We are pleased to announce the availability of a second online vision test at myvisiontest.com: The Macular Mapping Test (MMT). The MMT is based upon the pioneering work of Manfred MacKeben of the Smith-Kettlewell Eye Research Institute. It was originally designed for assessment of residual vision in patients with macular disease. However, it is also a valuable tool for monitoring disease progression. Our version of the MMT has been modified from the original to facilitate online self-assessment of vision.

The MMT is very different than our original vision test. It operates on an entirely different principle: letter recognition (our original tests uses video static). This means that some people may do better on one test than the other. And that is the whole idea behind offering more than one test. We encourage you to try both and see which you prefer.

I would like to thank the many people that have tested the MMT during the beta period and provided invaluable feedback. The MMT is much improved thanks to your feedback.

If you have not yet done so, I encourage you to stop by myvisiontest.com and give our new vision test a try.

Print version

Embryonic stem cells may someday cure disease, but scientists worry they also may trigger benign tumors, and even cancer.

The FDA convened a special public session April 10 to discuss the safety concerns. The agency scheduled the meeting to get help in balancing the pleas of patients with risks that may arise should the therapies gain wide use.

The FDA is under public pressure to release new treatments quickly, and it must also assuage safety concerns that have resulted when approved medicines were found to have dangerous side effects after they gained widespread use, Pratt said.

"Don't stand in the way of new medical therapies, and for God's sake, don't let any American get hurt," Pratt said of the mixed regulatory message the FDA hears.

Of particular concern to regulators are so-called teratomas, non-cancerous tumors that can contain a mixture of different types of cells. Growth of such tumors in the spine or brain would be harmful, according to the FDA's documents. In studies with animals whose immune systems are suppressed, injected human embryonic stem cells create teratomas.

Advanced Cell Technology, Inc. is testing therapies derived from embryonic cells for treating macular degeneration. The company plans this year to begin the first human tests of therapies created with stem cells extracted from human embryos. The U.S. Food and Drug Administration, which may soon approve the studies, is asking the companies to closely monitor whether the therapies can spur tumors, as has been seen in animal tests.

Print version

A systematic review of the scientific literature has found that heavy alcohol consumption (more than three standard drinks per day) is associated with an increased risk of early AMD.

A search of the published scientific literature uncovered 441 studies investigating alcohol consumption and AMD. Of these, 5 prospective cohort studies were selected for analysis. The data from the 5 studies included a total of 136,946 people, of whom 1,923 developed macular degeneration.

Pooled results showed that heavy alcohol consumption was associated with approximately 50% increased risk of early AMD, adjusted for age and smoking (OR, 1.47; 95% CI, 1.10 to 1.95), whereas the association between heavy alcohol consumption and risk of late AMD was inconclusive. There were insufficient data to investigate an association between moderate alcohol consumption and AMD.

These results are in keeping with the known adverse effects of heavy alcohol consumption. Photoxidative damage from blue light has been hypothesized as one cause for the pathogenesis of AMD. Alcohol similarly has been shown to increase oxidative stress or to impair the mechanisms that protect against oxidative stress. Additionally, because antioxidants may protect against AMD and heavy drinkers have lower serum antioxidant levels, it is possible that individuals with heavy alcohol consumption have diets deficient in antioxidants.

Alcohol consumption hypothetically may have both harmful and protective effects on AMD. Alcohol is a known neurotoxin that can result in oxidative brain damage and thus in heavy amounts may be expected to have an adverse effect on the retina. However, moderate consumption is associated with decreased platelet aggregation, lower serum fibrinogen levels, lower C-reactive protein concentrations, and higher high-density lipoprotein levels, all of which may be protective for AMD.

WHAT IT MEANS TO YOU: Cigarette smoking is the only consistently identified modifiable risk factor for AMD. This study identifies heavy alcohol consumption as another modifiable risk factor for the disease. Individuals seeking advice on AMD prevention should be encouraged to stop both smoking and heavy alcohol consumption, both of which can to lead to a multitude of health problems.

Print version

Age-related macular degeneration (AMD) is the leading cause of vision loss and blindness among older adults. "Although genetics plays a key role in susceptibility to AMD, environmental factors, such as smoking, are also important," the authors write. "Evidence of higher rates of AMD in women than in men and links between AMD and cardiovascular disease suggested a role for estrogen in the etiology" or development of the condition.

"Current postmenopausal hormone users had a notable 48 percent lower risk of neovascular AMD compared with those who had never used postmenopausal hormones, although risk did not decline linearly with longer durations of use," the authors write. "Risk was lowest for postmenopausal hormone users who had used oral contraceptives in the past."

In contrast, risk of early AMD was 34 percent higher among current postmenopausal hormone users and oral contraceptive use was not associated with early AMD risk. "The higher risk of early AMD among postmenopausal hormone users was unexpected and in apparent conflict with the observed inverse association for neovascular AMD," the authors write. Women who had given birth had a 26 percent lower risk of early AMD.

The authors conclude that "although [postmenopausal hormone] and [oral contraceptive] use were associated with a lower risk of neovascular AMD, no benefit was observed for early AMD. Factors influencing lifetime exposure to estrogens were not consistently associated with the disease."

WHAT IT MEANS TO YOU: This study found no consistent relationship between estrogen exposure and AMD, and there is certainly no clear-cut benefit of postmenopausal hormone replacement use. Postmenopausal hormone use appears to increase the risk of early AMD and yet decrease the risk of late AMD. When the waters are this muddy, it's often a sign that we don't yet know the whole story. It's probably best not to alter your hormone use on the basis of this study alone. If hormone use is indeed related to AMD development and progression, we will have to await future research to clarify the relation.

Print version

Dave Heeley, nicknamed Blind Dave, is the first blind person to complete seven marathons, on seven continents, in seven days. He undertook this challenge to raise 1 million pounds for the Guide Dogs for the Blind Association.

Heeley , 50, is a father-of-three from West Bromwich, UK, began the Seven Magnificent Marathons challenge at Mount Pleasant in the Falklands (Antartica) on Monday, April 7. Within 24 hours they had completed their second run in Rio de Janeiro (South America).

"Rio was tough," Mr Heeley said. " It was a bad flight out from the Falklands to Rio, in a small private plane, which meant we couldn't get any sleep or stretch out, and we had to start running as soon as we arrived.

From Rio it was on to Los Angeles (North America) for a race at the Rose Bowl stadium, before boarding a plane to Sydney (Australia) on Thursday for marathon number four.

"Four down, three to go," exclaimed Mr Heeley, smiling and punching the air in triumph. "The legs are hurting, no doubt about that, but this is one hell of a high."

On Friday, April 11th, the runners struggled through the baking heat of Dubai (Asia), and their penultimate run took place in Tunis (Africa) on Saturday. The final marathon took place in London (Europe) on Sunday April 13th.

The tortuous logistics for the trip fell to David Gagen, a former lieutenant colonel in the Royal Electrical and Mechanical Engineers and a self-described "Mr Grumpy" who was forced more than once to drag the runners from meal tables to catch flights.

Heeley spent six months training, under the care of Dr Philip Glasgow, head physiotherapist at the Sports Institute Northern Ireland. "The key thing is not the running of the marathons, but being able to recover properly between them," he said.

For Mr Heeley, it was not the running that is most draining. "It's all the flying, the different climates," he said.

Print version

Bionic eyes have been implanted in British patients for the first time offering hope to hundreds of thousands of blind people.

Two blind patients underwent the procedure, which surgeons say 'is straight out of science fiction', at Moorfields Eye Hospital in central London last month and are said to be "doing well".

Surgeons implanted an electronic device into the back of the eye to allow the patients to distinguish objects as pictures made up of spots of light.

A wireless signal is transmitted from the camera mounted in a pair of eyeglasses to a small processing device, the size of a walkman that can be worn on a belt. The signal is then sent to an ultra thin electronic device that is implanted in the eye and attached to the retina.

The electronic implant stimulates retinal nerves allowing a signal to be passed along the optic nerve to the brain. The brain perceives patterns of light and dark spots corresponding to which electrodes are stimulated.

Three more patients will have the four-hour operation as part of an international trial before the technique is evaluated and extended.

At first patients who are completely blind due to an inherited condition called retinitis pigmentosa are being treated but eventually it could be offered to thousands of patients as the devices are perfected.

Earlier trials in America have shown patients can see light, shapes and movement. They were able to navigate without their stick or guide dog and distinguish between objects on a table suggesting the device could help blind people to lead independent lives.

Print version

NeoVista, Inc. announced that the U.S. Food and Drug Administration (FDA) has granted the company's request to expand the number of sites participating in its pivotal Phase 3 trial from 10 to 30 in the United States. The approved expansion of CABERNET (CNV Secondary to AMD Treated with BEta RadiatioN Epiretinal Therapy) trial, which seeks to evaluate the safety and efficacy of the company's novel epiretinal brachytherapy for the wet form of age-related macular degeneration (AMD), was dependent on the FDA's review of 90-day safety data

"With this expansion to 30 sites, we will not only be able to recruit more patients at a higher rate, taking us one step closer to commercialization in the United States, but it will also allow additional retina specialists to see the benefits of our novel therapy first-hand while treating their patients," said John N. Hendrick, President and CEO of NeoVista.

The objective of the CABERNET trial is to evaluate the safety and effectiveness of focal delivery of radiation for the treatment of subfoveal choroidal neovascularization (CNV) associated with wet AMD. CABERNET is a multicenter, randomized, controlled study that will enroll 450 subjects at clinical centers worldwide. The study will evaluate the safety and efficacy of NeoVista's epiretinal brachytherapy, delivered utilizing a limited vitrectomy, concomitant with two intravitreal injections of the FDA-approved antiangiogenic therapy Lucentis (ranibizumab) versus Lucentis alone.

In contrast to previous forms of radiation therapy for wet AMD, NeoVista's therapy delivers a one-time peak dose of beta particle energy (24 Gy) directly to the lesion, and the normal retinal vasculature receives minimal exposure. Importantly for patients, the systemic exposure to radiation is minimal, as the effective dose to the entire body from NeoVista's epiretinal device is less than that from a typical chest x-ray.

Print version

Astaxanthin (AST) is a naturally occurring carotinoid, found is a wide variety of living organisms. Most crustaceans, including shrimp, crabs, and lobster, are tinted red by accumulated AST. The coloration of fish, including the pink flesh of wild salmon, is due to AST.

The AST molecule is similar in structure to other carotinoids, but it is a more potent antioxidant than either beta-carotene or lutein.

Although nutritional antioxidant supplements are beneficial in slowing the progression of macular degeneration, little is known about the effects of AST on the eye.

A group of researchers have studied the effect of AST on the eyes of laboratory mice. The mice received AST supplementation for 3 days, and then underwent a laser treatment known to induce choroidal neovascularization (CNV). The AST supplements continued for 1 week after the laser treatment, at which time the eyes were evaluated for CNV.

The CNV in AST-treated mice was less severe than in control mice. AST treatment also inhibited the expression of inflammation-related molecules, including VEGF.

The authors conclude that AST treatment led to significant suppression of CNV development and suggest that AST supplementation may be valuable as a therapeutic strategy to suppress CNV associated with AMD.

WHAT IT MEANS TO YOU: This study is another excellent example of why eating healthier can help prevent the progression of AMD. Becuase fish oil (omega-3 fatty acids) can help slow the progression of AMD, many people now take fish oil supplements. Unfortunately, doing so will not provide the all the benefits as eating fish - you will be missing out on astaxanthin. The same may said of taking vitamin supplements. While it may be true that you cannot possibly eat enough spinach to reach AREDS levels of antioxidant vitamins, failing to eat healthy can mean missing out on the many other health benefits of a good diet.

Print version

A new research paper published in Nature Neuroscience reports that for the first time ever, artificial photoreceptors have restored vision in blind mice.

The paper reports that scientists were able to restore vision lost to photoreceptor degeneration by engineering bipolar retinal cells to express a light-activated molecule called channelrhodopsin-2. This molecule, normally found in algae, causes the bipolar cell to react to the presence of light, much as a normal photoreceptor would.

"That one can target a specific cell type in the retina and make it light sensitive is a marvelous achievement," says John Dowling, professor of Neuroscience at Harvard.

"This may be the technology that brings the breakthrough for prosthetic devices for restoration of vision," says Steve Barnes, director of the Dalhousie Neuroscience Institute. "It may be possible to duplicate what the complex circuitry of the retina does for our vision, but without photoreceptors."

Retinal degeneration, such as retinitis pigmentosa, is a common cause of blindness. Prosthetic retinal implants are actively being developed to treat retinal degeneration. The current approach usually involves using electrodes to nonspecifically stimulate retinal ganglion cells. The ability to create bipolar photoreceptor cells offers the prospect of much improved vision from such prosthetic devices.

Print version

The U.S. Food and Drug Administration has approved a vision test that helps detect AMD. The test is called Foresee PHP, and is new way to help detect the wet-AMD in its earliest stages, even before a patient notices loss of vision. "The earlier that we diagnose these problems with the conversion from dry to wet, the better off the patient will do," said ophthalmologist Dr. William Varr. Before now, patients often took a more subjective test involving a printed grid. Varr said it worked fairly well but the new test is more objective. And with an earlier diagnosis comes good potentially sight-saving treatments.

Print version

Student athletes who are blind or visually impaired will gather on the Western Michigan University (WMU) campus May 4-10 for sports camps that have become a national model for helping such athletes hone their skills. The camps are designed to introduce students with visual impairments to sports and recreational activities and to provide training to those demonstrating athletic potential. Camp activities will include running, throwing, swimming, gymnastics, wrestling, bowling, track and field, goalball, cycling, power lifting and judo. Athletes who attend the camps have the unique opportunity to interact with others who have the same difficulties in physical education as they do.

Print version

Early results from the READ-2 study presented at the 2008 Annual Meeting of The Association for Research in Vision and Ophthalmology find that the drug Lucentis (ranibizumab) for the treatment of diabetic eye disease has performed better in clinical trials than the current standard treatment using laser surgery. The multi-center READ-2 Study (Ranibizumab for Edema of the mAcula in Diabetes) was designed to test the long-term safety and effectiveness of injections of the drug ranibizumab in patients with diabetic macular edema. In addition, the trial sought to determine the comparative efficacy of ranibizumab versus conventional treatment -- laser photocoagulation therapy -- or both together. Patients treated with ranibizumab experienced significantly greater improvements in visual acuity compared with patients receiving either of the other interventions. On average, the vision of ranibizumab-treated patients improved to 20/63 at month six, compared with essentially unchanged acuity scores of about 20/80 in both the laser and the combination treatment groups. In addition, patients treated with ranibizumab had a 56 percent reduction in excess retinal thickness, whereas only an 11 percent reduction was seen in those receiving laser treatments.

Print version

Researchers presented the results of a retrospective review of patient records recieving Avastin or Lucentis at the Association for Research in Vision and Ophthalmology (ARVO) 2008 Annual Meeting. The researchers observed no clinically relevant differences between the drugs used to treat choroidal neovascularisation secondary to age-related macular degeneration (AMD). Patients recieving Avastin required slightly fewer injections than patients undergoing Lucentis therapy. Improvements in visual acuity and foveal thickness were not significantly different between the two groups. No ocular complications such as endophthalmitis were seen in either group. The researchers concluded that Avastin appears to be as safe as Lucentis.

Print version

EURO MP Gary Titley is calling on the EU Government to take action after research showed smoking causes blindness. The MEP, whose office is based in Radcliffe, has written to health Secretary Alan Johnson urging him to place warnings on cigarette packets about the risk of blindness. The findings were made by Mr Simon Kelly, a consultant at Royal Bolton Hospital, who said a smoker's risk of developing age-related macular degeneration was four times higher than a non-smoker.

Print version

Canada Post has issued the country's first-ever Braille stamp at the Montreal Association for the Blind (MAB) in Notre Dame de Grace on April 21, coinciding with the 100th anniversary of the MAB's first board meeting. The 52-cent stamp, which will be available across the country, celebrates guide dogs and has the rate printed in Braille. The MAB is a private, non-profit rehabilitation centre serving blind and visually impaired people of all ages. It is also the oldest rehabilitation centre of its kind in Canada. There were a few countries that had produced Braille postage stamps. They included Britain, Costa Rica, Denmark and Mexico.

Print version