Anti-VEGF's Improve Helps Patients with AMD Sustain Vision

In a study of nearly 650 people with the eye disease age-related macular degeneration (AMD), half still had vision 20/40 or better, typically good enough to drive or to read standard print, after five years of treatment with anti-VEGF drugs that are injected into the eye. The authors of the study, funded by the National Eye Institute (NEI) at the National Institutes of Health, say those outcomes would have been unimaginable about 10 years ago, prior to the drugs’ availability. Read more.

NEI Study Finds Three More Genes Associated with Glaucoma

"An analysis funded by the National Eye Institute (NEI), part of the National Institutes of Health, has identified three genes that contribute to the most common type of glaucoma. The study increases the total number of such genes to 15." That's the start of a Science Daily post. Read more.

NEI Notes January as Glaucoma Awareness Month

Glaucoma Awareness Month starts next week. The disease is a major cause of vision loss in the U.S. It affects about 3 million Americans, and that number could more than double by 2050. “Early detection by having a comprehensive dilated eye exam is key to protecting vision,” said Paul A. Sieving, M.D., Ph.D., director of the NEI (National Eye Institute). Anyone can get glaucoma, but African Americans over age 40, everyone over age 60, especially Mexican Americans, and people with a family history of glaucoma are at higher risk. People at higher risk should have a comprehensive dilated eye exam every one to two years. Glaucoma is a group of diseases that damages the optic nerve, the bundle of nerve cells that relays visual information from the eye to the brain. In the most common form of glaucoma, called primary open angle glaucoma, nerve damage results from increased pressure inside the eye. Increased eye pressure occurs when the fluid that circulates in the eye drains too slowly. Read more.

Training the Brain to See Better

People are bad at staying focused. We’ve all had our minds wander when we try to concentrate on a task that requires paying close attention but isn’t all that engaging. But a new NIH-funded study suggests that one’s capacity to stay focused can improve with real-time feedback, according to a press release from the National Eye Institute.

“The reason we are bad at staying focused is because we are bad at monitoring our attentional state,” explained Nicholas Turk-Browne, Ph.D., associate professor in the Department of Psychology at Princeton University. Dr. Turk-Browne’s lab led the study published in Nature Neuroscience.

“Normally, the only way we know that our attention is drifting is when we make a mistake. But by then it’s too late.” For example, the root cause of driving off a road – a lapse in attention – happens well before any ensuing accident.

So Dr. Turk-Browne and his team asked: What if people could be warned about their waning attention long before they made a mistake? And could they use this feedback to learn to stay more focused, even when no longer provided with feedback?

To answer this question, the researchers recruited several adults to participate in a three-day experiment. Each day, study participants were rapidly shown photographs of male or female faces superimposed on indoor or outdoor scenes. After viewing each image, the participants pushed a button if the image met preset criteria, for example if it showed a male face. In this case, they had to pay attention to the face and ignore the scene.

On the second day, participants were scanned with functional magnetic resonance imaging (fMRI), which can measure patterns of activity in the brain. With fMRI, the investigators were able to monitor the attentional state of participants — that is, whether they were attending to faces or scenes — because these categories trigger different patterns of brain activity.

Read more.

Expensive Eylea Outperforms Avaastin and Lucentis, says NEI

In an NIH-supported clinical trial comparing three drugs for diabetic macular edema (DME), Eylea (aflibercept) provided greater visual improvement, on average, than did Avastin (bevacizumab) or Lucentis (ranibizumab) when vision was 20/50 or worse at the start of the trial. However, the three drugs resulted in similar average improvement when starting vision was 20/40 to 20/32. Investigators found no major differences in the safety of the three drugs. The trial was funded by the National Eye Institute (NEI), part of the National Institutes of Health. Read more on the NIH site.

New Treatment for Dry Eye

Supporting research into a better treatment for dry eye has been one of Dr. Jerome Wujek’s tasks for the past eight years and has just begun to reach fruition with the launch of an FDA-approved Phase I clinical trial that will test the safety and efficacy of a novel drug called P-321 Ophthalmic Solution. The drug is applied as an eye drop and targets a unique mechanism involved in maintaining moisture in the eye. Its development was supported through two NEI SBIR grants to Parion Sciences, Inc. and through the NCATS Bridging Interventional Development Gaps (BrIDGs) program, which gives investigators access to NIH subcontractors who conduct preclinical safety studies necessary for an FDA Investigational New Drug (IND) application. Read more.

Treating AMD-Related Depression

A multi-disciplinary rehabilitation therapy can cut the risk of AMD-related depression in half, says a new study funded by the National Eye Institute (NEI), part of the National Institutes of Health (NIH). The findings were published in Ophthalmology. The trial recruited 188 participants with bilateral AMD from an ophthalmology practice affiliated with Wills Eye Hospital in Philadelphia. They averaged 84 years, 70 percent were women, and half percent lived alone. Their best corrected vision was no better than 20/70. Participants manifested mild depressive symptoms and were at risk for developing clinical depression. Read more about the trial at NEI. The findings were published in Ophthalmology.

Blindness from Glaucoma Halved/Glaucoma Awareness Month

"The probability of blindness due to the serious eye disease glaucoma has decreased by nearly half since 1980, according to a study published this month in Ophthalmology, the journal of the American Academy of Ophthalmology," according to Medical News Today. "The researchers speculate that advances in diagnosis and therapy are likely causes for the decrease, but caution that a significant proportion of patients still progress to blindness." Read more.

Meanwhile the National Eye Institute tardily notes that January is Glaucoma Awareness Month.

Glaucoma is sometimes called the "silent thief of sight" because it slowly damages the eyes and can cause irreparable harm before there is any vision loss. But this disease is stealthy in more ways than one. Glaucoma has been known at least since antiquity, and yet, researchers today still do not know what causes it in most cases. There are treatments to delay vision loss, but no cure, making it a leading cause of blindness all over the world. Read more.

"Primary open-angle glaucoma remains a black box, but researchers are pursuing many avenues to investigate the underlying causes. As we develop a better understanding of the disease process, we hope this will lead to new, more effective treatments and possibly even preventive therapies for it," said Hemin Chin, Ph.D., director of the Glaucoma and Optic Neuropathies program at the National Eye Institute (NEI), part of the National Institutes of Health.

According to the 2013 "Cost of Vision Problems: The Economic Burden of Vision Loss and Eye Disorders in the United States," report, glaucoma and disorders of the optic nerve annually cost $5.8 billion, with an annual per-person treatment cost of $2,170. Today, more than 2.7 million Americans ages 40 and older have open-angle glaucoma. With the population of older Americans continuing to increase, these numbers will only grow. Read more.
 

NEI Looking at Adaptive Optics

If you've ever been sleep-deprived, you've probably had a firsthand glimpse of the blood vessels in your eyes. But what you haven't seen—and what many eye care professionals cannot see as well as they would like—are the vessels closest to the retina, the light-sensitive tissue at the back of the eye, according to a National Eye Institute (NEI) spokesperson. The federal agency is helping researchers develop new retinal imaging methods to solve this problem. Such methods have the potential to improve diagnosis and treatment of common eye diseases like age-related macular degeneration (AMD) and diabetic retinopathy. These diseases can cause a variety of defects in blood vessels inside the eye, including vessel loss, the growth of abnormal vessels, and small bulges that can rupture (called aneurysms).

Adaptive optics (AO) is one technology helping to overcome this problem. It deals with the tendency of light to become distorted as it passes through different media such as air, water, or living tissue. AO was originally developed because astronomers wanted to get a clear view of objects in space, without distortions caused by the atmosphere. But vision scientists and eye care experts have a similar problem: When light is shined into the eye, it is distorted by the cornea (the front, transparent part of the eye) and the lens. AO systems typically use a sensor to measure the pattern of blurring and a flexible mirror to correct it. Read more.

NEI Studies Link the Same Gene as Risk Factor for AMD

Three studies reported in Nature Genetics have converged on the same gene as a rare but powerful risk factor for age-related macular degeneration (AMD). The new research, sponsored by the National Eye Institute, solidifies a link between AMD and genes encoding the complement system, a set of proteins that plays a central part in immune responses and inflammation. In particular, the findings bring a gene called C3 into the spotlight. Read more.

Protein for Visual System Might Affect Alzheimer's

A class of proteins that controls visual system development in the young brain also appears to affect vulnerability to Alzheimer's disease in the aging brain. The proteins, which are found in humans and mice, join a limited roster of molecules that scientists are studying in hopes of finding an effective drug to slow the disease process. That's the word from the National Eye Institute. Read more.

NEI Remembers Stephen J. Ryan

Stephen J. Ryan, M.D., highly regarded for his leadership and tireless advocacy on behalf of the NEI, passed away April 29, 2013. An internationally recognized expert in retinal diseases and ocular trauma, Ryan was the president of the Doheny Eye Institute, an independent nonprofit institution affiliated with the University of Southern California (USC), from 1974 to 2012. As the first full-time chairman of the USC Department of Ophthalmology, Ryan in 1974 forged the affiliation between Doheny and USC. Today, Doheny is recognized as a premier institution for ophthalmic research, training, and clinical care. Ryan also served as dean of USC's school of medicine, now called the Keck School of Medicine, from 1991 to 2004. Read more.

NEI’s Healthy Vision Month—Education Materials Available

In May, Healthy Vision Month, the National Eye Institute (NEI) calls on Americans to make their vision a priority. Here are some stats about your patients. Some 38 million Americans over age 40 have glaucoma, diabetic retinopathy, age-related macular degeneration, or cataracts. That number could rise to 56 million by the year 2030. The NEI is encouraging individuals to have a comprehensive dilated eye exam. Read more.

NEI has set up a Healthy Vision Month website. It offers educational materials that you could use for your patients or the surrounding community. Click here. For example, its Healthy Eye Toolkit includes the following:  e-cards, toolkits, websites, handouts and fact sheets, posters, stickers and magnets, and calendars and coloring pages.

New Genetic Factors Associated with AMD Discovered

An international group of researchers has discovered seven new regions of the human genome—called loci-that are associated with increased risk of age-related macular degeneration (AMD), a leading cause of blindness. The AMD Gene Consortium, a network of international investigators representing 18 research groups, also confirmed 12 loci identified in previous studies. The findings are reported online today in the journal Nature Genetics. Supported by the National Eye Institute (NEI), a part of the National Institutes of Health, the study represents the most comprehensive genome-wide analysis of genetic variations associated with AMD. Read more.

NEI Launches New Low Vision Program

Last week—at the start of Low Vision Awarness Month (February)—the National Eye Institute released a 20-page large-print booklet and a series of videos to help people adapt to life with low vision. The booklet, Living with Low Vision: What You Should Know, urges people with low vision to seek help from a low vision specialist and provides tips to maximize remaining eyesight. The videos feature patient stories about living with low vision. A video for health care professionals emphasizes the importance of explaining the rehab services available to individuals with vision loss, which a 2012 report estimates at 2.9 million American. The NEI says that will increase 72 percent by 2030. Statistics on low vision are taken from the report, 2012 Fifth Edition of Vision Problems in the U.S., available on the NEI website at http://www.nei.nih.gov/eyedata. The new NEI booklet and videos along with other resources for people with low vision can be viewed and downloaded at http://www.nei.nih.gov/lowvision.

NEI Rewards the Audacious

The National Eye Institute (NEI) has selected 10 submissions from some 500 entries for its Audacious Goals challenge. The NEI Challenge is part of a government-wide effort to bring the best ideas to bear on the nation's most pressing challenges. During the judging process, more than 80 experts in the vision community helped narrow the field to 81 final candidates. A federal panel consisting of 13 clinicians and scientists then selected the following winning ideas:

• Regenerative Therapy for Retinal Disease (Dennis Clegg, Ph.D., University of California, Santa Barbara): To treat degenerative retinal disease with an off-the-shelf tissue graft that could be implanted in the back of the eye to replace cells lost to disease.
• Restoration of Vision by Opto-electronic Stimulation (Robert Duvoisin, Ph.D., Oregon Health and Science University, Portland): To restore vision by making nerve cells in the eye sensitive to light so that images captured by a camera can be converted to nerve signals that are sent to the brain.
• Precise Gene Editing In Vivo (Yingbin Fu, Ph.D., University of Utah, Salt Lake City): To permanently correct any disease-associated mutations in a patient through the use of molecules that are specially designed to target mutated DNA sequences and that can be delivered safely and efficiently into the eye.
• Using Molecular Scissors Genome Editing to Cure Ocular Genetic Disease (Steven Pittler, Ph.D., University of Alabama, Birmingham, AL): To permanently correct gene defects in patients at the site of the mutation using molecules that act like scissors to precisely replace genome errors with the correct DNA sequence.
• An Audacious Goal: Reprogramming the Retina (Rajesh Rao, M.D., Washington University School of Medicine in St. Louis and The Retina Institute, St. Louis): To directly reprogram easy-to-isolate skin or blood cells to retinal cells using gene therapy and other techniques to enable repair strategies for degenerative retinal diseases.
• Functional and Structural Neuroregeneration (Tonia Rex, Ph.D., Vanderbilt University, Nashville): To restore functional vision in patients who experience loss of axons-the threadlike extensions of a nerve cell that conduct electrical impulses-from the optic nerve as a result of traumatic optic neuropathy or glaucoma by complete axon regeneration.
• Fountains of Youth for the Eye (Julia Richards, Ph.D., University of Michigan, Ann Arbor): To turn back the aging process in the eye so that ocular diseases like age-related macular degeneration or glaucoma start 10, 20, or 30 years later than they now do.
• Endogenous Retinal Repair: Releasing our Inner Salamander (Jeffrey Stern, M.D., Ph.D., Capital Region Retina, PLLC, Albany, NY): To repair the retina by activating stem cells residing within the eye, awakening reparative processes that occur naturally in amphibians and other animals but which lay dormant in human patients.
• Reversing Retinal Blindness Using Small Molecules (Russell Van Gelder, M.D., Ph.D., University of Washington, Seattle): To restore vision to patients with retinal diseases through the use of a photoswitch, a small molecule that is chemically modified to become active or inactive after exposure to certain wavelengths of light.
• Vision BioBank - A Network of Ocular Phenotyping Centers Using Genomic and Epidemiologic Data to Promote Personalized Ophthalmology (Janey Wiggs, M.D., Ph.D., Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston) : To create a network of biobanks that collect corresponding phenotype (physical characteristics) and genotype (genetic) data of people with certain eye diseases; the biobanks could be used for a wide range of studies, including the development of sensitive and specific gene tests that could accurately determine a person's risk for glaucoma, age-related macular degeneration, diabetic retinopathy, and other common complex blinding diseases as well as their likely response to certain therapies.

Each winner will receive a $3,000 prize plus travel expenses to attend the NEI Audacious Goals Development Meeting, Feb. 24-26, 2013, at the Bolger Conference Center in Potomac, MD. There, some 200 vision researchers, patient advocates, ophthalmologists, and optometrists from the U.S. and abroad will discuss some of the ideas. Then NEI staff and members of the National Advisory Eye Council will publish the most compelling audacious goals for the institute and the broader vision research community. For more information, visit www.nei.nih.gov/challenge.

NEI Encourages Consumers to Get Dilate Eye Exams

During Glaucoma Awareness Month, the National Eye Institute (NEI) is encouraging Americans at higher risk for glaucoma to get a dilated eye exam. People at higher risk include African Americans more than 40 years of age; all adults older than 60, especially those who are Mexican American; and people who have a family history of the disease. Read more.

NEI Issuing Awards for Ideas that Advance Vision Science

The National Eye Institute (NEI), a part of the National Institutes of Health, is offering $3,000 awards to as many as 20 contestants who submit the most compelling one-page ideas to advance vision science. The submission deadline for the Challenge to Identify Audacious Goals in Vision Research and Blindness Rehabilitation is Nov. 12, 2012. Winning contestants will be invited to present, discuss, and refine their ideas at the NEI Audacious Goals Development Meeting, Feb. 24-26, 2013, in Washington D.C.Read more.

National Eye Institute Planning Document Near Completion

The NEI is completing Vision Research: Needs, Gaps, and Opportunities that is scheduled to be published and available by July 2012, here on the NEI website. This document represents the critical first step in our efforts to identify vision research priorities. With a thorough accounting of the state of vision research in place, the next phase of the planning process will extend and expand our efforts to obtain broad and diverse input from academia, industry, foundations, and other agencies and individuals worldwide. New ideas and approaches will energize research efforts, increase public awareness of vision research, and make important contributions to planning, priority setting, and operations at NEI in support of our mission to reduce the burden of ocular disorders and diseases worldwide. If you would like to receive an email notification when Vision Research: Needs, Gaps, and Opportunities is released, please send your request to NEIplan@mail.nih.gov.

NIH and NEI Create Great Site on Eye Care for the Elderly

It's a great website for those elderly patients who surf the web. It's called NIHSeniorHealth (nihseniorhealth.gov). And recently, the National Eye Institute contributed five vision-related topics to the enhanced version of NIHSeniorHealth. The National Institute on Aging and the National Library of Medicine recently announced the expansion and updating of NIHSeniorHealth, the National Institutes of Health (NIH) health and wellness website designed for older adults. Visitors to the site can learn about ways to prevent, diagnose, and treat aging-related diseases and conditions including age-related macular degeneration, cataract, diabetic retinopathy, glaucoma, and low vision.

Health information is one of the key topics that older adults search for online according to the Pew Research Center, and since its launch in 2003, NIHSeniorHealth has been an accessible source of reliable, up-to-date health information for adults 60 plus. Built to address cognitive and vision changes that commonly occur with age, NIHSeniorHealth includes senior-friendly features such as large type, simple navigation, and open-captioned videos that make the site especially easy for older adults to use.