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October 2007 Newsletter

My Two Cents: Introducing The New MyVisionTest Newsletter

Welcome to the new MyVisionTest (MVT) newsletter. Visitors to our website are aware that we have a Google News newsfeed of articles from around the web dealing with macular degeneration. I review the newsfeed daily, and post links to the most interesting articles on the site. This newsletter will feature those articles from the past month that I consider to be the most interesting, important, or inspirational for the macular degeneration community. Beyond the newsfeed, additional information from scientific journals, meetings, or other sources may also be included. You are welcome to submit items for inclusion in the newsletter by sending them to admin@myvisiontest.com. The aim will always be to provide accurate, reliable information that is relevant to the macular degeneration community.

Naturally, I will continue to use this newsletter as a means of keeping you up-to-date on MyVisionTest. In fact, progress on version 3 is nearing completion and I anticipate that it will be released within the next several weeks. The new version will include many new features, including an afterimage option, a blindspot monitor, dynamic sizing to take advantage of as much of your monitor real estate as possible, and other features that make the test easier to use. Thanks to our beta testers for their helpful feedback. Their assistance has been invaluable. If you would like to become a beta tester, send email to admin@myvisiontest.com. Thank you!

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Local Volunteers Help Visually Impaired Play

In a retirement community such as Green Valley, where the game of golf is the sport of choice, visually impaired and blind golfers are also able to play.

Their participation comes in part thanks to a program by the Veterans Administration Rehab Center in Tucson and a group of local volunteers who coaches and guide.

Local residents serve as volunteers to visually impaired golfers that play Wednesday mornings at Tortuga Golf Course.

Lee Besse has had macular degeneration for almost four years. His condition has stabilized and his left eye improved so much after eye surgery that he’s no longer eligible for membership in the U.S. Blind Golf Association. Emphasizing the ability of visually impaired and blind people to play golf, the U.S. Blind Golf Association’s catchphrase is, “You don’t have to see it to tee it.”

He explained that the VA takes three students at a time into the program and pays their golf fees and room and board while they’re in the program.

Donating their time and golfing expertise, the volunteers are paired one-on-one with a visually impaired or blind golfer giving direction and distance and telling the golfer what club to use.

“Volunteers provide visual assistance; sighted assistance helps a great deal,” Milo Borich, VA’s blind rehabilitation specialist said, adding that the VA operates 10 rehab centers for the blind in the United States, but only a few have the golf program.

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Macugen And Lucentis Slows Progression Of Age-Related Macular Degeneration

The investigators searched to identify eligible randomized controlled trials for analysis. They identified 267 articles for screening, and they culled these studies for review to a total of 5, with 2 articles examining pegaptanib (Macugen) and 3 focusing on ranibizumab (Lucentis).

All studies compared the effectiveness of either Macugen or Lucentis against a control group that received either a sham injection, photodynamic therapy alone, or a sham injection combined with photodynamic therapy. The primary outcome of all studies was the percentage of patients who lost fewer than 15 letters on vision testing. Macugen improved results vs control therapy by 15% in this outcome, whereas Lucentis improved outcomes by 22% to 32%. Both improvements were statistically significant.

Differences in the rates of subjects gaining 15 or more letters on vision testing were 4% in comparing Macugen and control therapy. Lucentis also seemed to produce more robust outcomes than Macugen in this outcome, with improvements of 18% to 35% vs control treatments.

Both Lucentis and Macugen improved the rate of patients losing vision to 6/60 or worse during treatment. Again, Lucentis seemed to produce stronger effects in this outcome vs control therapy (31% - 44%) compared with Macugen vs control therapy (18%). There was evidence of benefit for both treatments at 24 months.

Adverse events were common in patients treated with Macugen or Lucentis, but these were considered to be mild to moderate in severity.

The study authors conclude that both Macugen and Lucentis seem to retard the progression of AMD. Although the data might suggest that Lucentis is more effective than Macugen, the reviewers note that these 2 medications were compared with different patient populations and with different study methodologies. Head-to-head trials will help to compare the 2 medications directly.

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Research Team Finds Link Between Zinc And Macular Degeneration

In studying post-mortem human eye tissue samples, researches found that maculae of eyes with age-related macular degeneration (AMD) contained unusually high concentrations of zinc.

Because zinc is known to contribute to deposit formation in neurodegenerative diseases, such as such as Alzheimer’s disease and Parkinson’s disease, researchers suspected that zinc might be involved in deposit formation in AMD. One of the hallmarks of AMD is the accumulation of deposits, including drusen and basal laminar deposits, beneath the retina.

Using zinc specific molecular probes the researchers showed that subretinal deposits contain unexpectedly high concentrations of zinc. Zinc accumulation was especially high in the maculae of eyes with AMD.

The researchers concluded that zinc plays a role in sub-RPE deposit formation in the aging human eye and possibly also in the development and/or progression of AMD.

This finding might be particularly important because a 2001 study from the National Eye Institute found that high doses of zinc supplements, combined with antioxidants, may postpone the progression of AMD.

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New Treatment Uses Radiation To Fight Macular Degeneration

NeoVista, Inc. is developing a novel therapy to treat wet Age-Related Macular Degeneration (AMD) utilizing a Strontium-90 isotope. The delivery is made through a minimally invasive surgical procedure. The NeoVista, Inc. procedure involves a single treatment therapy of approximately 45 minutes in length. The therapy has an expected durability of 24 months or longer and is safe for patient and physician. The technology is an intraocular device that delivers and directs radiation to the choroidal vascular bed of the retina. Local delivery of radiation will permit selective treatment of the neovascular lesion while minimizing neurosensory degeneration due to secondary radiation exposure. Ionizing radiation causes changes in the structure of a small fraction of molecules in each exposed cell. Because proliferating cells are usually more sensitive to ionizing radiation than are non-proliferating cells, ionizing radiation is commonly used to retard/stop abnormal proliferation of cells, i.e. cancerous tumors. The device is currently being utilized in a definitive clinical study to support eventual filing for regulatory approval to market the product in the U.S.

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Alcon Receives FDA Decision On Retaane

Retaane is an injectable steroid suspension that inhibits blood vessel growth. It is a potential treatment of wet age-related macular degeneration. The FDA letter advised Alcon that approval of the drug will require an additional clinical study. The company has no immediate plans to conduct a new study of Retaane (anecortave acetate depot suspension) because of the availability of other similar treatments, such as Macugen and Lucentis. Therefore, Retaane is not expected to become commercially available within the United States. Retaane is available in several countries outside the U.S. Alcon will continue the Anecortave Acetate Risk-Reduction Trial, which has studied the ability of Retaane suspension to reduce the risk of progression from dry to wet age-related macular degeneration. The trial, which has enrolled more than 2,500 patients, could be complete within three years, the company said.

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Lutein, Zeaxanthin Cut Eye Disease Risk

Researchers found that higher dietary intake of lutein and zeaxanthin was independently associated with decreased likelihood of having neovascular AMD, geographic atrophy, and large or extensive intermediate drusen. The Age-Related Eye Disease Study Research Group assessed 4,519 individuals, aged 60 to 80. Photographs were taken of their retinas to determine if they had age-related macular degeneration, and if so, at which stage. The participants also completed a food frequency questionnaire that measured how often they ate foods rich in certain vitamins, minerals and other nutrients including lutein, zeaxanthin, beta-carotene, lycopene and vitamins C and E had been eaten. The participants who consumed the highest levels of lutein and zeaxanthin were significantly less likely to have advanced age-related macular degeneration. They were also less likely to have large or numerous intermediate drusen. No associations were seen with any of the other nutrients. The study was published in the September 2007 edition of Archives of Ophthalmology

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