Recently, several studies have helped to cement the bond between age-related macular degeneration (AMD) and cardiovascular disease (CVD). It now seems clear that it is no longer a question of whether the two diseases are related, only the degree of association.

Evidence for a link between CVD and AMD has been building over the past 10 years as researchers have added to the list of possible common risk factors. Recent studies have shown a link between AMD and blood pressure, body mass index and cholesterol.

Exactly how the two diseases are related is still an unanswered question. "One of the likely common pathways would be [the] inflammatory process," researcher Dr Jie Jin Wang said. "Other possible pathways could involve antioxidants and omega-3 fatty acids, but the exact mechanisms are less clear."

Researcher Dr Usha Chakravarthy offers another view: "Better vascular compliance and regulation of the ocular circulation through improved and early management of the systemic manifestations of cardiovascular disease could in the long term prove beneficial in reducing the risk of development of the late stages of AMD."

In any event, it now seems clear that what is good for the heart is also good for the eye. That includes not smoking, eating right, and getting regular exercise. Antioxidants, omega-3 fatty acids and a reduced glycemic index diet will also benefit both eye and heart health.

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By age 65, one-third, and by age 80, one-half of all Americans will suffer from some form of eye disease.

Many will not know their eyes are in jeopardy until it is too late to prevent severe vision loss or blindness.

Scott Uttley, M.D., president of the Minnesota Academy of Ophthalmology said, "Being over the age of 60 is a chief risk factor for many eye diseases. [Baby] Boomers are reaching the age when they should be alert to symptoms and should receive regular eye exams... In many cases, vision loss or blindness is preventable if an individual receives treatment."

For Caucasians 65 years of age and older, age-related macular degeneration is the leading cause of vision loss. It causes the macula, the small area in the retina at the back of the eye, to break down.

Macular degeneration affects your ability to see fine details clearly and to perform activities such as reading and driving. More than 10 million Americans now suffer from it. Dr. Uttley said, "Early diagnosis is important. Researchers are developing new treatments regularly for macular degeneration, and early treatment provides the greatest potential for avoiding blindness."

The two major risk factors for macular degeneration are an age of 60 years or older and a family history of the disease. Other risk factors include smoking, obesity, and hypertension.

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Although Medicare has covered low-vision services performed by an ophthalmologist, optometrist, or occupational therapist since 2002, the number of service providers is limited, leaving many people without needed help. The Low Vision Demonstration Project offers some relief by expanding Medicare's coverage to include services provided by low-vision therapists, orientation and mobility specialists, and vision rehabilitation therapists.

Although these changes represent a major step forward in meeting the needs of people with low vision, the major shortcoming -- at least for now -- is that the projects are limited to people who reside in one of the six demonstration sites: Kansas, New Hampshire, North Carolina, Washington state, New York City (all five boroughs), or Atlanta, Georgia.

If you live in one of the six areas involved in the project, contact your local Medicare office and ask how to take advantage of the program. The National Council of Private Agencies for the Blind and Visually Impaired (ncpabvi.org; or call 866-645-2449) can also identify participating agencies in each area.

If you do not live in one of the six demonstration areas, low vision rehabilitation services are available but be aware that some may not be covered by Medicare or private insurance. Your eye doctor is a good resource for the rehabilitation services in your area.

Another option is to go to visionconnection.org and use the "VisionConnection Help Near You Locator." The locator will help you find low-vision rehab professionals nearby. Another good resource is the American Foundation for the Blind website (afb.org).

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A new study has found that the prevalence of late AMD is similar in Caucasian and Asian populations

When AMD risk levels among racial and ethnic groups are compared, Caucasians are usually identified as at highest risk. Asians in particular have been assumed to have lower risk.

A new study compared the prevalence of early and late AMD in approximately 4000 residents of Japan to the rate in white participants in the Australian Blue Mountains Eye Study (BMES). Diagnostic definitions were identical in the two studies and age standardization enhanced data comparability.

The overall AMD prevalence rate among Japanese was 4.1%, very similar to the BMES rate of 4.4%. Prevalence of late AMD in men was also comparable for the two groups, 1.1% for Japanese and 1.2% for Australians. There was a large difference in the prevalence of late AMD for women; 0.3% for Japanese and 2.1% for Caucasian women.

The authors think a key reason for the difference in prevalence of AMD between Japanese men and women may be that 36.8% of the men smoked, but only 2.8% of the women. While many Asian men smoke, the habit is less socially acceptable for women. In the BMES study, 14.4% of women were smokers.

"Smoking is a well-recognized, modifiable AMD risk factor, and smoking cessation is an important public health measure to reduce AMD," the study authors said.

WHAT IT MEANS TO YOU: It is suspected that AMD manifests differently in Asians and Caucasians. AMD in Asians is often characterized by drusen that smaller and less numerous. In late AMD, Asians have a 20% chance of developing polypoidal choroidal vascularization, a condition rarely seen in Caucasians. The finding that early and late AMD is as common in Japanese men as it is in Australian men is important in confirming that we are dealing with essentially the same disease process in the two populations. The underlying genetic and environmental contributors to the disease are probably the same in the two groups. The large difference in smoking rates among Japanese men and women provided a unique opportunity to examine the role of smoking in AMD. This study if the first in a Japanese population to confirm a link between smoking and AMD prevalence.

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For 20 years - ever since the day the plant opened - Patrick Bobino has reported to work at Envision in Kansas City. Currently, he helps package trash can liners sold to the U.S. government.

Bobino, 67, is legally blind, as are most of his co-workers. They feed rolls of plastic cylinders through machines that slice and seal them into bags.

The plant is very busy due to a General Services Administration contract and the Javits-Wagner-O'Day Act, which mandates that federal institutions make certain purchases from agencies that employ disabled persons.

Coy says the factory, which has 24 on staff, is running two shifts and could add a third. But two factors make expansion difficult.

One is transportation. Most workers rely on public transportation or family members to get to work.

The second growth impediment lies in bureaucracy and policy.

To obtain a GSA contract, at least 75 percent of Envision's employees must be legally blind.

But because Envision's workforce is predominantly blind, the Kansas Department of Social and Rehabilitation Services will not refer workers with disabilities to them. The State adheres to a policy that requires "integrated employment" rather than placing persons with disabilities in sheltered workshops.

"Integrated employment" means that workers with disabilities work along side nondisabled persons. Unfortunately, there are few such employment opportunities, and thousands of Kansans with disabilities are out of work.

The state considers Envision to be a sheltered workshop because of its concentration of blind workers. But Coy, the plant manager, disagrees.

Unlike traditional sheltered workshops, which pay a sub-minimum wage to its employees, Envision pays between $6.90 and $9 an hour - well above the minimum wage.

Bobino said he is blessed to have his job, and would like to see other visually impaired people directed to jobs like his.

"I've been able to buy a car that my wife can drive, we're paying on a home, and we have subsidized health insurance through Envision," he said.

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Like many people, Charlie Kingston wakes up early on weekdays to make his commute to work.

But Kingston, 40, who is legally blind and cannot drive a car, travels 20 miles each way on an electric- and pedal-powered bike.

"Some of (my co-workers) think I'm crazy for riding that far and for riding in the heat, but I gotta do what I gotta do," Kingston said. "I have to take care of my family."

Kingston bought his first electric bike for $2,200 eight years ago. It resembles a mountain bike, but weighs 60 pounds - about 30 pounds heavier - and can do 20 mph with a flick of the wrist thanks to a battery-powered motor. He also can pedal at any point during the trip to save the battery.

"He's just adapted to it," said Stacy Kingston, 38, Charlie's wife. "He's really legally blind and he's riding a bike. It's a little dangerous for him and he's been in a couple of accidents, but he has to support his family."

Kingston said he was hit by a car in 2003, which put him through four months of physical therapy for his knee. Despite the danger and potential for riding in bad weather, Kingston still prefers his bike over public transportation.

Kingston said his bike is a good option for anybody looking to save money on a commute.

"You don't have licensing fees, you don't have insurance," he said. "And most importantly, you don't have gas."

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The SAILOR (Safety Assessment of Intravitreal Lucentis for AMD) study provides important information about the safety of Lucentis therapy. We now have 1-year data from this study, and can use it to evaluate the safety and effectiveness of Lucentis therapy in patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

The safety data is drawn from a group of 2378 patients in this randomized, single-masked study. The study was designed to evaluate the safety and tolerability of intravitreal ranibizumab (Lucentis), as demonstrated by the incidence of ocular and nonocular adverse events.

Patients were randomized to receive either 0.3 mg or 0.5 mg of Lucentis. Retreatment was indicated in patients who demonstrated a 5-letter decrease from BCVA or an increase in central foveal thickness of more than 100 um on OCT.

Ocular adverse events were essentially equal in the 0.3-mg and 0.5-mg groups, and this is consistent with what we have seen with other studies.

Twenty one factors related to stroke were evaluated, such as patients on coumadin, patients who had previous myocardial infarction, patients who had high lipids, and so on. Only five factors have an influence on the stroke rate: prior stroke, arrhythmias, angioplasty, congestive heart failure, and valve malfunction.

The statistically significant difference in stroke rate between patients receiving the 0.3-mg dose and those receiving the 0.5-mg dose of Lucentis that was reported in January 2007 was no longer present after 1 year of follow-up.

Looking at vascular deaths, there does not appear to be a difference in the rate of death from cardiovascular-related, stroke-related, or from other vascular causes between the two dose groups. Looking at nonvascular deaths - death from causes as diverse as cancer and accidents - there was almost a doubling of the rate at the higher dose - 0.7% vs 1.5%. It is not clear whether there is a biological reason for this, or whether the difference is just happenstance.

In summary, the dose groups were equivalent in the overall rate of adverse events, myocardial infarctions, and vascular deaths. There was a trend toward higher stroke and nonvascular death rates in the 0.5-mg group, but these were not statistically significant. Prior stroke was the most significant risk factor for stroke. Although the numbers were small, there was a trend for a higher rate in the 0.5-mg dose group than in the 0.3-mg dose group among subjects with this risk factor. Ocular safety was consistent with both doses and with the prior trials.

WHAT IT MEANS TO YOU: The results of the SAILOR study give us further confidence in the systemic safety of Lucentis. The most important risk factor for serious complication appears to be a history of stroke. It remains to be seen whether the selective anti-VEGF drug Macugen is a safer alternative for persons with the five identified risk factors for stroke from the SAILOR study (prior stroke, arrhythmias, angioplasty, congestive heart failure, and heart valve malfunction).

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A new study using high-definition optical coherence tomography (HD-OCT) finds that resolution of subretinal fluid is the most important determinant of visual acuity recovery following intravitreal Lucentis therapy for neovascular age-related macular degeneration (AMD).

This study was performed to examine the effects of Lucentis therapy on the 3 major compartments of the macular area (retinal volume, subretinal fluid volume, and pigment epithelial detachment volume) in patients with choroidal neovascularization (CNV). These compartments can be visualized using HD-OCT, but not with conventional OCT. HD-OCT was performed using a prototype of the Cirrus HD-OCT. This is a frequency domain OCT system with an axial resolution of 6 um. Conventional OCT was performed using a Stratus-OCT instrument.

Patients were examined using both conventional OCT, and HD-OCT. Intravitreal Lucentis injections were administered at baseline and weeks 4 and 8.

Detailed analysis of retinal volume (RV), subretinal fluid volume (SRFV), and pigment epithelial detachment volume (PEDV), revealed that Stratus-OCT thickness measurements include a mixture of multiple components in overall retinal thickness (RT) values because RT is defined as the distance between internal limiting membrane and RPE layers. These findings suggest that changes in retinal microstructure following Lucentis therapy might be masked in conventional OCT measurements of RT.

Using measurements obtained by conventional OCT, a significant correlation between the decrease in RT and improvement in BCVA was found (P<0.005).

Data from HD-OCT analysis showed no correlation between the decrease in RV or PEDV and improvement in BCVA. The decrease in SRFV, however, correlated well with increase in BCVA (P<0.05), as well as with the characteristic time course of vision recovery. The immediate and intensive response of SRFV to anti-VEGF therapy correlates well with the rapid recovery of visual acuity following anti-VEGF therapy.

In conclusion, HD-OCT data indicate that subretinal fluid volume is the most important determinant of visual acuity recovery following anti-VEGF therapy. SRFV may be the most important parameter to consider when defining retreatment criteria for anti-VEGF treatment regimens in the future.

WHAT IT MEANS TO YOU: OCT technology is relatively new and continues to rapidly evolve. Spectral domain OCT is the latest technology that is commercially available. HD-OCT is a variant of spectral domain OCT, and is not yet commercially available. This paper demonstrates how improvements in technology can lead to greater understanding of disease processes, and that, in turn, can lead to improvements in therapy. Recognition of the key role that subretinal fluid plays in vision recovery following anti-VEGF treatment may improve our ability to individually tailor treatment protocols.

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Eating oily fish once a week may reduce the risk of developing age-related macular degeneration (AMD)

A team of researchers across seven European countries and coordinated by the London School of Hygiene & Tropical Medicine sought to investigate the association between fish intake and omega 3 fatty acids with wet AMD, comparing people with wet AMD with controls. Participants were interviewed about their dietary habits including how much fish they ate and what type. Information on the main omega 3 fatty acids -docosahexaenoicacid (DHA) and eicosapentaenoic acid (EPA) - was obtained by linking dietary data with food composition tables.

The findings show that people who habitually consume oily fish, such as salmon, tuna or mackerel, at least once a week are 50% less likely to have wet AMD. There was no benefit from consumption of non-oily white fish. There was a strong association between low omega 3 consumption and wet AMD. People in the top 25% of omega 3 fatty acid consumption (300 mg per day and above) were 70% less likely to have wet AMD.

Astrid Fletcher, who led the study, commented: "This is the first study in Europeans to show a beneficial association on wet AMD from the consumption of oily fish and is consistent with results from studies in the USA and Australia. Two 3oz servings a week of oily fish, such as salmon, tuna or mackerel, provides about 500 mg of DHA and EPA per day".

The research team is not, however, recommending omega 3 supplements as the study did not investigate whether supplements would have the same benefit as dietary sources.

WHAT IT MEANS TO YOU: Oily fish consumption seems to be one of the most effective means currently at our disposal to decrease the risk of developing AMD. It is worth reemphasizing that the results do not necessarily extrapolate to fish oil supplementation. Actual fish contains many nutrients and compounds not included in fish oil supplements, and those nutrients that are present may not be as effective in supplement form. The best advice is to incorporate oily fish into your diet at least twice weekly.

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The Touch Sight is a revolutionary digital camera from Samsung designed for visually impaired people. Chueh Lee , the camera's designer, has created the worlds first camera designed specifically for use by the blind.

Although not yet commercially available, the Touch Sight camera was honored with a gold award in the prestigious 2008 International Design Excellence (IDEA) competition in the Communications Tools Concept category. Judges lauded the Touch Sight for its unique features and attention to detail.

Product highlights include a feature that records sound for three seconds after pressing the shutter button, allowing the individual to use the sound a reference when reviewing and managing the photos. Touch Sight also possesses a lightweight, flexible Braille display sheet which displays a 3D image by embossing the surface, allowing the user to touch their photo.

Chueh discovered in his research that holding the camera to the forehead, like a third eye, is the best way for the blind to stabilize and aim the camera. He also found the visually impaired have no problems estimating distances, since their sense of hearing is especially sharp. Every rustle of wind in the trees catches their attention and can be used to judge distances. Other senses come into play as well. The heat of the sun or a lamp in a living room, for example, signals a direct source of light. They regularly use their non-visual senses to feel the world and manifest it into a mental photograph.

Check out the link below for photos of this remarkable device.

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In a new study reports the discovery of the first gene associated with severe, "dry" age-related macular degeneration, also known as geographic atrophy. They also show that there could be adverse consequences, including blindness, if individuals who possess a particular variation of this gene are treated with RNA interference therapy.

The research team discovered a link between dry AMD and a key molecule that alerts the immune system to the presence of viral infections, a molecular protein called toll-like receptor (TLR)3.

The researchers found that a genetic variant associated with low activity of the TLR3 receptor appears to confer protection against dry AMD, probably by suppressing the death of certain retinal cells.

Importantly, this research indicates that individuals with a genetic variant of TLR3 who undergo a new treatment called RNA interference (RNAi) could be at risk. RNAi is used to turn off or silence genes related to various diseases. Several human clinical trials are currently using RNAi, including therapies to treat the "wet" form of AMD.

"Ironically, in some individuals, using RNAi to cure wet AMD might actually increase the risk for blindness from dry AMD," said Zhang.

"These findings pave the way for using TLR3 inhibitors as a potential new therapy for dry AMD, and simultaneously highlight the importance of critically assessing the potential risk posed to patients by RNAi-based therapies," added Jayakrishna Ambati, who participated in the study.

The discovery may have major preventive and therapeutic implications, according to Hemin Chin, at the National Eye Institute. "Given its high prevalence in the United States and the world, finding effective prevention and treatment strategies for AMD is of critical importance. This finding represents a major advancement in our understanding of dry AMD, for which effective treatment is not yet available," said Chin.

WHAT IT MEANS TO YOU: This study represents a giant step forward in our understanding of dry AMD. Unraveling the mechanisms behind the disease may one day lead to effective therapies. A byproduct of this research is the surprising finding that RNAi treatments for wet AMD could trigger dry AMD. This serves to remind us that new experimental therapies, no matter how promising they may seem, may carry the risk of unintended consequences.

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Insight Radio, Europe's first radio station for the blind, is planning to broadcast nationwide on DAB digital radio and the BBC's new Freesat service. The announcement coincided with the station's first anniversary in August. Currently the station, based in Partick, Glasgow, is available only over the internet, on digital television and on FM in the Glasgow area. Insight Radio's first year has been a success: it won a silver in the Sony awards, regarded as the Oscars of the radio world, last October. Bankrolled by the Royal National Institute of Blind People (RNIB), Insight is a non-commercial station dedicated to giving blind and visually impaired people news and information specific to their lives. Some 60% of the station's staff are visually impaired. No one is more excited about the expansion than John Legg, director of the RNIB. He said: "We're delighted that our service is expanding. We've had huge success broadcasting from our base in Partick, but opening up our satellite stations will enable us to cover stories in different parts of Britain in more depth, interviewing local people."

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In a phase 2 extension trial of VEGF Trap-Eye, the agent significantly reduced retinal thickness and improved visual acuity among patients with wet age-related macular degeneration, according to a press release from the developers of the drug. The VEGF Trap is a unique fusion protein that binds all forms of Vascular Endothelial Growth Factor-A (VEGF-A) and Placental Growth Factor (PLGF). Both VEGF-A and PLGF are proteins that are involved in the abnormal growth of new blood vessels. In the double-masked, prospective, multicenter study, 157 patients were randomly assigned to five dosing groups and treated with the drug in one eye. Patients who received four monthly doses of VEGF Trap-Eye in either 2-mg or 0.5-mg concentrations achieved a mean visual acuity improvement of 9 letters and 5.4 letters, respectively, at week 52. The 2-mg and 0.5-mg doses also achieved mean decreases in retinal thickness of 143 um and 125 um, respectively. During the subsequent as-needed dosing phase, patients who initially received 2-mg doses received a mean of 1.6 additional injections and patients who initially received 0.5-mg doses received a mean of 2.5 additional injections, the release said.

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Twenty-eight teenagers, ages 14 to 18, from Miami Lighthouse for the Blind summer camp had the opportunity to partake in the Dolphin Encounter of a lifetime on August 7th at Miami Seaquarium. The teenagers had a chance to touch dolphins, feed them, play with them and get up-close and personal with these loving creatures. "We are very grateful to Miami Seaquarium for offering our blind and visually impaired teenagers this wonderful opportunity to experience the use of their other senses by swimming with the dolphins. We want to give our transition teens an unforgettable experience and show them the unlimited opportunities that lie ahead of them," said Virginia A. Jacko, CEO of the Miami Lighthouse. "We are very excited to have the teenagers come out to the park and experience the magic of these animals. Interacting with dolphins truly is an unforgettable experience," said Eric Eimstad, of the Miami Seaquarium.

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That world champion Im Dong-Hyun can even hit the target is a minor miracle. Not many Olympic archers are legally blind. The South Korean has no idea where his arrow lands on the target, and from 70 meters away all he has to aim at is a blob of color. "When I look down the range at the target all I can do is try to distinguish between the different colors," he told Reuters in an interview. Im's eyesight is 20/200 due to severe myopia. That makes Im legally blind. The 22-year-old relies on "feel" when he shoots. Im, who made Time magazine's list of 100 'Athletes to Watch' in Beijing, became archery's youngest male champion four years ago in Athens when South Korea won gold in the team competition. He picked up his second Olympic gold medal in the team archery competition in Bijing.

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An exercise program has been designed for visually impaired and deaf-blind people with the aim of reducing their most common physical problems: those of balance, posture, coordination, tense neck and shoulder muscles, and loss of spinal rotation and reciprocal arm swing. The program was evaluated and the results published in the British Journal of Visual Impairment. Twenty-seven participants (23 visually impaired, 4 deaf-blind; mean age 54 years) participated in a 5-6 week physical training program (three 60-minute sessions per week). Twenty-four participants completed the program, 12 of whom had a 'physically active' lifestyle and 12 a 'sedentary' lifestyle. After the intervention, the participants assessed the effect of it through a questionnaire. Drawing upon their responses, three different indicators were examined further: physical condition, mental state and balance. All except one of the 24 participants who completed the program reported that at least one of these indicators had improved.

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In the eyes, UV light and infrared light are generally absorbed by the corneas and lens. But high-energy blue light is visible and passes through the cornea and lens and reach the retina where it can cause damage. Melanin, which gives eyes their color, helps to trap high-energy light rays so that they don't damage the macula. This may be why people with fair skin or light-colored eyes are more susceptible to macular degeneration. One way to cut down on the exposure to blue light is to wear sunglasses. Lutein, from the Latin lutea meaning "yellow," is one of 600 naturally-occurring carotenoids (a natural colorant or pigment) found in dark green, leafy vegetables and fruits that are yellow, red or orange in color. Lutein protects the macula by absorbing and filtering blue light. Lutein cannot be manufactured by the body and must be obtained from foods that are rich in lutein such as kale, spinach, bok choy, mangoes, tomatoes and carrots.

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