC) INC. 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 RATHE ACHIEVER P a g e 8 RETINA AUSTRALIA (VIC) INC. 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. RATHE ACHIEVER P a g e 9 RETINA AUSTRALIA (VIC) INC. 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 RATHE ACHIEVER P a g e 1 0 RETINA AUSTRALIA (VIC) INC. 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 RATHE ACHIEVER P a g e 1 1 RETINA AUSTRALIA (VIC) INC. 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. RATHE ACHIEVER P a g e 1 2 RETINA AUSTRALIA (VIC) INC. 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 RATHE ACHIEVER P a g e 1 3 RETINA AUSTRALIA (VIC) INC. 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 RATHE ACHIEVER P a g e 1 4 RETINA AUSTRALIA (VIC) INC. 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. RATHE ACHIEVER P a g e 1 5 RETINA AUSTRALIA (VIC) INC. 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. RATHE ACHIEVER P a g e 1 6 RETINA AUSTRALIA (VIC) INC. 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 RATHE ACHIEVER P a g e 1 7 RETINA AUSTRALIA (VIC) INC. CHANGE OF ADDRESS OR OTHER DETAILS To advise change of address or name, please enter your new particulars below. 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