Lower Blood Sugar Less Retinopathy

People with type 2 diabetes who intensively controlled their blood sugar level during the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial Eye Study were found to have cut their risk of diabetic retinopathy in half in a follow-up analysis conducted four years after stopping intensive therapy. Investigators who led the ACCORD Follow-on Eye Study (ACCORDION) announced the results today in New Orleans at the American Diabetes Association annual meeting. The study was supported by the National Institutes of Health’s National Eye Institute (NEI).

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.

High-Energy Demand for Eyes May Account for Its Vulnerability, Says NEI Study

"Our eyes are especially demanding when it comes to energy: Along with our brain, they require a substantial amount of power to keep them functioning and healthy. Now a new study by the National Eye Institute suggests that because of their high-energy demands, our eyes function at high efficiency and with little reserve capacity, which scientists say may explain why they become vulnerable to degenerative diseases." That's from a post from the NEI. 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.

NEI Funding Robotics for Visually Impaired

As part of the National Robotics Initiative (NRI), the National Institutes of Health announced that it will fund the development of three innovative co-robots—robots that work cooperatively with people. One of these will be a hand-worn device to help visually impaired people identify and grasp objects. Read more.

Usually Beneficial Cells in Eye and Brain Accelerate Damage of Eye Disease, Says NEI Study

Spider-like cells inside the brain, spinal cord and eye hunt for invaders, capturing and then devouring them. These cells, called microglia, often play a beneficial role by helping to clear trash and protect the central nervous system against infection. But a new study by researchers at the National Eye Institute (NEI) shows that they also accelerate damage wrought by blinding eye disorders, such as retinitis pigmentosa. Read more.

NEI Research Will Noninvasively Image Cells in Greater Detail

Artist's rendering of neural activity in the retina. Light that enters the eye
activates rod and cone photoreceptors, which in turn activate retinal ganglion cells.
Signals travel to the brain via retinal ganglion cell axons.
Photo credit: National Eye Institute.

"Five bold projects will develop new technology to noninvasively image cells of the eye in unprecedented detail," according to NEI. "The National Eye Institute (NEI) announced the awards as part of its Audacious Goals Initiative. NEI has committed $3.8 million to the projects in 2015 and up to $17.9 million over the next five years, pending the availability of funds. NEI is part of the National Institutes of Health. The NEI Audacious Goals Initiative is a coordinated effort to spur new therapies for blinding diseases. The central audacious goal is to restore vision by regenerating neurons and neural connections in the eye and visual system. Special emphasis is devoted to cells of the retina, including the light-sensitive rod and cone photoreceptors, and the retinal ganglion cells, which connect photoreceptors to the brain via the optic nerve." 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.

NEI Study Makes Connection between Sun and Cataract

A new study funded partially by National Eye Institute explains how years of chronic sunlight exposure can increase the risk of cataract as a result of oxidation stress. Oxidative stress refers to harmful chemical reactions that can occur when cells consume oxygen and other fuels to produce energy. It's an unfortunate consequence of living, but it's also considered a major contributor to normal aging and age-related diseases-including cataract formation in the lens. The new study, led by researchers at Case Western Reserve University in Cleveland, Ohio, suggests that UV light may provide an answer. It shows that UV light can damage lens proteins in a distinct way (called glycation)  typically seen in cataract and in cells damaged by oxidative stress. In other words, UV light can substitute for oxygen to trigger harmful oxidative reactions in the lens. Read more.

Can Soft Bifocal CLs Slow Children's Myopia? NEI Study Looks to Find Out

"The University of Houston (UH) is part of a National Institutes of Health (NIH) study to determine whether commercially available, soft bifocal contact lenses slow the progression of nearsightedness in children," writes Your Houston News. "Investigators at UH and The Ohio State University (OSU) Colleges of Optometry were awarded grants from the NIH’s National Eye Institute, worth approximately $7.5 million over five years. The Bifocal Lenses In Nearsighted Kids (BLINK) Study is a multicenter randomized clinical trial that will follow nearly 300 children over the course of three years. Dr. David A. Berntsen, an assistant professor in the UH College of Optometry, is the principal investigator for the UH clinical site of this collaborative effort. Children 7 to 11 years old will be enrolled and randomly assigned to wear soft contact lenses with no reading power, soft contact lenses with medium reading power or soft contact lenses with high reading power. The investigators will measure the length of the eye and the amount of nearsightedness to determine whether light focused by the reading power of the soft bifocal contact lenses in front of the retina will result in slower eye growth and, thus, slower progression of nearsightedness." Read more.

No Implants for Infants after Cataract Surgery

"It is standard for adults and children who undergo cataract surgery to be implanted with an artificial lens in their eye. But a clinical trial funded by the National Eye Institute suggests that the ideal treatment for infants should be surgery followed by the use of contact lenses for several years, and then an eventual lens implant." That's the world from Medical News Today. Read more.

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.

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.

New Study Shows How a Plant Bacteria Might Help Us Better Understand Eye Disease

By borrowing a tool from bacteria that infect plants, scientists have developed a new approach to eliminate mutated DNA inside mitochondria—the energy factories within cells. Doctors might someday use the approach to treat a variety of mitochondrial diseases, including the degenerative eye disease Leber hereditary optic neuropathy (LHON). The research, published online today in Nature Medicine, was funded by the National Eye Institute (NEI), a part of the National Institutes of Health (NIH). Read more.

Better Understanding of How Glaucoma Begins

Researchers are making progress toward understanding how some cases of glaucoma begin. A new study from the National Eye Institute reveals that myocilin—a protein linked to a significant fraction of glaucoma—is needed to insulate peripheral nerves. The researchers theorize that myocilin could perform a similar function in the eye. That’s the word from a NEI press release. (Picture on the left: These are slices of mouse peripheral nerve. Left: In a normal mouse, a structural protein in myelin [red] surrounds nerve fibers (green). Right: When myocilin is missing, myelin proteins disappear, too. Credit: Kwon et al. Journal of Biological Chemistry.) Genes play a role in glaucoma. Mutations in the myocilin gene have been found in up to four percent of people with adult-onset glaucoma and 10 percent with juvenile-onset glaucoma. Researchers have long believed that myocilin helps maintain normal eye pressure. It's found at high levels within a sponge-like drainage system that regulates pressure inside the eye. But mice lacking the myocilin gene seem to have a normal drainage system, raising the possibility that the gene might be needed elsewhere. Read more.

Meanwhile, “researchers in Taiwan have discovered that people with sleep apnea are far more likely to develop glaucoma compared to those without the sleep condition,” notes Medical News Today. “The results of this study, which is the first to calculate the risk of the disease among people with the sleep disorder following diagnosis, is published in this month's edition of Ophthalmology.” Read more.