doctormartinelli.com

Sabbatical

2012-02-01T16:49:00.000-05:00

Hello patients and friends:

Currently I am away on extended sabbatical at St. George's University School of Medicine but will be returning to see patients in July. Of course, my associates Drs. Molina and my father are always available so you will continue to be under the best of care. However, if you would like to contact me, email is best: john@doctormartinelli.com.

Iris Recognition & Medical Records

2010-03-15T10:37:00.002-04:00

The future is here...

At Bronx clinic, the eyes are windows to medical records - CNN.com

Stargardt's Macular Dystrophy and Stem Cell Treatment

2010-03-07T05:39:00.000-05:00

Advanced Cell Technology‘s RPE Cells Granted Orphan Drug Status from FDA for Treatment of Stargardt’s Macular Dystrophy

First-Ever Designation for Treatment Using Embryonic Stem Cells

WORCESTER—Advanced Cell Technology, Inc. (OTCBB: ACTC – News), a biotechnology company applying cellular technology in the field of regenerative medicine, announced today that the U.S. Food and Drug Administration (FDA) has granted orphan drug designation for the company’s MA09-hRPE cells for use in the treatment of Stargardt’s Macular Dystrophy (SMD). As a result, the company is eligible to receive a number of benefits, including tax credits, access to grant funding for clinical trials, accelerated FDA approval and allowance for marketing exclusivity after drug approval for a period of as long as seven years.

“We are pleased that the FDA has, for the first time, granted orphan drug status for the use of an embryonic stem cell derived therapy in treating an unmet medical need,” said Edmund Mickunas, Vice President Regulatory. “We believe that our terminally differentiated RPE cells represent a promising treatment for patients with SMD and expect to be in a position to accelerate clinical development and hopefully make RPE cellular therapy available to the majority of patients sooner.”

US orphan drug designation is granted to companies with products aimed at treatment of a rare disease or condition that affects fewer than 200,000 Americans. The National Institutes of Health (NIH) recently proposed broadening the definition of a human embryonic stem cell to include ACT’s “single blastomere technology platform” which was used to derive ACT’s MA09-hRPE cells. The Company believes that the SMD program should be eligible for federal funding once the change is published in the Federal Register.

Degenerative diseases of the retina are among the most common causes of untreatable blindness in the world, and as many as ten million people in the United States have photoreceptor degenerative disease. While most of these patients have Age-Related Macular Degeneration (AMD), a smaller number have Stargardt’s, an Orphan disease and to date an untreatable form of juvenile macular degeneration leading to blindness in a much younger group of patients than are affected by AMD. ACT’s treatment for eye disease uses stem cells to re-create a type of cell in the retina that supports the photoreceptors needed for vision. These cells, called retinal pigment epithelium (RPE), are often the first to die off in SMD and AMD, which in turn leads to loss of vision.

While there is currently no treatment for SMD, several years ago ACT and its collaborators discovered that human embryonic stem cells could be a source of RPE cells. Subsequent studies found that the cells could restore vision in animal models of macular degeneration. In a Royal College of Surgeons (RCS) rat model, implantation of RPE cells resulted in 100% improvement in visual performance over untreated controls, without any adverse effects. The cells survived for more than 220 days and sustained extensive photoreceptor rescue. Functional rescue was also achieved in the ‘Stargardt’s’ mouse with near-normal functional measurements recorded at more than 70 days.

About Advanced Cell Technology, Inc.

Advanced Cell Technology, Inc. is a biotechnology company applying cellular technology in the field of regenerative medicine. For more information, visit http://www.advancedcell.com.

Glaucoma Meds Linked to Lower Mortality Risk

2010-02-10T08:38:00.002-05:00

Surprising study...

Medical News: Glaucoma Meds Linked to Lower Mortality Risk - in Ophthalmology, Glaucoma from MedPage Today

Photoreceptors generated from adult human skin cells

2010-02-04T08:39:00.000-05:00

Fascinating!

Crafting Light-Sensing Cells from Human Skin

http://www.technologyreview.com/biomedicine/24457/

Light and Migraines

2010-01-11T08:17:00.002-05:00

Very interesting research...

Scientists shed new light on migraines, pain - BostonHerald.com

Pet tarantulas pose risk to owners' eyes, say doctors

2010-01-04T09:07:00.002-05:00

For those of you with pet tarantulas - just in case!

BBC News - Pet tarantulas pose risk to owners' eyes, say doctors

Laser Deemed Best Treatment for Diabetic Retinopathy

2010-01-04T09:01:00.003-05:00

Standard therapy still recommended over steroid injections, researchers say

HealthDay

Dr. Edward Kondrot, Homeopathic Ophthalmologist: Pittsburgh Seminar - December 6. Three Day Treatment Program - December 7 - 9

2009-11-15T20:55:00.014-05:00

I'd like to welcome home my long-time associate and friend, Dr. Edward Kondrot.

Dr. Kondrot will be returning to Pittsburgh from December 6 - 9, 2009 and will hold a 1 day informational seminar on Sunday, December 6, followed by a 3 day treatment program beginning Monday, December 7.

During the seminar, a wide range of ocular conditions will be discussed along with alternative and homeopathic treatment strategies. Learn how vision threatening conditions such as Macular Degeneration, Glaucoma, and Diabetic Retinopathy can often be successfully treated and managed incorporating Dr. Kondrot's unique non-invasive holistic therapies.

More about Dr. Kondrot:

Has practiced ophthalmology for over 18 years and classical homeopathy for 10 years
Received his MD in 1977 from Hahnemann Medical College in Philadelphia, Pennsylvania
Completed his residency in Ophthalmology at the Scheie Eye Institute in Philadelphia, Pennsylvania and at St. Francis General Hospital in Pittsburgh, Pennsylvania, becoming a board certified Ophthalmologist in 1981
Received his diploma from the Hahnemann Homeopathic College in Albany, California in 1995
Became certified by the Council of Homeopathic Certification in 2000
Became Doctor of Homeopathic therapeutics (DHt) in 2002
Dr. Kondrot has an active medical license in Arizona and Pennsylvania

If you would like to learn even more or register for this exciting seminar and/or treatment program, please follow this link: http://www.healingtheeye.com/seminars.html

You may also contact me directly either by email or phone. I will promptly reply to all inquiries.

I will be joining Dr. Kondrot for his Sunday seminar and I look forward to seeing many of you there!

Keep Online Health Information in Perspective

2009-11-10T08:22:00.002-05:00

A reminder!...

Googling can mislead people seeking health information - washingtonpost.com

Myopia (Nearsightedness) and Diabetic Retinopathy

2009-10-29T06:57:00.003-04:00

Medical News: AAO: Myopia May Minimize Diabetic Eye Damage - in Meeting Coverage, AAO from MedPage Today

Gene Therapy and Leber's Congenital Amaurosis

2009-10-26T09:43:00.002-04:00

Medical News: AAO: Gene Therapy Restores Partial Vision - in Meeting Coverage, AAO from MedPage Today

Improved Stem Cell Creation Developing

2009-10-19T12:34:00.002-04:00

BBC NEWS | Health | 'Ethical' stem cell crop boosted

Heart Disease Linked to Macular Degeneration

2009-10-02T08:19:00.002-04:00

Large study reveals association between Age Related Macular Degeneration and Heart Disease:

Medical News: Heart Disease Linked to Macular Degeneration - in Ophthalmology, Ophthalmology from MedPage Today

Retinal Implants Show Promise In Visually Handicapped

2009-09-29T08:22:00.003-04:00

Technology Review: A Brighter Future for Retinal Implants

Amazing research from the University of California - Berkeley

2009-09-26T23:14:00.002-04:00

Brain scans reveal what you've seen - CNN.com

'Radical' surgery uses patient's tooth to restore sight

2009-09-17T11:37:00.002-04:00

An example of true medical ingenuity! Wonderful story...

'Radical' surgery uses patient's tooth to restore her sight - USATODAY.com

Retinal Implant Produces "Vision" in RP Patient

2009-09-08T08:24:00.002-04:00

Implant gives new hope to the blind | Philadelphia Inquirer | 09/08/2009

Gene Therapy and Leber's Amaurosis

2009-09-02T23:29:00.001-04:00

Great news for my recent patient with probable Leber's...creation of a "pseudo-fovea" via gene therapy:

Medical News: Gene Therapy Improves Vision in Leber's Amaurosis - in Ophthalmology, Ophthalmology from MedPage Today

Possible Future Stem Cell Treatment and Type I Diabetes

2009-09-02T07:36:00.002-04:00

Diabetes and Diabetic Retinopathy is a leading cause of vision loss. News of creating stem cells from skin cells - a possible future treatment for Type I Diabetes:

A Stem Cell Discovery Could Help Diabetics - TIME

Treatment for Trachoma also Life Saving

2009-09-02T07:20:00.002-04:00

Exciting trend seen with Zithromax treatment for this vision threatening condition:

Fighting blindness may prevent deaths in Ethiopia - Forbes.com

Back to School Eye Exams

2009-09-01T07:11:00.002-04:00

Nice article from Healthday.com stressing the importance of yearly eye examinations for school age children:

HealthDay

Reversing the damage of Glaucoma possibly on the horizon.

2009-08-05T09:14:00.001-04:00

Follow the link describing this promising Italian study:

HealthDay

Stem Cells and the Retina

2009-08-02T09:49:00.002-04:00

Stem cell treatment continues to become closer to reality!

University of Florida Health News -- UF scientists program blood stem cells to become vision cells

Leber's Optic Neuropathy

2009-07-27T17:19:00.002-04:00

My patient earlier this year exhibited all the signs and symptoms of Leber's although his genetic testing returned negative. Recent article below:

Leber's hereditary optic neuropathy can cause rapid deterioration of vision

Ingenious Device to aid the Blind

2009-07-21T07:34:00.002-04:00

'Lollipop' Device Helps Reveal Shapes To the Blind - washingtonpost.com

Exciting news for our Macular Degeneration patients

2009-07-21T07:06:00.002-04:00

Novelties - Better Vision, With an Implanted Telescope - NYTimes.com

Laser Treatment for Dry Macular Degeneration

2009-07-07T10:23:00.001-04:00

Exciting possibilities for our dry macular degeneration patients...

BBC NEWS | Health | Laser 'cure' for blindness tested

New Treatment for Cystoid Macular Edema from Retinal Vein Occlusion

2009-06-22T07:49:00.001-04:00

Exciting development for our patients who have lost vision due to a Retinal Vein Occlusion:

Medical News: FDA Approves Implant for Retinal Vein Occlusion - in Product Alert, Prescriptions from MedPage Today

Stem cell treated contact lenses for repair of corneal disease

2009-05-29T19:30:00.001-04:00

Fascinating! Please refer to the study linked in the article...

The contact lens that can make the blind see again | Mail Online

Researchers developing contact lenses to deliver drugs to the eye for a month or more.

2009-05-22T08:10:00.001-04:00

This will be a welcome option for our glaucoma patients! Potential to be revolutionary:

Technology Review: A Drug-Dispensing Lens

Cataract feature story in the New York Times

2009-05-17T23:28:00.001-04:00

Cataracts - Reporter's File - Clearer Vision After Cataracts - NY Times Health

Microwave treatment vs. LASIK on the horizon.

2009-05-07T04:39:00.001-04:00

Microwave treatment may be in the future of corneal refractive surgery - - Ophthalmology Times

Lifestyle over 65 linked to type II Diabetes

2009-04-28T10:51:00.002-04:00

...not too surprising!

Diabetes Preventable in People Over Age 65 With Diet, Exercise - Bloomberg.com

Stem cell treatment for Age Related Macular Degeneration (AMD) on the horizon.

2009-04-20T13:12:00.002-04:00

Of course, we hope this to hold some truth:

Blind to be cured with stem cells - Times Online

LATISSE now available at Martinelli Eye & Laser Centers!

2009-04-18T20:26:00.002-04:00

Exciting news!...

LATISSE™ Home | LATISSE™ — the first and only FDA-approved eyelash growth treatment

Predictions of a future surge in Age Related Macular Degeneration (AMD) cases

2009-04-15T13:58:00.002-04:00

Case load to double by 2050...but advancing treatments promising.

Medical News: Therapy Can Reduce Future Eye Disease Burden - in Ophthalmology, Ophthalmology from MedPage Today

Genetic testing for Macular Degeneration and Glaucoma coming soon!

2009-04-13T15:49:00.002-04:00

We are pleased to announce our genetic testing service to be introduced beginning June 2009. Genetic markers of common eye conditions such as Macular Degeneration and Glaucoma have recently been identified with testing soon available for our patients. If you have been told you are at risk for developing these conditions, we can provide this advanced service in addition to current diagnostic and preventative measures. For further information, please contact Dr. Martinelli, Jr.

LASIK and Patient Satisfaction

2009-04-03T14:07:00.002-04:00

Recent report on satisfaction after LASIK:

Medical News: Most Lasik Patients Happy with Results - in Ophthalmology, Laser Surgery from MedPage Today

High Levels of Serum Cystatin C and Chronic Kidney Disease Linked to AMD

2009-03-05T08:08:00.003-05:00

Interesting findings regarding kidney disease & macular degeneration -JRM
---
Serum cystatin C level and chronic kidney disease may have a link to incidence of age-related macular degeneration (AMD) that is independent of smoking and other risk factors, according to a population-based cohort study reported in the February issue of the Archives of Ophthalmology.

"Serum cystatin C has been used to estimate glomerular filtration rate to define the presence of CKD," write Ronald Klein, MD, MPH, from the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues. "It is abundant in retinal pigment epithelium (RPE) cells and has been hypothesized through its effects on cathepsins to have a role in the pathogenesis of AMD."

The goal of this study was to examine the associations of the serum cystatin C level and chronic kidney disease with the incidence and progression of AMD during 15 years of follow-up in 4926 participants of the Beaver Dam Eye Study.

The participants were residents of Beaver Dam, Wisconsin, and were 43 to 84 years old at the time of their baseline examination, which took place between March 1, 1988, and September 14, 1990. Follow-up examinations were done at 5-year intervals. The 15-year follow-up examination was performed from March 31, 2003, through April 30, 2005, and included 2119 survivors of the original study cohort.

Casual blood specimens were obtained at each examination to determine white blood cell count, serum blood urea nitrogen, glomerular filtration rate, and cystatin C. The glomerular filtration rate from serum creatinine was estimated using the Modification of Diet in Renal Disease (Study) prediction equation. Mild chronic kidney disease was defined as a glomerular filtration rate of more than 45 mL/min/1.73 m2 to 60 mL/min/1.73 m2 or less. Moderate to severe chronic kidney disease was defined as a glomerular filtration rate of 45 mL/min/173 m2 or more. Gross proteinuria concentration was determined using a dipstick test on a casual urine sample. AMD was determined by grading photographs of the macula.

The 15-year cumulative incidence of early AMD was 14.3%; pure geographic atrophy, 1.3%; exudative AMD, 2.0%; and progression of AMD, 12.2%. The prevalence and 15-year cumulative incidence and progression of AMD were similar in men and women and increased with age.

After controlling for age and other risk factors, the level of serum cystatin C at baseline was associated with the incidence of early AMD (odds ratio [OR] per log standard deviation, 1.16; 95% confidence interval [CI], 1.01 – 1.35) and exudative AMD (OR, 1.42; 95% CI, 1.03 – 1.96). However, baseline cystatin C was not associated with geographic atrophy (OR, 0.89; 95% CI, 0.56 – 1.41) or progression of AMD.

Mild chronic kidney disease was associated with the 15-year cumulative incidence of early AMD (OR per log standard deviation, 1.36; 95% CI, 1.00 – 1.86). However, it was not associated with the incidence of other AMD endpoints.

The statistically significant relationship of mild chronic kidney disease with early AMD but not with exudative AMD, geographic atrophy, or progression of AMD that was found in the Beaver Dam Eye Study is consistent with data from earlier studies, the authors comment.

"The Blue Mountains Eye Study showed that after adjusting for age, sex, and other risk factors, individuals with moderate CKD are 3 times as likely to develop early AMD compared with individuals with no or mild CKD (OR [95% CI], 3.2 [1.8 – 5.7]; P&lt;.001)," the study authors write. "When using the same definition of CKD (based on the Cockcroft-Gault equation) as used in the Blue Mountains Eye Study, while controlling for other factors in a multivariable model, we found a relationship of CKD to incident early AMD (OR [95% CI], 1.53 [1.10 – 2.11]; P = .01) but not to incident exudative AMD (1.38 [0.68 – 2.66]; P = .37)."

The authors warn that the low frequency of chronic kidney disease and pure geographic atrophy "limit our ability to detect (or reject) meaningful relations" and that some findings that appear to be of potential biological significance may be entirely owing to chance, given the number of associations examined. Finally, they point out the possibility that no significant relationships between some risk factors and AMD were found because individuals with these factors who developed AMD did not live to participate in the follow-up examination.

They conclude that confirmation of their findings in other studies and a better understanding of the biological processes underlying these findings are needed.

This study was supported by the National Eye Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institutes of Health, and Senior Scientific Investigator Awards from Research to Prevent Blindness. The authors have disclosed no relevant financial relationships.

By Fran Lowry
Copyright © 1994-2009 by Medscape
Arch Ophthalmol. 2009;127:146–152.

Vitamins and Macular Degeneration in Women

2009-02-25T09:28:00.002-05:00

B vitamins reduce macular degeneration - UPI.com

Taking a combination of vitamins B6 and B12 and folic acid appears to decrease the risk of age-related macular degeneration in women, U.S. researchers said.

William G. Christen of Brigham and Women's Hospital and Harvard Medical School in Boston and colleagues conducted a randomized, double-blind clinical trial involving 5,442 women age 40 and older who already had heart disease or at least three risk factors.

Of these, 5,205 did not have age-related macular degeneration at the beginning of the study. In April 1998, these women were randomly assigned to take a placebo or a combination of folic acid -- 2.5 milligrams per day, pyridoxine hydrochloride -- vitamin B6, 50 milligrams per day and cyanocobalamin -- vitamin B12, 1 milligram per day. Participants continued the therapy through July 2005 and were tracked for the development of age-related macular degeneration through November 2005.

Over an average of 7.3 years of treatment and follow-up, 137 new cases of age-related macular degeneration were documented, including 70 cases that were visually significant -- resulting in a visual acuity of 20/30 or worse.

Women taking the supplements had a 34 percent lower risk of any age-related macular degeneration and a 41 percent lower risk of visually significant age-related macular degeneration.

"The beneficial effect of treatment began to emerge at approximately two years of follow-up and persisted throughout the trial," the study authors said in a statement.

Visual Problems Often Accompany Hearing Loss in Childhood

2009-02-17T14:11:00.002-05:00

PITTSBURGH, Feb. 16 -- Vision problems are common among children who already have sensorineural hearing loss, researchers found.

The occurrence of ophthalmologic findings in children with sensorineural hearing loss was 21.7%, including refractive problems in 10.2% of the children and nonrefractive abnormalities in 12.8%, David H. Chi, M.D., of the Children's Hospital of Pittsburgh, and colleagues reported in the February issue of the Archives of Otolaryngology -- Head & Neck Surgery.

This rate of ophthalmologic abnormalities in the retrospective study was significantly higher than the 14.0% found in an earlier screening study of elementary school students in the general population (P=0.02).
Action Points

* Explain to interested patients that some conditions that cause sensorineural hearing loss, such as congenital rubella, also increase risk of loss of visual acuity.

* The American Academy of Pediatrics recommends ophthalmologic evaluation for all children with sensorineural hearing loss.

"Especially early in life, sensorineural hearing loss is associated with delays in language, speech, and cognitive and social development," the researchers said.

Because children with hearing loss rely heavily on their other senses, unrecognized ophthalmologic abnormalities that limit visual acuity could have further detrimental effects on development, they noted.

Dr. Chi's group recommended routine ophthalmologic examination for all children with sensorineural hearing loss in order to make an early diagnosis and start interventions to maximize visual acuity.

Their retrospective medical record review included all 226 children ages 18 and younger with sensorineural hearing loss and ophthalmologic evaluation at Children's Hospital of Pittsburgh from 2000 through 2007.

Most of the patients had bilateral sensorineural hearing loss (76.9%) and more than 55 dB of hearing loss (8.8% moderately severe, 15.9% severe, and 33.2% profound).

Ophthalmologic examination revealed that 21.7% had an ophthalmologic abnormality: 10.2% had refractive errors, such as myopia, hyperopia, and astigmatism, and 12.8% had nonrefractive conditions, such as strabismus or retinitis pigmentosa.

Syndromic causes of sensorineural hearing loss were found for 4.8% of patients, including Waardenburg syndrome, Stickler syndrome, and Usher syndrome.

In some cases, "the ophthalmologic examination was helpful because it suggested or confirmed the diagnosis of the respective syndromes," which the researchers said is another advantage of early ophthalmologic examination. "Knowledge of the cause can be comforting to patients and family members while providing relevant prognostic information."

The prevalences of ophthalmologic abnormalities were not significantly different for the 29.2% of children whose sensorineural hearing loss was initially detected by newborn screening compared with those whose hearing loss was detected later.

Likewise, vision problems were similar regardless of severity and laterality of hearing loss.

However, genetic testing results were significantly linked to the presence of coexisting vision and hearing loss.

Among the many genes associated with nonsyndromic sensorineural hearing loss, the GJB2 mutation has been found in at least 50% of hereditary cases in whites.

In Dr. Chi's study, the 18.8% of children with biallelic mutations in GJB2 were significantly more likely to have visual problems than the 7.6% with a single allele mutation in the gene (3.7% versus 0%, P=0.04). But even the bilateral GJB2 group had substantially lower rates than children without any GJB2 mutation (20.7% versus 3.7%, P=0.04).

The researchers cautioned, though, that the study might have been subject to selection bias because families with concerns about visual impairment were probably more likely to follow recommendations to see an ophthalmologist. Also, some patients may have had more thorough ophthalmologic evaluation than others.

By Crystal Phend, Staff Writer, MedPage Today
Published: February 16, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine

Primary source: Archives of Otolaryngology -- Head & Neck Surgery
Source reference:
Sharma A, et al "Ophthalmologic findings in children with sensorineural hearing loss" Arch Otolaryngol Head Neck Surg 2009; 135: 119-123.

Exercise and your Eyes

2009-02-11T23:30:00.003-05:00

Interesting article from the Los Angeles Times:

Why exercise is good for the eyes

Cataract Surgery Doesn't Worsen AMD

2009-02-06T16:17:00.003-05:00

Understanding that after cataract surgery, the eye loses its natural protection from UV radiation - a known major contributor in AMD. Interesting that in the following study no correlation was found after cataract surgery.

- Dr. Martinelli, Jr.

---

Cataract surgery doesn't hasten vision loss in people with age-related macular degeneration (AMD).

That's the conclusion of a new study that challenges the findings of several large epidemiological studies that suggested a link between cataract surgery and accelerated AMD progression.

AMD and cataracts are leading causes of vision impairment in the United States. Both are related to aging and share other risk factors. AMD affects the retina and leads to loss of central vision. Cataract is cloudiness in the eye's lens that interferes with clear vision.

For the new study, Dr. Emily Y. Chew, of the U.S. National Eye Institute, and colleagues analyzed data from 4,577 participants (8,050 eyes), ages 55 to 81, who took part in the Age-Related Eye Disease Study (AREDS). The researchers compared the risk of advanced age-related macular degeneration in people who had surgery to remove cataracts and in those who didn't have the surgery.

Chew and her team found little evidence that cataract surgery influences AMD progression. The study was published in the February issue of the journal Ophthalmology.

"These data may provide some reassurance to patients with AMD who are considering cataract surgery," Chew said in an American Academy of Ophthalmology news release.

Several possible factors may explain the conflicting conclusions of this new study and previous population-based research, Chew said. The most likely factor is that earlier studies may have had unintended biases or confounding variables. Chew also noted that cataract surgery and lens replacement techniques have advanced, and the AREDS participants' procedures were performed more recently than people included in earlier studies.

-- Robert Preidt
SOURCE: American Academy of Ophthalmology, news release, Feb. 2, 2009
Copyright © 2009 ScoutNews, LLC. All rights reserved.

Can eye color change as you get older?

2009-02-04T09:38:00.002-05:00

For those of you who have always wondered...

Eye color can change as we age, but sometimes what is perceived as a change is really just reflection of color from outside the eye. Age-related changes in eye color do occur among 10 to 15 percent of Caucasians (who have lighter eyes than other races). In these cases, eyes become lighter as a result of the progressive decrease in the number of pigment granules in the connective tissue (stroma) of the front layer of the iris.

Eye color changes in about 43 percent of children between the ages of 3 months and 6 years as the iris is exposed to light to which the pigment granules react. The one study I was able to find on changes in eye color after early childhood concluded that genetics are responsible. It looked at 693 sets of twins and their mothers. The researchers found that over the course of the 40 years of the study, 17 percent of the twins and 11 percent of their mothers had eye color lighten or darken by at least two shades. The changes were more likely to occur at the same time and with the same rate of change in identical twins than in fraternal twins, and so appeared to be genetically determined.

(Rarely, eye color changes can also accompany diseases of the eye, including macular degeneration, pigmentary glaucoma, and Horner's syndrome.)

Common Eye Problems Include Macular Degeneration and Cataracts

2009-01-29T13:51:00.004-05:00

Few 40-year-olds' to-do lists include "Be proactive about not going blind," so you might have to play catch-up. Age 40 really is the time to start protecting your eyes against serious diseases such as glaucoma and macular degeneration, neither of which has symptoms in the early stages. (That's in contrast to the loss of close-focus vision that forces 45-year-olds into bifocals but doesn't threaten blindness.) "Patients may go to the drugstore and get these over-the-counter reading glasses and think, 'Hey, I've fixed my eyes,' " says Andrew Iwach, an ophthalmologist who is executive director of the Glaucoma Center of San Francisco. "Yet they may be unaware that they can be silently losing vision."

Related News

The best defense: a comprehensive eye exam that screens for glaucoma, macular degeneration, diabetic retinopathy, and cataracts. (And no, passing your driver's license retest doesn't count.)

Cataracts are the most common age-related eye disease, with more than 17 percent of Americans age 40 and over affected. The main cause, aside from plain old aging, is exposure to ultraviolet B radiation in sunlight. Wearing sunglasses and brimmed hats while outside can reduce exposure and delay the need for surgery to remove a clouded lens. The good news is that cataract surgery has been refined so that the supersmall incisions are self-sealing; new artificial lenses can be folded or rolled and slipped into place.

Glaucoma and macular degeneration are more insidious conditions; by the time you know you're a victim, vision has often been lost forever. In glaucoma, the optic nerve becomes damaged, and vision loss usually starts at the side. Most people with glaucoma have increased pressure inside the eyeball, and although it's unclear how that pressure affects the optic nerve, medications that lower the pressure are effective at slowing damage.

With age-related macular degeneration, the macula, a spot in the center of the retina that provides clear central vision, is damaged by abnormal blood vessel growth or slow loss of light-sensitive cells. High doses of supplements, including vitamins C and E and beta carotene and the mineral zinc, have been found to slow the progression of AMD in several trials. But because some studies have linked high doses of beta carotene and vitamin E to cardiovascular risks, ophthalmologists advise against taking supplements as a preventive measure unless they're doctor-prescribed. It's impossible to get that quantity of antioxidants and zinc in food alone, but some studies have found that people who eat a lot of dark-green leafy vegetables have a lower risk of AMD. Smoking increases the risk of macular degeneration, so there's one more reason to quit.

People with diabetes have added reason to worry: Diabetic retinopathy affects some 40 percent of people with the disease, with 8 percent of all diabetics facing significant vision loss. Keeping your blood sugar levels under control reduces the risk of harm.

By Nancy Shute

One-third of U.S. seniors have diabetes

2009-01-28T08:14:00.004-05:00

Understanding that Diabetes is a leading cause of vision loss in the U.S., the following release is a reminder as to the importance of routine medical checks...

BETHESDA, Md., Jan. 27 (UPI) -- Nearly one-third of U.S. adults age 65 and older have diabetes, while an additional 30 percent have pre-diabetes, researchers said.

"We're facing a diabetes epidemic that shows no signs of abating, judging from the number of individuals with pre-diabetes," lead author Catherine Cowie of the National Institute of Diabetes and Digestive and Kidney Diseases, a part of the National Institutes of Health said in a statement.

"For years, diabetes prevalence estimates have been based mainly on data that included a fasting glucose test but not an oral glucose tolerance test," Cowie said in a statement. "The addition of the oral glucose tolerance test gives us greater confidence that we're seeing the true burden of diabetes and pre-diabetes in a representative sample of the U.S. population."

The oral glucose tolerance test gives more information about blood glucose abnormalities than the fasting blood glucose test, which measures blood glucose after an overnight fast. The fasting blood glucose test is easier and less costly than the oral glucose tolerance test , but the two-hour test is more sensitive in identifying diabetes and pre-diabetes, especially in older people, Cowie explained.

The 2005-2006 National Health and Nutrition Examination Survey is the first national survey in 15 years to include the oral glucose tolerance test.

The study, published in Diabetes Care

, also found 13 percent of adults age 20 and older have diabetes, but 40 percent of them have not been diagnosed.

First Embryonic Stem-Cell Trial Gets Approval From the FDA

2009-01-23T09:25:00.002-05:00

By RON WINSLOW and ALICIA MUNDY

In a watershed moment for one of the most contentious areas of science and American politics, the U.S. Food and Drug Administration cleared the way for the first-ever human trial of a medical treatment derived from embryonic stem cells.

Geron Corp., a Menlo Park, Calif., biotechnology company, is expected to announce Friday that it received a green light from the agency to mount a study of its stem-cell treatment for spinal cord injuries in up to 10 patients. The announcement caps more than a decade of advances in the company's labs and comes on the cusp of a widely expected shift in U.S. policy toward support of embryonic stem-cell research after years of official opposition.

"This is the dawn of a new era in medical therapeutics," said Thomas B. Okarma, Geron's president and chief executive officer. The hope that stem-cell therapy will repair and regenerate diseased organs and tissue "goes beyond what pills and scalpels can ever do."

Limits on stem-cell research, which prevented federal funding and were imposed by Congress and former President George W. Bush for ethical and religious reasons, have had a chilling effect on both academic and corporate research involving such cells. Proponents of stem-cell research say restrictions have delayed development of promising new treatments, while critics contend that harvesting stem cells from embryos destroys human life.

President Barack Obama said during his campaign that overturning research limits would be a top priority in his administration.

Both Geron and the FDA said the timing of the decision to approve the study was coincidental. "The FDA looks to the science on these types of issues, and we approve [such applications] based on a showing of safety," said Karen Riley, an FDA spokeswoman. "Political considerations have no role in this process."

Approval of the study is far from a guarantee that stem-cell treatments will work or make it to the market, but it is likely to be seen as an indication that opportunities for stem-cell research are poised to open and will fuel enthusiasm among academic and corporate researchers.

Mr. Obama's plans for acting on the current research restrictions haven't been finalized. Shortly after the election, Obama advisers thrilled biotech companies and investors when they suggested that the new president could use his executive authority to undo the Bush administration ban. But in a Jan. 18 interview on CNN, Mr. Obama said he might let Congress take the lead. "I like the idea of the American people's representatives expressing their views on an issue like this," he said.

Regulating stem-cell therapy is new turf for both industry and the FDA, a major reason why it took the agency nearly a year to review Geron's 21,000-page application for the trial, which it filed last March. Approval came in a phone call Wednesday afternoon, Dr. Okarma said.

The study will focus on the safety of the treatment. At an FDA hearing in April, several firms' executives and researchers complained that they were at a loss about what the FDA wanted in terms of clinical trials involving stem cells because the FDA itself wasn't sure.

Embryonic stem cells are the building-block cells that help drive prenatal development. Geron has developed banks of embryonic stem cells and found a way to coax them into differentiating as they do in nature into progenitors of specific cells that make spinal-cord tissue, heart muscle, cartilage and other organs and tissues.

Spinal-cord injury is one of medicine's most debilitating conditions, typically causing paralysis and other issues for which there are few, if any, effective treatments. The Geron study will enroll paralyzed patients who can be treated within 14 days of their injury. Patients will be evaluated for at least one year, after which, if the treatment proves safe, the company hopes to increase the dose and expand the potential candidates for the therapy.

In addition to safety, researchers will look for signs that the treatment is effective.

Printed in The Wall Street Journal, page A12

Write to Ron Winslow at ron.winslow@wsj.com and Alicia Mundy at alicia.mundy@wsj.com

Protease inhibitor found to aid diabetic retinopathy treatment

2009-01-22T07:17:00.000-05:00

The study, which was partly funded by the Juvenile Diabetes Research Foundation (JDRF), is published in the February 2009 issue of the journal Hypertension .

In the published study, led by Edward P. Feener, Ph.D., an Investigator in the Section on Vascular Cell Biology at the Joslin Diabetes Center and Associate Professor of Medicine at Harvard Medical School, continuous systemic administration of ASP-440 proved effective in decreasing hypertension-induced increased retinal vascular permeability in rodents, by as much as 70%. Increased retinal vascular permeability is a characteristic finding in diabetic retinopathy and a primary cause of diabetic macular edema, a leading cause of visual impairment associated with diabetes. Hypertension is a known risk factor for the development of retinopathy. ASP-440 was also found to be effective in lowering the elevated blood pressure in these animals.

"These findings represent a pivotal step towards understanding the importance of plasma kallikrein as a target in diabetic eye disease and how its inhibition may support the development of a safe and effective therapy for diabetic retinopathy," said Barbara Araneo, Director of Complications Research for the Juvenile Diabetes Research Foundation. "While further studies are needed to determine the therapeutic potential of ASP-440, the research underscores the relevance of the kallikrein system in diabetic microvascular disease."

In previous JDRF-funded research, Joslin researchers identified plasma kallikrein as a potential therapeutic target in people with diabetic retinopathy. "This recent study suggests new opportunities to inhibit plasma kallikrein and reduce retinal blood vessel leakage," said Dr. Feener. "While these results are encouraging, more work is needed to understand plasma kallikrein's role in other retinal functions, as well as other diabetic complications, which can occur concurrently with diabetic retinopathy."

"We are very encouraged by the pharmacological activity demonstrated by ASP-440 in this model of hypertensive retinal vascular permeability," said Tamie Chilcote, Ph.D., Vice-President, Lead Discovery, for ActiveSite Pharmaceuticals. "We look forward to further studies in collaboration with Dr. Feener to better establish the therapeutic potential of this and other plasma kallikrein inhibitors for treatment of retinopathy."

Diabetic Retinopathy

Diabetic retinopathy is the most common and most serious eye-related complication of diabetes. It is a progressive disease that causes retinal swelling and destroys small blood vessels in the retina, eventually leading to vision problems. In its most advanced forms, known as "diabetic macular edema" and "proliferative retinopathy," it can cause moderate to severe vision loss and blindness. Nearly all people with type 1 diabetes show some symptoms of diabetic retinopathy usually after about 20 years of living with diabetes. Approximately 20 to 30 percent of patients develop the advanced form. Those with type 2 diabetes are also at risk.

Over time, the disease progresses to its advanced or proliferative stage, and fragile new blood vessels grow along the retina. However, these fragile vessels can hemorrhage easily, and blood may leak into the retina and the clear, gel-like vitreous that fills inside of the eye. Unless quickly treated, this can result in spots, floaters, flashes, blurred vision, vision loss, and even temporary blindness. In later phases of the disease, continued abnormal vessel growth and the formation of scar tissue may cause serious problems such as retinal detachment and glaucoma, both of which can cause permanent blindness. Diabetic macular edema, which involves swelling in the retina that transiently or permanently impairs vision, can occur at any stage of diabetic retinopathy. Treatment to prevent or reverse this condition remains a major unmet clinical need.

http://www.jdrf.org/

Stem cell eye surgery to be tried

2009-01-21T12:12:00.002-05:00

A new surgical treatment offering hope to patients with corneal blindness is to be trialled in Scotland.

Doctors in Edinburgh and Glasgow will work together using an innovative technique involving adult stem cells.

About 20 patients will take part in the initial tests, using cells cultivated before being transplanted onto the surface of the cornea.

Millions of people worldwide suffer from corneal blindness, 80% of whom are elderly.

Stem cells are a source of great scientific interest as a result of their ability to renew and multiply indefinitely, potentially regenerating entire organs from only a few cells.

Unlike the more controversial embryonic stem cell research, the technique takes stem cells from dead adult donors.

The trial is being led by Prof Bal Dhillon at the Princess Alexandra Eye Pavilion in Edinburgh, working with the Gartnavel General Hospital in Glasgow.

Prof Dhillon said: "This study is the first of its kind anywhere in the world and it is exciting to be involved in such groundbreaking work.

"I probably see two or three new cases of corneal disease every month. On a larger scale, it's a significant problem."

The trial will hope to emulate the success of a similar study in the US in September last year.

In trials at the University of Pennsylvania, subjects with inherited blindness experienced dramatic improvements in vision after a corrective gene was injected into the eye.

Copyright 2009, BBC

Saliva Test Could Monitor Type 2 Diabetes

2009-01-21T12:06:00.000-05:00

TUESDAY, Jan. 20 (HealthDay News) -- Scientists say they are on the verge of developing a saliva test for monitoring type 2 diabetes, which might someday replace invasive blood tests.

For the first time, researchers from Oregon and India have identified proteins in saliva that appear more frequently in people with diabetes than in non-diabetics. Using these proteins, they are working to develop a test to monitor and perhaps diagnose the condition.

However, Dr. Umesh Masharani, an associate clinical professor of medicine at the University of California, San Francisco, doesn't think this approach is going to replace current blood tests any time soon.

"I think this is an interesting and novel approach," Masharani said. "I do not think this approach will be used in the diagnosis or treatment of diabetes any time in the near future. It is interesting, I think, for research studies in diabetes."

The report was published in the Jan. 2 issue of the Journal of Proteome Research.

For the study, Paturi V. Rao, from the departments of Endocrinology and Metabolism and Medicine at Nizam's Institute of Medical Sciences University in Hyderabad, India, and colleagues analyzed saliva samples from people with and without type 2 diabetes. Their goal was to find proteins associated with the blood sugar disease.

The researchers found 65 proteins that occurred twice as frequently in the people with diabetes than in those without the condition.

Using these proteins, Rao's team hopes to develop a noninvasive test for diabetes screening, detection and monitoring.

Rao's group thinks the pain involved with current diabetes monitoring causes many diabetics to be lax in monitoring their condition. A noninvasive test could make it easier and less painful for patients to keep track of their blood sugar levels.

"As recent studies have shown that early and multi-factorial intervention in diabetes prevents cardiovascular complications and mortality, advances in understanding molecular aspects of preclinical diabetes will further facilitate accurate diagnosis and early intervention," the authors wrote.

Diabetes expert Dr. Charles F. Burant, a professor of internal medicine at the University of Michigan, isn't convinced that a test using proteins in saliva is needed.

"I think it has minimal clinical impact," Burant said. "To be a valid biomarker, a test has to be sensitive and specific. We don't know the value of either for any of the proteins at the present time."

The biggest question is why this is needed, Burant noted. "Diabetes and prediabetes have a valid biomarker -- glucose -- that is the measure of the disease state. Thus, this is interesting biochemistry and raises questions why these changes occur, but the clinical utility is unclear."

More information

For more about type 2 diabetes, visit the American Diabetes Association.

SOURCES: Umesh Masharani, M.D., associate clinical professor, medicine, University of California, San Francisco; Charles F. Burant, M.D., Ph.D., professor, internal medicine, University of Michigan, Ann Arbor; Jan. 2, 2009, Journal of Proteome Research

Last Updated: Jan. 20, 2009

Paintballs can cause 'devastating' eye injuries.

2009-01-16T07:42:00.000-05:00

CTV.ca News Staff

Paintball looks like a great indoor activity for kids in winter, but the American Journal of Ophthalmology is warning that the sport can cause severe and "visually devastating" eye injuries, especially when used in unsupervised settings.

Players gather in teams to shoot the opposition with paint pellets that fly up to speeds of 300 km per hour. The challenge however, is not in shooting the pellets, but dodging them.

Many paintball facilities require customers to wear protective eye goggles. Most of the injuries studied by medical professionals involve injuries at home or in unsupervised and unofficial settings.

"Eye injuries secondary to high-velocity paintballs can cause tremendous damage to vital ocular structures often requiring extensive surgical intervention," Dr. Kyle J. Alliman of Bascom Palmer Eye Institute said in a news release. "Unfortunately, visual loss is often permanent."

Alliman and colleagues at the institute, in Miami, analyzed the characteristics and outcomes of 36 patients treated for paintball injuries between 1998 and 2005. The patients were mainly young men, average age 21 years.

The injuries were often quite severe:

rupture of the eyeball in 28 per cent of patients
detached retina in 19 per cent
surgery was required in 81 per cent of patients
removal of the eye (enucleation) in 22 per cent

Even when the eye was saved, many patients had permanent visual loss, the study found. Overall, near-normal vision (20/40 or better) was restored in only 36 per cent of eyes.

All of the patients were injured when using paintballs in a "non-recreational, uncontrolled setting," according to Alliman. None of the injuries occurred in formal, sponsored event. In all but one of the 36 cases, the patient was not wearing any type of eye protection when the injury occurred.

This study, published Thursday in the American Journal of Ophthalmology, follows a recommendation last year from the Montreal Children's Hospital that paintball arenas to refuse entry to children under the age of 16.

A study published in the Canadian Medical Association Journal in the late 1980s found 17 people out of 44 injured by paintball pellets became legally blind. Thirteen became visually impaired and only 14 regained normal vision.

They also found that most of the injuries happen at home and not at arenas where goggles are mandatory.

A later study published by U.S. journal, Pediatrics, estimated that more than 40 per cent of paintball injuries happened to children.

Research suggests cell-phone use does not appear to increase risk of uveal melanoma.

2009-01-14T07:54:00.000-05:00

For those of you who have wondered...

By Caroline Wilbert
WebMD Health News

Reviewed by Louise Chang, MD

Jan. 13, 2009 -- Talking on your cell phone does not increase your chances of getting melanoma of the eye, according to a new study.

The findings override an earlier report that linked the use of mobile phones with this type of cancer, according to researchers. The latest study is published in the Jan. 13 online issue of the Journal of the National Cancer Institute.

Andreas Stang, MD, of the Martin-Luther-University of Halle-Wittenberg in Germany, and colleagues, examined the association between phone use and risk of uveal melanoma in 459 patients with uveal melanoma compared to people without uveal melanoma.

Past research has shown there is no link between exposure to radio waves, including those on a cell phone, and DNA changes that can lead to cancer, according to background information cited by the study. However, studies addressing the possible link between use of cell phones and cancer continue to be performed.

This most recent study overrides an earlier study by the researchers involving only 118 participants with uveal melanoma. For that study, the exposure was only assessed if it was in the workplace. The findings at the time seemed to suggest a greater risk of uveal melanoma in people who used cell phones more often at work.

"In conclusion, we observed no overall increased risk of uveal melanoma among regular mobile phone users or users of radio sets in Germany, where digital mobile phone technology was introduced in the early 1990s," the researchers write.

Researchers identify protein that may prolong lives of retinal cells

2009-01-09T07:48:00.001-05:00

THURSDAY, Jan. 8 (HealthDay News) -- Researchers working with mice have identified a protein that appears to prolong the lives of retinal cells in both healthy and diseased eyes.

The discovery could one day lead to treatments that would prevent blindness among people genetically predisposed to develop retinal disease, the scientists said.

The protein, known as histone deacetylase 4 (HDAC4), is naturally produced by both mice and humans and is typically involved in the regulation of bone and muscle development.

Reducing the amount of HDAC4 to below-normal levels appears to lead to premature photoreceptor cell death in healthy eyes, the study revealed. In contrast, increasing quantities of this protein to above-normal levels appears to protect the lifespan of these critical vision cells -- both in healthy mouse eyes and in those mice suffering from a genetic flaw, also present in humans, that gives rise to degenerative retinal disease.

The finding -- if replicated in people -- could ultimately lead to new interventions to prevent such disease-driven blindness, or even to the development of methods to restore lost sight to diseased retinas.

"There are some inherited genetic defects that lead to the death of the two types of photoreceptor cells in the eye that capture light, first directly killing the rod cells and then the cone cells which depend on rod cell survival," explained study author Bo Chen, a postdoctoral research fellow with the Howard Hughes Medical Institute at Harvard Medical School in Boston. "So, this mutation eventually leads to complete blindness."

"But what we found," Chen noted, "is that we could actually promote the survival of these genetically affected photoreceptors by introducing more of this particular protein, even though the photoreceptors themselves continue to remain genetically defective."

Chen and his colleagues report their findings in the Jan. 9 issue of Science.

The findings are based solely on a series of neural cell experiments, focused on the retinal health of live mice, that were designed to assess the impact of both under-expression and overexpression of the HDAC4 protein.

Subsequent lab work led the researchers to determine that in sufficient quantities the protein indeed displays a protective effect against eye cell death and thereby has an "essential role in neuronal survival," they wrote.

Yet despite expressing enthusiasm for his current work, Chen emphasized the ongoing nature of the effort.

"Even though the genetics are the same in mice and humans, at this stage it's really very experimental," he stressed. "And much more work needs to be done before we know this will be efficacious in humans."

Nevertheless, Dr. Robert Cykiert, a clinical associate professor of ophthalmology at New York University Langone Medical Center in New York City, described the current work as an "impressive" effort.

"Clearly a lot of people go blind from retinal diseases," he said, noting that glaucoma and macular degeneration are two serious conditions that result from retinal cell death. "And this protein they worked with appears to be what we call neuro-protective, in that it has protective benefits on both the photoreceptor layer that gets damaged in macular degeneration as well as on the ganglion cell layer which is damaged by glaucoma. So this finding could actually turn out to be a major accomplishment, affecting a lot of patients down the road."

However, Rando Allikmets, an associate professor of ophthalmology, pathology and cell biology at Columbia University in New York City, took Chen's cue in cautioning that the true measure of the current work awaits human clinical trials.

"It's a very good study, an interesting observation and a very encouraging finding that will definitely lead to an investigation of this pathway for possible therapeutic targets," he said. "But the problem is that they have identified a protein involved with very basic functions -- including muscle development and bone growth -- so it's very difficult to predict if what they did in mice can be done in humans at all and, even if it can, if it will work in the same way."

Cykiert agreed.

"Of course, it's a mouse study," he acknowledged. "So you certainly don't know if what they've found will be reproduced in patients. And in any case, it would take 10 years to develop any drugs from this that might benefit people. So, yes, it's just a first step."

More information

For more on the causes of blindness, visit the World Health Organization.

SOURCES: Bo Chen, Ph.D., postdoctoral research fellow, Howard Hughes Medical Institute, Harvard Medical School, Boston; Robert Cykiert, M.D., ophthalmologist and clinical associate professor, ophthalmology, New York University Langone Medical Center, New York City; Rando Allikmets, Ph.D., associate professor, ophthalmology, pathology and cell biology, Columbia University, New York City; Jan. 9, 2009, Science

Last Updated: Jan. 08, 2009

Coping with Decreasing Vision

2009-01-07T09:12:00.000-05:00

ROCHESTER, Ill., Jan. 6 (UPI) -- A U.S. health newsletter suggests there are ways to help compensate for fading vision.

If eyesight fades over time because of aging or an eye disease, the Mayo Clinic Health Letter suggests:

-- Reducing differences in brightness. Equalize indoor and outdoor light sources by leaving some house lights on during bright sunny days.

-- Reducing glare by covering shiny surfaces, such as a polished table, with a cloth. Dark-colored place mats can help at mealtime. Use furnishings with a flat or matte finish.

-- Lighting up dark spots. Install lighting in dark areas, such as inside closets. Keep a pocket flashlight handy for dark areas.

-- Using bright, direct lighting. Position an adjustable lamp about 4 to 8 inches from reading material or a close-up task. Keep the lamp slightly to one side to reduce glare. If possible, position the light over the shoulder on the side of the better-seeing eye.

-- Taking advantage of natural light by positioning windows to the side or behind tasks.

-- Using a dark background when reading to reduce glare. A piece of dark construction paper can cover areas of text not being read.

Researchers' vision: restoring sight through artificial retinas

2008-12-30T07:14:00.000-05:00

WASHINGTON — Scientists are testing artificial retinas that they hope can restore partial sight to people who've lost their vision to the most common causes of blindness.

Retinitis pigmentosa, which ruins peripheral vision, and macular degeneration, which causes a blurred or blind spot in central vision, affect millions of people, especially the elderly.

Both diseases irreparably damage the retina, the light-sensitive patch at the back of the eye that converts images into signals and relays them the brain.

The government-sponsored researchers' goal is to create sensitive devices that can be implanted in the eye and will let previously blind people recognize faces and read large print.

"Retinal prostheses represent the best near-term hope for individuals with incurable, blinding diseases of the outer retina," said Dr. Mark Humayun, a surgeon at the Doheny Eye Institute at the University of Southern California, Los Angeles, who's implanted artificial retinas in patients.

Tests of a relatively crude artificial retina began on six patients in 2002. With the aid of these devices, people who'd been totally blind were able to read foot-high letters, tell a plate from a cup, find doors and windows, and navigate around large objects, according to Brian Mech, vice president of Second Sight Medical Products.

The Sylmar, Calif., company produced the devices for the U.S. Energy Department's Artificial Retina Project. The department has been engaged in biological research since the atomic bomb tests of the 1950s raised fears of radiation poisoning.

This first-generation eye implant, named Argus One, consisted of a tiny camera mounted on a pair of dark glasses and a hip-mounted microprocessor. The bionic gadget relayed images to a silicon chip containing an array of 16 electrodes — conductors of electrical signals — that was surgically attached to the front of the retina. The electrodes created a 4 by 4 pattern of light and dark spots in the visual processing center at the back of the brain.

At first, patients saw only scattered bits a light. With this scant information, plus weeks or months of retraining, however, they learned to make out straight lines, distinguish light areas from dark ones and detect motion. The training was necessary because the brain loses its ability to interpret sight after long disuse.

One retinitis pigmentosa patient, identified as Linda, could shoot a basketball through a hoop and tell which way the offense was moving on a TV screen, Mech said.

Another patient, Terry, spotted the shadow of his 18 year-old son as he passed by on a sidewalk. "It was the first time I'd seen anything of him since he was 5 years old," Terry told Artificial Retina News, a publication of the Artificial Retina Project.

Argus One is still in use, but it's being succeeded by Argus Two, a smaller, more sophisticated device with an array of 60 electrodes, providing a much sharper image to its users.

The newer device is being tested on 17 blind people in the U.S. and Europe, and more patients are being enrolled. At a retina conference in October, patients reported improvements in orientation and mobility. They were able to find a door from 20 feet away and to follow a line on the floor for 20 feet, Mech reported.

Meanwhile, researchers in the Energy Department's National Laboratories are creating a third-generation artificial retina. Much smaller than its predecessors, the device will contain 200 or more electrodes on a thin, flexible film that curves to fit the shape of the retina. Human tests are scheduled to begin in 2011.

"We're aiming for a 1,000-electrode array," said Ray Orbach, the department's undersecretary for science. Such a device would "let a blind patient recognize objects and read large-scale newsprint," Orbach told a scientific conference in early December.

Artificial retinas are still experimental and won't be available for commercial use for years. The devices will cost at least $30,000, Mech said, and many technical problems remain.

Still, scientists are optimistic about the future of artificial retinas.

"It's exciting to know that one day blind people won't be stuck with darkness," said Terry, who's still using his early model Argus One.

By Robert S. Boyd | McClatchy Newspapers

Researchers find genetic link to dry AMD.

2008-08-29T10:23:00.002-04:00

Interesting: Viral etiology and genetic factors influencing protection from Dry AMD. - Dr. Martinelli, Jr.

In continuing coverage from the Aug. 28 edition of First Look, the San Diego Union-Tribune (8/28, Clark) reported that researchers have "found the first genetic link to dry age-related macular degeneration (AMD), the most common form of progressive blindness," according to a study published in the Aug. 28 online edition of the New England Journal of Medicine. Kang Zhang, M.D., Ph.D., of the Shiley Eye Center at the University of California-San Diego School of Medicine, and colleagues, discovered "a genetic variant in about 66 percent of the population that appears to protect people from certain kinds of viral damage, a leading suspect in the development of the eye disease. People who lack this variant are not protected, and thus" are "more vulnerable to dry" AMD.

"People with two copies of the so-called T allele of the TLR3 gene had a significantly reduced likelihood for having dry age-related macular degeneration," MedPage Today (8/28, Gever) added. By genotyping "a total of 2,684 people in four series, including 687 with dry AMD, 760 with wet age-related macular degeneration, 152 with soft and confluent drusen, and 1,085 normal controls," and by performing "in vitro lab experiments" involving "dosing human and mouse retinal cells with RNA strands known to activate functional TLR3," the investigators "identified two clinical implications for the" study's "findings. One is that inhibitors of TLR3 activity could slow or halt progression of dry age-related macular degeneration." The other is that small interfering RNA sequences (siRNA), several of which "are now in clinical trials for 'wet'" AMD, "could activate retinal TLR3 in susceptible individuals to trigger dry AMD" when "introduced into the eye."

Florida Bright House cable affiliate Bay News 9 (8/28) pointed out on its website that age-related macular degeneration is "the leading cause of blindness in people older than sixty." Virginia NBC affiliate WSLS-TV also covered the story on its website, as did California ABC affiliate KGTV-TV (8/28) on its website.

Column explains causes of, treatment for cataracts.

2008-08-27T21:17:00.001-04:00

In the Baltimore Sun's (8/25) Ask The Expert column, Holly Selby interviewed Sheri Rowen, M.D., about cataracts, which "occur when the eye's natural lens hardens and becomes cloudy." By age 80, more than half "of all Americans have a cataract, or have been treated for cataracts with a relatively simple surgical procedure." In addition to aging, other risk factors for cataracts include "heredity, sun exposure, diet, and smoking." In addition, "diabetes, or any inflammatory disease, or [taking] steroids also can be risk factors." Cataracts are painless and often develop gradually. Symptoms include "blurred vision, inability to see reading material properly, or to see far away," as well as seeing "glare or halos at night, or even during the day." Dr. Rowen counseled patients to see a doctor when they notice they "are starting to not see properly." In a "10-minute procedure," a "surgeon will remove the clouded lens and replace it with a clear, plastic lens." Dr. Rowen explained that cataracts cannot be prevented, but eating "a diet filled with good antioxidants, such as leafy greens," and "wearing sunglasses" are good for general eye health.

Antioxidants in fruits and vegetables may help protect against cataracts, AMD, researchers say. The Miami Herald (8/25) reported that according to Harvard Medical School's Healthbeat newsletter, "Carrots, which contain vitamin A, are one of several vegetables that are good for the eyes." Even better are "fresh fruits and dark green leafy vegetables, which contain more antioxidant vitamins, such as C and E," that "may help protect against cataracts and age-related macular degeneration (AMD)."

Regular eye exams may help detect early warning signs of disease.

2008-08-18T12:22:00.001-04:00

The North American Press Syndicate (8/17) reported that "[r]egular eye exams are not just about obtaining optimal vision through the right eyeglass or contact prescription, but can also help detect early warning signs of disease that can affect your eye health and general health." And, because "an eye examination can help detect many health problems, eye-care practitioners often work in conjunction with internists and general practitioners to help empower individuals on their health and wellness journey." Many eye doctors now "offer new technology, such as digital retinal eye scans, that are quick and comfortable, and produce a computerized picture of blood vessels in action. This new technology effectively provides information on eye health and certain systemic health conditions, such as diabetes and glaucoma." For good eye health, patients are urged to "[b]egin a regular routine of eye exams with an optometrist or ophthalmologist once a year, or as often as the doctor recommends."

LASIK - 20/20 Guaranteed - or it's FREE!

2008-07-16T09:01:00.013-04:00

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AOA Champions National Effort to Combat Diabetes

2008-07-09T11:27:00.000-04:00

ST. LOUIS, MO (May 8, 2008) — The American Optometric Association (AOA), representing over 34,000 members in more than 6,500 communities nationwide, joined with other health care provider groups, government officials and leaders from the business and academic communities to announce a new national effort to stem the tide of diabetes in the United States. Unveiled May 7 at the Newseum in Washington, D.C., the National Diabetes Goal aims, by 2015, for 45% of Americans, who are at risk for type 2 diabetes, to know their blood glucose level and what actions to take.

While over 21 million Americans have diabetes, it is thought that more than 6 million Americans are unaware that they have the disease. The American Diabetes Association estimates that 54 million Americans aged 40 to 74 have pre-diabetes, a condition that puts them at risk for type 2 diabetes. Without decisive action, an estimated 50 million people - a full 15 percent of the population - will suffer from diabetes by the 2025. While diabetes is already recognized as the number one cause of acquired blindness in the U.S., type 2 diabetes can be prevented if people at risk get tested, learn their blood glucose level and take appropriate action.

Robert Layman, O.D. Chair of the AOA Diabetes Eye Care Project Team represented the AOA at the unveiling of the National Diabetes Goal. "Individuals should consider and eye exam the first line of detection for diabetes and its complications", said Dr. Layman. "In nearly all cases, diabetic retinopathy, a potentially blinding complication of diabetes and sometimes the very first sign of diabetes, can be diagnosed during a dilated eye exam in which drops are put into the eyes." "By having the courage to confront this issue head-on, we can be successful in reducing the incidence, progression and impact of diabetes", he added.

"Early detection is critical in maintaining healthy vision", said AOA president, Kevin L. Alexander, O.D., PhD. "Recognizing the importance of diabetes prevention and early treatment for lifelong eye health, AOA fully supports the National Diabetes Goal."

The AOA reminds patients that several factors influence whether someone with diabetes develops diabetic retinopathy. These include controlling blood sugar and blood pressure levels, the length of time with diabetes, race and family history. Be sure to see an optometrist if your vision becomes blurry, you have trouble reading signs or books, experience double vision, feel pressure in your eyes, encounter straight lines appearing indistinct or your side vision is limited.

Eye problems may affect 29 million people over age 40, National Eye Institute says

2008-06-24T07:48:00.001-04:00

The Arizona Republic (6/24, Midey) reports that according to the National Eye Institute, "age-related macular degeneration, glaucoma, diabetic retinopathy, and cataracts" may affect "about 29 million people" over the age of 40. While cataracts usually become problematic after age 60, some "age-related vision problems" may "begin decades earlier, most often with...presbyopia," when "the eyes' lenses lose their ability to focus on near objects." To maintain optimal eye health as individuals grow older, Emily Chew, M.D., deputy director of the National Eye Institute, "recommends eye exams every two years for healthy people in their 40s and 50s, and yearly for older people, and those with diabetes or other health issues." Notably, "[e]xams with eyes dilated may uncover conditions that produce no outward warning signs but can be managed, if not stopped," Dr. Chew points out. Eating a healthful diet may also be beneficial to "protect eyes from UV-caused damage." Exercise may "help circulation to the optic nerve, and decrease eye pressure," which could help some patients with glaucoma.

Research suggests babies born in summer months may have increased risk of myopia

2008-06-23T07:34:00.000-04:00

The Chicago Tribune (6/22, Deardorff) reported that "a growing body of scientific research shows the month you were born can predispose you to certain traits, affecting everything from your personality and mental health, to your lifespan." For example, "[i]f you're celebrating a birthday this month, you're more likely to be nearsighted than those born in the winter." According to Israeli researcher Yossi Mandel, M.D., "[l]ight exposure...can change the balance between dopamine and melatonin. A study performed by Mandel and colleagues suggested "that babies born in summer months had increased risks for moderate and severe myopia, or nearsightedness." Dr. Mandel explained that "[t]he dopamine-melatonin balance 'is known to participate in the eye-growth control mechanism.'" He added, "Altered eye growth pattern, such as larger eye length, can be associated with myopia."

Artificial Retina Project developing new generation of retinal prostheses

2008-06-19T08:21:00.001-04:00

In the Open Forum column in the San Francisco Chronicle (6/18), Doug Kaplan wrote about Terry Byland, who was blinded by "the degenerative eye disease retinitis pigmentosa," at age 45. In 2002, he "learned about the Artificial Retina Project, a nationwide consortium of doctors, scientists, and other individuals who had developed a retinal prosthesis that they were ready to implant into the eyes of human subjects." Byland underwent surgery at the Doheny Eye Institute at the University of Southern California, where "surgeons attached an array of 16 microelectrodes to his retina." Afterwards, he "learned to interpret the stream of electric signals that the implanted device was sending through his optic nerve to the visual cortex of his brain." While the "first-generation device implanted in Byland's eye transmits a crude 16-pixel image to his brain," a "second-generation, 60-pixel device is now undergoing clinical trials," and a "third-generation, 200-pixel device is in development." Someday, "a planned 1,000-pixel model" might "generate a signal with enough resolution to restore a blind individual's ability to read large print, and to recognize faces."

Retinal prostheses theoretically could replace retina, restore sight, neuroscientist says. The San Diego Voice (6/19, Dotinga) reports that approximately five to "10 million Americans suffer from partial or total blindness caused by diseases like inherited retina pigmentosa and age-related macular degeneration. In many cases, retinal cells die and cannot be replaced." Because "the rest of the brain apparatus that allows us to see may still work perfectly,...a prosthesis could -- theoretically -- replace the retina, and restore sight." Neuroscientist E.J. Chichilnisky, Ph.D., of the Salk Institute in San Diego, Calif., "is working with a company called Second Sight that is testing early versions of a retinal implant on volunteers." The device works "[w]ith the help of a tiny camera mounted in eyeglasses," and "transmits image information through 16 electrodes." So far, "volunteers only report seeing flashes of light." In the future, Chichilnisky said, "the 16 inputs should grow to hundreds." He explained, "We want to be able to produce an image that's fine-grained enough that you can read," and that can "identify a face, and sense that something is moving."

Copyright © 2008 by U.S. News Custom Briefings
12021 Sunset Hills Road, Suite 110 Reston, Virginia, 20190

Genetic Variant Linked to Severe Diabetic Eye Disease

2008-05-10T21:16:00.002-04:00

In continuing coverage from previous editions of First Look, HealthDay (5/8, Preidt) reported, "A gene called erythropoietin (EPO) is linked to severe diabetic eye and kidney diseases," according to a study published online May 5 in the Proceedings of the National Academy of Sciences. Lead author Kang Zhang, M.D., Ph.D., and colleagues, focused on "1,618 people with proliferative diabetic retinopathy (PDR) and end-stage renal disease (ESRD), and 954 diabetic patients without any eye or kidney disease." The authors "found that people with a copy of mutant EPO gene have an increased risk of developing PDR and ESRD." Dr. Zhang pointed out that this result "may affect the use of EPO in treating patients with anemia," since "EPO is used extensively to help in the production of red blood cells when treating patients with anemia resulting from renal failure or chemotherapy." HealthDay noted that "PDR is the most common cause of legal blindness in working-age adults in the United States, accounting for 10 percent of new onset blindness overall," while "[d]iabetes is the leading cause of ESRD."

Researchers design "bionic eye" to restore basic level of vision to patients with retinitis pigmentosa

2008-04-22T08:40:00.000-04:00

The BBC (4/21) reported, "A 'bionic eye' may hold the key to returning sight to people left blind by" retinitis pigmentosa. As "part of a clinical study," a "team at London's Moorfields Eye Hospital" has "carried out the treatment on the U.K.'s first patients." Developed by the U.S. company Second Sight, the artificial eye, known as Argus II, is "connected to a camera on a pair" of eyeglasses. It is designed to "restore a basic level of vision."

Britain's Guardian (4/22, Sample, Williams) adds that eye-care specialists "have fitted 'bionic eyes' to two men in their fifties to partially restore their eyesight." The men are the first patients in the U.K. "to have the artificial retinas fitted, in three-hour operations." Both men were totally "blind, but will now be able to walk around unaided, and identify simple objects. If the trial is successful, the £15,000 retinas could be approved for general use within three years." The two men "are among 15 patients given the artificial retinas as part of a three-year trial in the U.S., Mexico, and Europe."

According to the U.K.'s Telegraph (4/21, Smith), "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." The 'bionic eye' "works with a tiny camera mounted in a pair of glasses, which transmits a wireless signal via a small processor on a belt into a receiver, and a panel of electrodes placed in the back of the eye." Previous "trials in America have shown patients can see light, shapes, and movement." Indeed, these patients "were able to navigate without their stick or guide dog, and distinguish between objects on a table." Such results suggest that the "device could help blind people to lead independent lives."

Consultant ophthalmic surgeon Lyndon da Cruz, M.D., who carried out the operations at Moorfields, said that "[i]f the device worked, it could help people suffering from severe blindness of any cause, provided their optic nerve was still functioning," Britain's Independent (4/22, Laurance) notes. Nevertheless, Dr. da Cruz cautioned that the device "would not be suitable for people suffering from macular degeneration, the commonest cause of blindness which destroys the center of the retina, because these patients retain peripheral vision, and that would still be better than anything the device could deliver."

The U.K.'s Times Online (4/22, Rose) quotes Mark Humayun, M.D., professor of ophthalmology and biomedical engineering at the Doheny Eye Institute in Los Angeles, California, which developed the technology, as saying, "The camera is very, very small, and very low power, so it can go inside your eye, and couple your eye movement to where the camera is." Dr. Humayun added, "With the kind of missing information the brain can fill in, this field is really blossoming. In the next four to five years, I hope...that we see technology that's much more advanced." Britain's Press Association (4/22) also covers the story.

Employment Opportunities Available

2008-04-19T09:12:00.002-04:00

Currently we are hiring experienced opticians for both sales and management positions. Positions are available in our Charleroi and Uniontown locations. Please contact Melissa or Annette at 724-483-3675 for additional information.

Global review finds that 95.4% of patients are satisfied with outcomes after LASIK

2008-04-10T12:33:00.001-04:00

OSN SuperSite Top Story 3/7/2008

Global review finds that 95.4% of patients are satisfied with outcomes after LASIK

FAIRFAX, Va. — On average, 95.4% of LASIK patients appear satisfied with their visual outcomes, according to a preliminary review of worldwide patient satisfaction literature, the American Society of Cataract and Refractive Surgery announced in a press release.

Similarly, more than 95.2% of LASIK patients in the United States appear satisfied with their visual outcomes, the release said.

These preliminary results follow the February publication of a syndicated newspaper article citing depression and suicide as possible complications of LASIK. Specifically, the article described one case of suicide and one case of attempted suicide allegedly stemming from dissatisfaction with visual outcomes after LASIK.

"While patient satisfaction is extremely high, we recognize that there are patients who have unsatisfactory outcomes. As surgeons, we have taken the Hippocratic Oath. The well being of all of our patients is central to what we do and what we are. As such, and as the history of medicine has shown, we are committed to advancing our technology, patient selection and surgical techniques so that we can continue to enhance the quality of our patients' lives," said ASCRS President and OSN Chief Medical Editor Richard L. Lindstrom, MD.

Led by Kerry D. Solomon, MD, the meta-analysis, which utilized the Ovid and PubMed databases to search for the keyword "LASIK" and related terminology, is currently evaluating approximately 3,000 peer-reviewed articles, including 308 studies of primary LASIK cases, published over the past decade in clinical journals from North America, South America, Europe, Asia, Africa and Australia, according to the release.

The main objective of the literature review is to present a global perspective on patient satisfaction after LASIK for further analysis by a joint task force formed by the U.S. Food and Drug Administration. The task force includes members of the ASCRS, the American Academy of Ophthalmology, the National Eye Institute, as well as other delegates from the medical community, the release said.

The meta-analysis incorporates results obtained from a total of 2,199 participants in 19 studies that specifically address patient satisfaction. The remaining 289 studies are currently under review to determine if and to what extent additional data may be obtained.

Dr. Solomon will present the final results of the review at the ASCRS meeting in April, the release said.

Eye Disease Continuing To Increase Among Americans

2008-04-07T11:22:00.000-04:00

Millions of Americans are currently living with age-related eye disease and, according to the latest research from Prevent Blindness America and the National Eye Institute, that number is continuing to climb. With more than 130 million Americans aged 40 and older, more than 30 million suffer from leading causes of vision loss such as cataract, diabetic retinopathy, macular degeneration and glaucoma, according to the newly revised edition of the "Vision Problems in the U.S." study.

The study was an updating of the data from the 2002 Vision Problems in the U.S. report on the prevalence of eye diseases and conditions in America. Information gathered was the result of data collection from a systematic review of the major epidemiological studies from leading ophthalmologic epidemiologists.

Revised data from the Vision Problems in the U.S. study showed that among Americans aged 40 and older:

-- Age-related macular degeneration (AMD) cases rose 25 percent, the largest increase of the major eye diseases. Currently, 2 million Americans have been diagnosed with AMD.

-- Diabetic retinopathy affects more than 4.4 million. As the diabetes epidemic rages on, the number of cases of the disease will continue to soar.

-- There are 2.29 million American adults with glaucoma, the sneak thief of sight. Yet 2 million more are estimated to have the disease and do not know it.

-- Cataract is the leading cause of blindness in the world and 22.3 million American adults have the disease. Although surgery can be highly successful, not all Americans are fortunate enough to have access to affordable care.

"Our research shows that vision loss continues to threaten the quality of life for millions of Americans," said Daniel D. Garrett, senior vice president of Prevent Blindness America. "Our challenge continues to be education, whether it be convincing the public to practice regular eye care or by convincing our government leaders that millions of precious healthcare dollars can be saved through prevention services."

As the baby boomer population continues to age, the number of those who are visually impaired is expected to double in the next 30 years. And, from an economic perspective, the costs associated with adult vision problems in the United States are $51.4 billion. Research from Prevent Blindness America's 2007 "Economic Impact of Vision Problems: The Toll of Major Adult Eye Disorders, Visual Impairment, and Blindness on the U.S. Economy," totaled the financial costs of vision conditions to individuals and their caregivers, and the impact on the economy.

"The good news is that in most cases, the effects of eye disease can be minimized through early detection and treatment," added Garrett. "We strongly urge everyone to make an appointment with their eye care professional today to help protect their sight!"

About Prevent Blindness America

Founded in 1908, Prevent Blindness America is the nation's leading volunteer eye health and safety organization dedicated to fighting blindness and saving sight. Focused on promoting a continuum of vision care, Prevent Blindness America touches the lives of millions of people each year through public and professional education, advocacy, certified vision screenings, community and patient service programs and research. These services are made possible through the generous support of the American public. Together with a network of affiliates, divisions and chapters, it's committed to eliminating preventable blindness in America.

Prevent Blindness America
http://www.preventblindness.org

Congratulations to our March LASIK patients!

2008-03-10T13:58:00.002-04:00

I'd like to congratulate our recent LASIK patients...everyone returned the next day 20/20 or better!

Thank you for your trust and confidence in us...I'm looking forward to seeing everyone next week for your follow-ups.

On the horizon: A possible future treatment for Keratoconus

2008-02-21T16:53:00.003-05:00

Case series confirms benefits of collagen cross-linking

BARCELONA — A 3-year follow-up analysis of 44 eyes treated with collagen cross-linking at the University of Siena, Italy, confirmed the benefits of the technique in restoring corneal biomechanical stability and significantly improving vision, according to a surgeon speaking here.

"There are a certain number of conclusions we have reached through our experience," said Aldo Caporossi, MD, at the winter meeting of the European Society of Cataract and Refractive Surgeons.

"First of all, we consider young age — between 12 and 26 years — [to be] a primary indication because this is the time of maximum evolution of the disease. Of course we have to make sure that there is a progression of the disease and that the thinnest point in the cornea is more than 400 µm," he said.

Patients older than 36 years of age are excluded, Dr. Caporossi noted.

The second conclusion is that the epithelium should be removed to allow riboflavin penetration, and therefore UV light absorption, in the corneal stroma.

"With the epithelium in situ, [the] riboflavin concentration in the stroma is very low, not time-dependent, and the cross-linking effect is limited to the first 80 µm to 100 µm of the anterior stroma. If the epithelium is removed, riboflavin penetration is time-dependent, much deeper, and the cross-linking effect is well distributed in the 300 µm of the anterior-mid stroma," Dr. Caporossi said.

Functional outcomes in this case series were good, with a progressive improvement in uncorrected visual acuity, from 20/100 preoperatively to 20/40 at 2 years. Best corrected visual acuity also improved, from an average of 20/33 preoperatively to 20/25.

Mean keratometry values decreased during follow-up, and the symmetry index improved significantly beginning 10 months after treatment, Dr. Caporossi said.

"The increased symmetry of the cornea explains the improvement in BCVA," he noted.

Corneal wavefront analyses showed a significant reduction in coma aberration.

Complications were few and transient. Early haze, which is the most common side effect, occurred in only five cases and was eliminated within 2 to 3 weeks after beginning treatment with corticosteroids.

In comparing the treated eye with the non-treated eye of individual patients, investigators found that keratoconus progressed over 36 months in patients' untreated eyes but was halted in the fellow eyes treated with collagen cross-linking, Dr. Caporossi said.

"The other important conclusion that we gathered from these functional results is that, although collagen cross-linking is not a refractive procedure, it has some stable positive effects on vision because it is a stabilizing treatment that increases corneal symmetry," he said.

The latest cross-linking procedures were performed using a new prototype machine (CMB Vega, CE labeled), with one UVA LED (370 nm) for irradiating the cornea, two focusing LEDs (644 nm), one fixation point for the patient and an integrated camera for monitoring the changes throughout treatment.

World Glaucoma Day Set for March 6th

2008-02-03T10:00:00.000-05:00

World Glaucoma Day Set for March 6th
In an effort to combat one of the main causes of blindness around the globe, the World Glaucoma Association and the World Glaucoma Patient Organization have announced the first annual World Glaucoma Day, to be observed on March 6, 2008. The day will be marked by awareness and educational events organized by glaucoma institutions and local patient support groups worldwide, as listed on www.wgday.net

To aid in this worldwide effort, our practice will be providing free glaucoma screenings all day on Thursday, March 6. Please call our office to set up your appointment!

Great link for for our Low Vision patients!

2008-01-25T03:20:00.001-05:00

Here is a great resource for our patients with subnormal vision due to Macular Degeneration, Glaucoma, Diabetic Retinopathy, and other disorders.

http://www.ocusource.com

Age Related Macular Degeneration (ARMD) & Smoking

2008-01-23T18:38:00.000-05:00

January 16, 2008 — Current smoking was linked with an approximately 45% higher odds of developing age-related macular degeneration (AMD) vs never smoking, according to the results of the Beaver Dam Eye Study reported in the January issue of the Archives of Ophthalmology.

"Smoking affects risk factors hypothesized to be involved in the pathogenesis of AMD, eg, immune activation, depression of antioxidant levels, reduction of choroidal blood flow, decrease in luteal pigments in retina, reduction of drug detoxification by the retinal pigment epithelium (RPE), and nicotine potentiation of angiogenic activities," write Ronald Klein, MD, MPH, from the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues. "The purpose of this article is to describe the association between baseline smoking status, age at initiation, duration, intensity, pack-years, age at quitting, and time from the baseline examination since quitting and the 15-year cumulative incidence and progression of AMD in the population-based Beaver Dam Eye Study."

In this population-based, longitudinal cohort study, 4926 people in Beaver Dam, Wisconsin, who were aged 43 to 84 years in 1987 and 1988, were examined between 1988 and 1990 and again at 5-year intervals for 15 years. Stereoscopic color fundus photographs were graded for AMD status.

After adjustment for age, sex, and baseline severity of AMD, people who were current smokers at baseline were at increased risk for incident early AMD during a 15-year follow-up vs those who never smoked (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.08 - 1.99; P = .01). Current smokers were also at increased risk for progression of AMD (OR, 1.43; 95% CI, 1.05 - 1.94;
P = .02).

Characteristics of smoking, such as intensity, pack-years smoked, duration, and age at initiation and quitting were not specifically associated with AMD outcomes. There was no apparent association between smoking status and incident signs of late AMD. Exposure to environmental tobacco smoke in nonsmoking individuals was not associated with the 5-year incidence of early AMD or progression of AMD.

Limitations of the study include small numbers of either exudative AMD or geographic atrophy, causing an inability to rule out the possibility of an association with smoking status; and limited power to observe a relationship between smoking and incidence of late AMD in people aged 65 years or older.

"Smoking appears to be related to the long-term incidence and progression of AMD," the study authors write. "This has important health care implications because early AMD increases the risk of developing late AMD and smoking behavior is modifiable."

The National Eye Institute, the National Institute of Aging, and Research to Prevent Blindness supported this study. The study authors have obtained funding.

Arch Ophthalmol. 2008;126:115-121.

2008 Speaking Engagements

2008-01-21T18:56:00.005-05:00

March 5, 2008

Glaucoma "Mini-Rounds"
COPE Approved: Course 21302-GL

Youngstown, OH
Sponsored by Alcon Pharmaceuticals, Inc.

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March 26, 2008

LASIK & Refractive Surgery

Youngwood, PA
Sponsored by WCCC - Westmoreland County Community College

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April 2, 2008

Aging & The Eye
Cataracts, Macular Degeneration, Glaucoma, Systemic Disease

Youngwood, PA
Sponsored by WCCC - Westmoreland County Community College

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September 11, 2008

Diabetes & The Eye

Monongahela, PA
Sponsored by the Monongahela Rotary
Luncheon: 12PM - 1PM

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October 20, 2008

NO B.S.
Fearless Management of People and Problems in the Real World
Real Cases for Real Clinicians
COPE Approval Pending

Altoona, PA
Sponsored by Alcon Pharmaceuticals, Inc.

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October 25, 2008

Multifocal IOL's combined with Corneal Refractive Surgery: A Case Study in Management
COPE Approved: Course 21306-RS

Anaheim, CA
American Academy of Optometry

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Laser Surgery for Myopia Effective Over a Decade

2008-01-09T17:52:00.000-05:00

By Judith Groch, Senior Writer, MedPage Today

ALICANTE, Spain, Dec. 28 -- A 10-year follow-up found that laser in-situ keratomileusis (LASIK) is safe and effective in patients needing a high degree of correction, with a retreatment rate of 27%.

Action Points

§ Explain to patients who ask that for patients with myopia needing at least a 10 diopter correction, LASIK surgery appeared to be still effective 10 years after the procedure.

§ Explain that the technology has improved since 1992-1995 when the study began.

A decade after LASIK surgery, a follow-up of 118 patients needing at least a 10 diopter correction to achieve 20/20 vision found that 42% of eyes were within ± 1.00 diopter, thus allowing patients to avoid using glasses, according to Jorge L. Alió of Miguel Hernandez University here, and colleagues.

Of these patients, 61% were within ± 2 diopters 10 years after LASIK, the researchers reported in the January 2008 issue of the American Journal of Ophthalmology.

Since the early 1990s about 18 million LASIK procedures have been done worldwide, with eight million in the U.S. alone. However, the limitation of LASIK for high myopia remains controversial, the researchers wrote.

The study included 196 myopic eyes of 118 patients with a mean preoperative spherical equivalent of -13.95 ± 2.79 D treated with myopic LASIK.

Patients were treated at the Instituto Oftalmológico de Alicante in Spain from April 1992 through December 1995. The patients returned for follow-up at three months and at one, two, five, and 10 years.

Treatment was given with the VISX 20/20 excimer laser and the Automated Corneal Shaper Microkeratome. The main outcome measures were refractive predictability and stability, mean corneal keratometry, topographical cylinder, safety, efficacy, stability of visual acuity, and postop complications.

Uncorrected vision was 77% of best spectacle-corrected visual acuity (BSCVA) before surgery. At 10 years, 82 (42%) of 196 eyes were within ± 1.00 D and 119 (61%) were within ± 2.00 D.

The retreatment rate was 27.5%, with 54 of 196 eyes (41 of 118 patients) requiring another procedure. Only one patient needed more than one retreatment.

The indications for a second procedure were under correction in 37 eyes (68%) of 27 patients, followed by regression in 14 eyes (26%) of 11 patients, and both over correction and regression in three eyes (6%) for three patients.

Most retreatments occurred between three months and two years after the original procedure. Myopic regression decreased with time in eyes that did not undergo retreatment, with a mean rate of -0.25 ± 0.18 D per year.

Only 11 eyes (5%) lost more than two lines of BSCVA and 40% avoided the use of glasses with vision of 20/40 or better.

Two eyes (1%) with more than a 15 D myopic correction developed corneal ectasia at six months and two years, respectively, after LASIK, the researchers reported.

Haze or scarring in the interface was minimal when present at all. Wrinkles on the flap and dot remnants in the interface were rare and should be avoided with proper surgical technique. Other significant late complications were rare and not attributable to the procedure itself, the researchers said.

"This reference study, with a long time perspective, allows us to know the safety, precision, and limits of LASIK in highly myopic eyes," they wrote.

Recent advances in corneal profiles and technologies should be taken into account when comparing these results with those of more recent procedures, they concluded.

In an accompanying editorial, George O. Waring, M.D., of Emory University and Inview in Atlanta, discussed various technologies including LASIK.

Refractive surgery outcomes have improved steadily over past decades, he said. Current studies of LASIK report ± 0.50 D in more than 90% of eyes.

"Unfortunately," he said, "Dr. Alió and associates did not report the use of optical correction after surgery -- a most important outcome."

Although the technology for LASIK has changed from that used in their report, Dr. Waring said, and although the follow-up at 10 years represents approximately one in five of the original patients treated, Dr. Alió's study demonstrates that LASIK retains general stability of refraction over 10 years and achieves a high degree of safety with excellent retention of BSCVA.

"The efficacy data allow us to judge the ongoing improvements in refractive surgery," he concluded.

The Lasik study was supported by a grant of the Spanish Ministry of Health.

The authors reported no financial conflicts of interest.

Dr. Waring reported that he is a consultant for Nidek, Inc., Advanced Medical Optic, Calhoun Vision, and AcuFocus.

Primary source: American Journal of Ophthalmology
Source reference: Alió JL, et al "Ten-year follow-up of laser in situ keratomileusis for high myopia" Am J Ophthalmol 2008; 145: 55-64.
Additional source: American Journal of Ophthalmology
Source reference: Waring G, "Have you seen the 10-year long-term safety data on laser in situ keratomileusis?" Am J Ophthalmol 2008; 145: 1-2.

Buying Contact Lenses on Internet Symptomatic of Risky Eye Care

2008-01-08T09:16:00.000-05:00

By John Gever, Staff Writer, MedPage Today

Published: January 07, 2008
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.

NEW YORK, Jan. 7 -- Buying contact lenses directly from doctors is more likely to lead to prudent eye care than is patronizing Internet sites or optical chain stores, found a small survey here.

Action Points

Explain that the survey found lower rates of annual eye exams and proper follow-up eye care among patients who bought contact lenses from vendors other than eye doctors' offices.
Point out that the survey involved college students at a single location, and that actual adverse events were not investigated.

Contact lens wearers who bought their lenses from online vendors or at stores were significantly less likely to get yearly eye exams or to have lens fit checked by a professional, Joshua Fogel, Ph.D., and Chaya Zidile, of Brooklyn College, reported in the January issue of Optometry: Journal of the American Optometric Association.

The researchers surveyed 151 lens-wearing students at Brooklyn College about their contact lenses attitudes and practices.

The survey came in the wake of the Fairness to Contact Lens Consumers Act of 2003, which requires eye care professionals to make copies of contact lens prescriptions available to patients so they may purchase lenses elsewhere. Dr. Fogel and Zidile sought to determine whether patients taking advantage of the law were following recommendations for proper eye care issued by professional groups and the FDA.

Thirty-four of the students said they bought lenses over the Internet. Sixty-five obtained them from their eye doctors and 83 bought them at a chain store, a shopping mall outlet, or wholesale club. The numbers total more than 151 because some respondents bought lenses at more than one location.

Among the 123 students who bought exclusively from one type of seller, 21.1% who purchase online and 32.2% buying from stores said they don't have an annual eye exam. These were significantly more than the 11.1% of those who purchase from a doctor's office (P=0.034).

Significantly more Internet purchasers (57.9%) and store customers (62.7%) also said they don't have a professional ensure proper lens fit, compared with the 33.3% of patients who buy from their doctors (P=0.01).

"Those who purchase contact lenses over the Internet or at stores could be more at risk for unhealthy eye care practices," Dr. Fogel and Zidile wrote. "Eye doctors should take the time to emphasize to all of their patients about important eye care practices, especially for those who purchase contact lenses over the Internet or at stores."

Another finding was that 31.6% of Internet purchasers, 22% of store customers, and 22.2% of students who buy from doctors' offices said they obtained lenses without a prescription, which is illegal.

The differences were not statistically significant. Nevertheless, Dr. Fogel and Zidile concluded, "there should be better monitoring of Internet stores and traditional stores that sell contact lenses to ensure that contact lenses are provided only to consumers with a valid prescription."

Louise Sclafani, O.D., of the University of Chicago, commented that patients need to follow all recommendations for contact lens care regardless of where they purchase lenses.

Said Dr. Sclafani, who chairs the American Optometric Association's section on contact lenses, "Although buying contacts online can be more cost-effective and convenient, we strongly urge patients to understand that there are risks involved [in] wearing contact lenses. Because of this, it's necessary that patients visit their eye doctor on a regular basis."

Dr. Fogel and Zidile addressed the convenience issue by asking their sample about time pressures in their lives. Those who said they felt strong time pressures were significantly more likely to buy lenses from Internet vendors (F statistic: 8.06, P=0.005), whereas low time pressures correlated strongly with doctor's office purchase (F: 5.22, P=0.024).

The investigators noted that their survey did not explore actual adverse effects related to contact lenses. They also said that, since their sample was drawn from a narrow age group in one location, generalizability to the nation as a whole is limited.

No funding was received for the study.

The investigators reported no financial conflicts of interest.

Primary source: Optometry: Journal of the American Optometric Association
Source reference:
Fogel J, Zidile C, "Contact lenses purchased over the Internet place individuals potentially at risk for harmful eye care practices"Optometry: Journal of the American Optometric Association 2008; 79: 23-35.

Happy New Year!

2008-01-03T10:36:00.000-05:00

Happy New Year to All!

For 2008 we are excited to offer additional options if you are considering LASIK. Standard or Custom with the traditional Microkeratome flap...or now Intralase - a bladeless method to create the corneal flap. Please refer to the link below for more information:

http://www.getilasik.com/

I believe Intralase is the way of the future and has been proven to be a superior method to create the corneal flap with respect to precision and comfort. For more information, please contact our office to schedule a free screening or to request our informational packet.

Dr. Martinelli, Jr.

Glaucoma: SLT Laser Treatment Update

2007-11-16T04:55:00.000-05:00

Here is an update on SLT laser therapy for Glaucoma. We have been providing this treatment option for 3 years and have also found very favorable results.

- Dr. Martinelli, Jr.

NEW ORLEANS, Nov. 15 -- Selective laser trabeculoplasty offers a safe and effective approach as first-line therapy to lower intraocular pressure in patients with glaucoma, according to data reported here.

Action Points

Explain to interested patients that a laser procedure has shown promise as primary therapy for glaucoma.
Note that the findings of this study were based on a retrospective chart review, not a randomized, controlled clinical trial.
Emphasize that the findings were reported at a conference and should be considered preliminary until they appear in a peer-reviewed journal.

The laser treatment reduced IOP by about a third, and the improvement was maintained for as long as five years, Lawrence Jindra, M.D., of Columbia University, told attendees at the American Academy of Ophthalmology meeting.

In almost 900 treated eyes, the overall success rate, defined as no additional treatment, was 93%.

"I think we're going to see a paradigm shift in the initial approach to treatment of glaucoma," said Dr. Jindra. "The results with selective laser trabeculoplasty have been consistently impressive in the studies conducted to date."

Selective laser trabeculoplasty involves use of a Q-switched frequency-doubled Nd:YAG laser that targets melanocytes in the trabecular meshwork. The laser treatment induces release of cytokines that trigger macrophage recruitment and other responses that lead to reduced IOP (Ophthalmology 1998; 105: 2082-2090).

To investigate the treatment's effectiveness as primary treatment in glaucoma, Dr. Jindra and colleagues did a chart review of consecutive cases involving 2,008 eyes from patients treated with selective laser trabeculoplasty from January 2002 through January 2007 and followed for an average of 509 days. For 853 eyes the laser therapy was the primary treatment.

The chart review showed that only 7% of the 853 eyes required additional treatment after the initial application of laser energy.

Dr. Jindra said 3% of patients required repeat laser treatment, 1% required repeat treatment plus hypotensive medication, and 3% required medication after laser treatment.

Among those for whom laser treatment was primary therapy, mean intraocular pressure (IOP) decreased from 19.1 mm Hg at baseline to 13.2 mm Hg after treatment, a 31% decrease.

The investigators retrospectively followed 60 of the 853 eyes at six-month intervals for five years. Pretreatment IOP averaged 21.1 mm Hg, decreasing to less than 14 mm Hg at six months.

The reduction was maintained throughout follow-up, and IOP averaged 13.7 mm Hg after five years (P<0.01>

"Our findings build on [previous studies] and suggest that selective laser trabeculoplasty may be effective primary therapy for newly diagnosed glaucoma patients," said Dr. Jindra. "Further study in controlled clinical trials is indicated."

Dr. Jindra disclosed that he is a technical adviser and consultant to Lumenis Corp.

Primary source: American Academy of Ophthalmology
Source reference:
Jindra LF, et al "Five-year experience with selective laser trabeculoplasty as primary therapy in patients with glaucoma" AAO Meeting 2007; Abstract PO329.

Visual Rehabilitation and Glaucoma

2007-11-12T21:49:00.000-05:00

OSN SuperSite Breaking News 11/12/2007

Vision rehabilitation assists in restoring glaucoma patients' quality of life

NEW ORLEANS — Training glaucoma patients to use their remaining vision more effectively can help them maintain their independence and self-esteem after visual loss, a glaucoma expert said here.

Eydie Miller-Ellis, MD, spoke about rehabilitation at the Glaucoma Subspecialty Day preceding the annual American Academy of Ophthalmology meeting. She said a physician's job is not only to lower glaucoma patients' IOP, but also to help them adapt to visual changes.

"Vision loss takes a toll on our patients," Dr. Miller-Ellis said. "They need low vision services to maximize function."

She recommended that physicians conduct "functional histories" of patients' visual abilities, to determine what areas of their lives have been most affected by visual loss and what assistance they require. The effect of visual loss on specific areas of their lives, including near vision tasks, distance vision tasks, mobility and communication skills should be established, Dr. Miller-Ellis said.

Those effects can then be addressed with low vision rehabilitation services, she said. The use of devices, such as talking clocks and appliances, signature guides and large print material, can help patients learn how to live with visual loss and continue to take part in every-day activities, she explained.

Even the most inconsequential change can greatly assist patients, Dr. Miller-Ellis said. For instance, the contrasting use of color — dark furniture coupled with light carpet or floors or light plates coupled with dark food — can make all the difference in a glaucoma patient's environmental adaptation for contrast sensitivity loss.

Thanks to Academy - Tampa

2007-10-28T09:58:00.001-04:00

I'd like to thank the American Academy of Optometry for a wonderful weekend of education, meeting new friends, and visiting with some old! Special thanks to Drs. Andy Gurwood and Greg Caldwell for their time, advice, and guidance. See everyone next year in Anaheim!

The 21st Century is Here...EMR & More!

2007-05-24T23:13:00.000-04:00

Hello all,

We are excited to announce some major additions to our practice. Beginning this summer, in both locations, we will be implementing Electronic Medical Records (EMR) which will be the start of our "paperless" office. Charting and record keeping will now be performed on portable wireless tablet computers...with all patient testing and information instantly accessable. This will be much more efficient from a patient care standpoint...and will also further our commitment to accurate documentation.

Also, in both locations, we will be installing wall-mounted flat-screen Macintosh computers in each exam lane. These will replace the "old-fashioned" projector and screen method of checking vision. They are remotely controlled from the exam chair area and can also be used for viewing educational DVD videos of various eye problems we often encounter. Perhaps you can even slip in your favorite video!

Finally, for our Uniontown location, we will be installing a new digital "anterior segment" camera. This technology allows instant photography of many diseases which occur on the front of the eye.

We are thrilled to offer this "next level" service for our patients as we continue to be at the forefront of eyecare in the tri-state area.

American Academy of Optometry Case Reports

2007-04-22T08:29:00.000-04:00

As I complete my case reports for this years academy meeting, I will publish each under my "Original Articles" section. Please feel free to to read through...comments are welcome!

A Success Story

2007-02-18T09:16:00.000-05:00

Thought I'd share a recent case I was privileged to manage...

J.D., a patient of mine, 31 year old gentleman, came to see me last summer (06') complaining of progressively blurred vision in one eye over a 2 -3 month period.

Interestingly enough, I discovered a significant Cataract present in his right eye. Considering his age and being in good health, a Cataract present in only one eye is almost always indicative of a former injury to the eye. We call this a "Traumatic" type of Cataract. There also appeared to be the start of an early cataract in his other eye, which suggests a possible genetic/systemic etiology. He did not, however, have a family or systemic history that would contribute to bilateral cataracts.

Unfortunately, not only had he developed this problem, this was in addition to having a most extreme eyeglass prescription for astigmatism in both eyes. This extreme prescription is something he had lived with since he was a young child...and it had been nearly impossible for him to wear contact lenses comfortably. For those of you who may understand the "numbers", the following is a copy of his eyeglass rx and vision:

R: -1.00 -5.00 x 099 20/200 (due to cataract)

L: -1.00 -6.75 x 180 20/20

I found this to be very exciting because only very recent technology allows us to give him options...options not available just a few months prior to examining him!

My plan was to not only remove the cataract...but to also eliminate his eyeglass prescription for distance in each eye...without sacrificing his focus at near. A feat not possible before...and now possible only with select technology we currently incorporate in our centers.

My recommendation:

1. Removal of the Cataract with a "sutureless/clear corneal" technique and implanting a newly developed "focusing" Intraocular Lens (IOL), the ReZOOM Multifocal IOL manufactured by AMO.

2. "Clear Lens Extraction" for the other eye (with early Cataract) utilizing the same technique and Multifocal IOL.

3. LASIK for both eyes utilizing our VISX Star S4 CustomVue System to eliminate the very high degree of astigmatism.

The above process was nearly 6 months in the making with multiple procedures and office visits...and everything went just as planned. A wonderfully successful outcome. I'm happy to say that Mr. J.D. is now thrilled (and so am I)! He now enjoys nearly 20/20 uncorrected vision in both eyes...near and far!

As a clinician, this is such an exciting time to be in practice. We have technology and options that we could only dream of just a few years ago! It is always about helping people...and there is nothing greater I can imagine being a part of.

2007 Speaking Engagements

2007-02-18T08:47:00.000-05:00

The following are my most recently confirmed speaking engagements for 2007:

3/14/07

The Personality of Multifocality
Incorporating Multifocal IOL Technology in your Practice

Buffalo, N.Y.
Sponsored by AMO - Advanced Medical Optics, Inc.

4/18/07

Aging & The Eye
Cataracts, Macular Degeneration, Glaucoma, Systemic Disease

Belle Vernon, PA. - Mon Valley Education Center
Sponsored by WCCC - Westmoreland County Community College

5/21/07

Glaucoma "Mini-Rounds"
Unique Cases - Unique Treatments

State College, PA
Sponsored by ALCON Pharmaceuticals, Inc.

6/20/07

Aging & The Eye
Cataracts, Macular Degeneration, Glaucoma, Systemic Disease

Youngwood, PA
Sponsored by WCCC - Westmoreland County Community College

6/25/07

Dry Eye & Ocular Therapeutics: A Panel Discussion

Beaver Lakes, PA
Sponsored by ALCON Pharmaceuticals, Inc.

9/07 (TBA)

Glaucoma "Mini-Rounds"
Unique Cases - Unique Treatments

Latrobe, PA
Sponsored by ALCON Pharmaceuticals, Inc.

Welcome Dr's. Molina!

2007-01-07T09:08:00.000-05:00

I'd like to introduce Dr's. Molina who will be soon joining us in March. Below are their brief bio's. Looking forward to having them aboard the team!

Alejandro J. Molina, OD

Dr. Alex Molina is a 2006 graduate of the Pennsylvania College of Optometry. Dr. Molina is currently completing a primary care/ocular disease residency at The Eye Institute in Philadelphia. He is currently an active member of the American Academy of Optometry and the American Optometric Association.

Alethea Rivera-Molina, OD

Dr. Alethea Rivera-Molina is a 2006 graduate of the Pennsylvania College of Optometry. Dr. Rivera-Molina completed clinical externships with Regional Eye Associates in Morgantown, WV; the Veterans Affairs Hospital in Clarksburg, WV, and The Eye Institute in Philadelphia. Dr. Rivera-Molina is currently an active member of the American Optometric Association.

Happy New Year to All!

2006-12-31T11:32:00.000-05:00

Best Wishes for 2007 to our Wonderful Staff and Patients! Happy New Year!

New Case Photos!

2006-12-31T11:04:00.000-05:00

Hello All!

Please feel free to look at some interesting cases I've just recently seen...

http://www.flickr.com/photos/jrmod/

ReZOOM MultiFocal Intraocular Lens now being utilized at Martinelli Eye & Laser Centers

2006-10-05T06:29:00.000-04:00

I'd like to update our patients with regards to the success we have had utilizing the new ReZOOM IOL. The ReZOOM implant is an excellent option for individuals who are not candidates for Laser Vision Correction (i.e. LASIK) as well as our Cataract patients who desire cutting edge technology. The implant incorporates a revolutionary "Multi-Focal" design which allows both improved far AND near vision. To learn more, follow the link below:

http://www.rezoomiol.com/

DRS. MARTINELLI TO PROVIDE INFANTSEE™ ASESSMENTS AT NO-COST

2006-08-31T13:40:00.000-04:00

FOR IMMEDIATE RELEASE

Former President Carter and American Optometric Association Raise Awareness of Infant Eye Health

Charleroi, PA 8/31/06 – Drs. Martinelli are one of 7,000 optometrists nationwide who are participating in InfantSEE™, a no-cost public health program developed to provide professional eye care for infants. Under this program, supported by former President Jimmy Carter, who serves as honorary national chair and spokesman, Drs. Martinelli and participating optometrists will provide a one-time, comprehensive eye assessment to infants in their first year of life, offering early detection of potential eye and vision problems at no cost regardless of income.

“I’m very proud to be involved in InfantSEE™ to ensure healthy vision for our community’s infants,” said Dr. Martinelli, Jr.

InfantSEE ™ was launched in June by the American Optometric Association (AOA), in partnership with The Vision Care Institute of Johnson & Johnson Vision Care, Inc.

Experts from AOA and American Public Health Association (APHA) agree that visual development is most dramatic between 6 and 12 months of age and that early detection can prevent and help reduce the threat of serious vision impairments. In fact, one in every 10 children is at risk from undiagnosed eye and vision problems by the time they are 18 years of age. However, a survey fielded by BabyCenter.com, on behalf of the AOA, reveals that nearly half of new and expectant mothers mistakenly believe that because a baby’s eyes are changing and their vision is developing in their first year of life, it is best to wait until the child is older to get them screened by an eye care professional. This discrepancy suggests a lack of understanding about the importance of early intervention. If left untreated, eye and vision problems can impact learning and may lead to permanent vision impairment.

“As parents, we regularly take our children to the dentist to help prevent cavities. Likewise, we should take our babies to the optometrist to help prevent potential eye and vision problems,” said former President Carter. “Given my family’s experience managing vision problems that were not caught early, I strongly encourage all parents with babies to visit an optometrist for an InfantSEE™ assessment during the first year of their child’s life and I applaud AOA for providing parents this opportunity.”

The BabyCenter.com survey also showed that the large majority of mothers feel confident that their pediatricians have the time and resources to identify potential eye and vision problems. Actually, a typical well-child visit to the pediatrician, including care and services performed by all personnel, lasts an average of 22.1 minutes, which is effective for detecting only readily identifiable eye problems. Using retinoscopy, optometrists can detect asymmetric development of refractive errors that can lead to amblyopia, often referred to as lazy eye, just as commonly as eye misalignment. Significant risk factors to eye and vision disorders, however, are typically not detectable by base-level infant eye screenings, and even early retinoblastoma (the seventh most common pediatric cancer) is detected more than 80 percent of the time by a family member or friend, as opposed to a health care professional.

Although infants cannot respond verbally, the first year of life is an ideal time to conduct an extensive eye assessment. Not only is this a critical time for eye and vision development, but generally children at this age do not yet fear doctor visits and find the assessment painless and often enjoyable. Typically, infants sit on their parent’s lap during the assessment, in which the optometrist uses lights and other hand held objects to check that their eyes are working together and that there are no significant refractive issues that will impede proper vision development. The optometrist may also use drops or a spray to dilate the baby’s pupils to ensure the health of the eye.

As part of the national launch, former President Carter issued a call-to-action through a public service announcement (PSA), which will educate parents about InfantSEE™ and urge them to take advantage of the program. The PSA cites his personal experience regarding his grandchildren’s eye problems. His granddaughter was diagnosed and treated as a toddler for amblyopia, a leading cause of vision loss in people younger than 45, which will affect one in 30 children. His grandson’s amblyopia was not identified until grade school and may never be fully corrected.

To learn more about InfantSEE™, call toll-free (888) 396-EYES (3937) or visit www.infantsee.org.

Survey Methodology:

BabyCenter.com completed 543 online surveys among moms with children under 2 and/or pregnant women. Data was collected in March 2005 and took four to six minutes to complete.

About the American Optometric Association:

American Optometric Association doctors of optometry are highly qualified, trained doctors, on the frontline of eye health and vision care, who examine, diagnose, treat, and manage diseases and disorders of the eye. In addition to providing eye and vision care, optometrists play a major role in an individual's overall health and well-being by detecting systemic diseases. Doctors of optometry have the skills and training to provide more than two-thirds of all primary eye care in the United States. The American Optometric Association represents more than 34,000 doctors of optometry, optometry students and paraoptometric assistants and technicians in nearly 6,500 communities across the country. For more information, visit www.aoa.org.

About Vision Care Institute:

The Vision Care Institute of Johnson & Johnson Vision Care Inc. is an innovative educational resource created to prepare optometry students for a successful transition into the real world of delivering quality eye care, as well as to assist practicing Eye Care Professionals in the growth and development of their practice. The state-of-the-art facility gives participants a rare opportunity to gain first-hand experience with the latest in vision diagnostic and treatment technologies through hands-on contact lens instruction. Besides clinical training, participants also concentrate on communication skills. The curriculum, taught by leading eye care practitioners from around the country, gives participants the skills and confidence necessary to excel in today's professional practice. The Vision Care Institute has hosted students from all 19 of the schools and colleges of optometry throughout North America at its headquarters in Jacksonville, Florida.

About BabyCenter.com:

Founded in 1997, BabyCenter operates www.babycenter.com, the most visited online resource for new and expectant parents, www.parentcenter.com, the leading online resource for parents of children ages 2 to 8, and www.babycentre.co.uk , the leading U.K. resource for new and expectant parents. Offering extensive, medical advisory board-approved content, BabyCenter's Web sites attract over 3.5 million visitors each month, as measured by comScore Media Metrix, and have been honored with numerous awards, including the 2005 People's Voice Webby Award for Best Family/Parenting Web site. In addition, the BabyCenter sites offer an array of interactive tools, a supportive online community, a premium subscription service, and an online store featuring thousands of products for parents and children.

# # #

Welcome Dr. Mark Mayle!

2006-08-18T21:32:00.000-04:00

We are pleased to introduce Dr. Mark Mayle to our practice. Dr. Mayle graduated from Mt. Vernon University with an undergraduate degree prior to attending medical school at West Virginia University. His internship and residency were both completed at West Virginia University School of Medicine. Dr. Mayle is an accomplished LASIK and Refractive Surgeon with extensive experience utilizing the VISX CustomVue system. We are excited to have him aboard our team!

Iris Registration Technology Arrives at Martinelli Eye & Laser Centers

2006-08-18T19:31:00.000-04:00

Here is a copy of our recent News Release:

Iris Registration Technology Arrives at Martinelli Eye & Laser Centers

In order to achieve optimized outcomes for laser vision correction patients, accurate alignment is essential to optimizing customized wavefront-guided procedures. The VISX™ Iris Registration Technology is a revolutionary method of aligning the treatment to the cornea and providing the most precise laser alignment accuracy to date. “The technology replaces previous methods of attaining precise alignment,” says Dr. Martinelli. Previously, physicians used manual methods to align the treatment to the eye.

“Unlike manual methods, Iris Registration Technology automatically aligns the laser to the cornea,” says Dr.Martinelli. “This allows us to center the treatment accurately, so that a patient’s breathing or other normal movements won’t affect the treatment.” As a result, Iris Registration Technology can provide potentially better outcomes for our patients.

“This is an exciting advancement in the CustomVue™ procedure,” says Dr. Martinelli. “VISX Iris Registration Technology makes it easer than ever to achieve accurate alignment with a fully automated, touch-free method of measuring and marking the eye.”

Learn More about CustomVue and Iris Registration

At Martinelli Eye & Laser Centers, we pride ourselves in the quality of our patient education. At an initial consultation, you’ll have opportunities to ask questions, learn about VISX Iris Registration Technology, the CustomVue treatment, and to meet our staff. During the evaluation, Dr. Martinelli will determine if you are a good candidate for CustomVue treatment based on your WaveScan™ test findings.

“The WaveScan test is a part of the evaluation. It captures unique imperfections in each individual’s vision and is 25-times more precise than standard measurements for glasses or contact lenses,” says Dr. Martinelli. “WaveScan technology produces a detailed map of the eye—much like a fingerprint. No two maps are alike—in fact, each treatment is tailored to the unique characteristics of the individual’s eye,” says Dr. Martinelli. “Then, the WaveScan digital information is transferred to the laser, providing a new level of precision and accuracy, and providing potentially better results.”

There’s never been a better time for laser vision correction. So schedule a consultation and get your WaveScan test to determine if you are a candidate. Call Martinelli Eye & Laser Centers at 724-483-3675 today!

Recent Patient: 16 year old girl with Compressive Optic Neuropathy? Optic Neuritis? Atypical Pseudotumor?

2006-08-13T09:56:00.000-04:00

Recent patient of mine, 16 year old girl, came to see me complaining of blurred vision occuring only in a certain section of one eye. She first noticed her vision changing 2 weeks prior and was not sure if it began gradually or suddenly. She has an unremarkable systemic and ocular history.

Her corrected vision in the affected eye proved to be 3 lines less than her last exam, dropping from 20/20 to 20/30. A significant superior visual field defect was evident as well. A mild afferent pupillary defect was apparent. The Optic Disc showed significant Edema which was confirmed by 3D imaging via Heidelberg Retinal Tomography (HRT). The other eye was unaffected and unremarkable.

The possibilities in this case are:

1). Compressive Optic Neuropathy - Space occupying mass, tumor, aneurysm - behind the Eye and before the Optic Chiasm - along the Optic Nerve.

2). Optic Neuritis - Inflammation of the Optic Nerve - many times linked to M.S.

3). Atypical Pseudotumor Cerebri - CSF pressure build-up within the brain and spine - usually shows Optic Disc Edema in both eyes.

Immediately I obtained an MRI of the Brain and Orbits. Thankfully the imaging was normal with no sign of a space occupying lesion or demyelinating disease (M.S.). This leaves us with the greatest possibility of Optic Neuritis without evidence of M.S. - which may be of a viral etiology, lyme disease, or a host of other possibilities. Historically, oral steroids and sometimes IV steroids have been used to treat Optic Neuritis, however, recent studies have shown that the end resulting is the same without medical treatment - unless evidence of demylinating disease is shown on MRI within one month of the onset in which IV steroids are then utilized. Therefore, I reassured the family that the inflammation can subside on its own over a period of several weeks or months.

Finally, there is remote possibility of atypical Pseudotumor Cerebri, which is normally evident in heavy-set younger females (which my patient is not). In addition, Pseudotumor normally will show involvement in both eyes, not just one. Sometimes Pseudotumor can be associated with other etiology's such as oral Tetracycline treatment. However, a Lumbar Puncture (Spinal Tap) may be considered in this case to rule-out elevated Cerebral Spinal Fluid (CSF) pressure with Pseudotumor Cerebri.

I did have her follow-up with Neurology for a second opinion, blood work with lyme titer, and re-assesment of the MRI. I'll be following her up in a month to see how she is doing.

KOWA VX-10 Digital Retinal Camera with Fluorescein Angiography Imaging Now Available

2006-08-11T18:06:00.000-04:00

I'd like to update our patients regarding our new KOWA VX-10 Digital Retinal Imaging System.

The KOWA system allows us to digitally photograph the Retina with and without dilating drops. With a resolution of 6MP (megapixels), even the most subtle variations in retinal disease can be imaged, displayed, and reviewed instantly for our patients.

Digital Fluorescein Angiography allows us to immediately analyze diseases of the Retina such as Macular Degeneration and Diabetic Retinopathy. Therefore, treatment will not be delayed compared to older "35mm Camera" technology in which we had to wait for film development.

Faster decisions allow us to more effectively treat disorders of the Retina that may be progessive.

Once again, we are excited to continue providing world class care and technology for our patients.

-Dr. Martinelli, Jr.

Congratulations to our August 9 LASIK patients!

2006-08-09T21:17:00.000-04:00

Please follow the link to my photoblog and find your photo!

http://jrmod.blogspot.com/

-Dr. Martinelli

LASIK: VISX CustomVue Iris Registration Currently Being Utilized

2006-07-29T14:18:00.000-04:00

I'd like to update our patients who are considering Custom LASIK with us. We are now routinely utilizing Iris Registration / Iris Recognition for our patients undergoing Custom LASIK with our VISX CustomVue STAR S4 System.

Iris registration is considered the latest cutting edge technology utilized to automatically track and compensate for eye movements during the treatment process. Adjustments for vertical, horizontal, rotational, and even pulsating movements (z axis) of the eye are now continously performed automatically during the procedure. As an additional safegaurd, the system will not treat any patient unless the individual's unique iris data is matched on the day of the procedure.

Complementing the Custom Wavescan Data, Iris Recognition / Iris Registration adds yet another level of sophistication and precision for our LASIK patients. We are excited to continue offering the latest state-of-the-art LASIK technology for our patients!

-JRM

Inflammation Gene Variant Linked to Macular Degeneration

2006-07-20T07:14:00.000-04:00

ROTTERDAM, The Netherlands, July 19 -- A gene involved in inflammation plays a major role in the risk of age-related macular degeneration, the most important cause of vision loss in the elderly, according to Dutch researchers.

In a large, prospective, population-based cohort study, 36.2% of participants -- the 5,681 residents of a Rotterdam suburb -- had at least one copy of a variant of the complement factor H (CFH) gene that has been previously linked to an increased risk of age-related macular degeneration, said Dominiek Despriet, M.D., of the Erasmus Medical Center here.

By the age of 95, the cumulative risk for age-related macular degeneration for people carrying two copies of the variant gene was 48.3% and 42.6% for people carrying just one copy, Dr. Despriet and colleagues reported in the July 19 issue of the Journal of the American Medical Association. By contrast, non-carriers had a cumulative risk of just 21.9%,

The population-attributable risk of late age-related macular degeneration -- the proportion of the disease in the population that can be blamed on the variant -- was 54%, the researchers calculated.

The variant gene -- dubbed CFH Y402H -- "is involved in early as well as late disease pathogenesis and markedly increases risk of late age-related macular degeneration in the very old," the researchers reported, and its effects are significantly affected by environmental factors such as smoking.

The findings come from a long-term population cohort of 7,983 people in the Rotterdam suburb of Ommoord, or 78% of the 10,275 residents ages 55 and older. The ophthalmologic section of the study included 6,418 participants, who underwent an eye examination and had gradable photographs of the fundus. Of those, 5,681 also had a valid genetic assessment for the CFH gene.

At baseline, 2,062 participants had some stage of age-related macular degeneration, the researchers said, and the risk of disease was consistently higher in all categories for people carrying either one or two copies of the variant, compared with non-carriers. For instance, they found, 0.6% of non-carriers had stage 3 age-related macular degeneration, compared with 1.4% of people with one copy of the gene, and 2.8% of those with two copies. The differences with respect to non-carriers were significant at P<0.05 and P<0.001, respectively.

The pattern was similar for incident cases during the follow-up, which averaged eight years, and when prevalent and incident cases were combined, the researchers noted. Combing both incident and prevalent cases for stage 4 age-related macular degeneration, for example, gave an odds ratio of 11.02 (with a 95% confidence interval from 6.82 to 13.86) for people with two copies of CFH Y402H, compared with non-carriers.

The researchers also evaluated the effects of other factors, including smoking, and C-reactive protein serum levels.

Smoking, as several other studies have shown, increased the risk of age-related macular degeneration, especially for those with the variant gene. Smokers with two copies of CFH Y402H had an odds ratio for age-related macular degeneration of 34.0 (with a 95% confidence interval from 13.0 to 88.6) compared to non-carriers who had never smoked.

Also, high serum levels of C-reactive protein interacted with the variant gene to increase the risk of disease, the researchers reported.

VRT Therapy for Stroke & Traumatic Brain Injury

2006-07-05T09:02:00.000-04:00

Informational link related to the KDKA story about visual recovery following Stroke or Trauma:

http://www.novavisiontherapy.com/english/index.asp

Lucentis Approval for "Wet" Macular Degeneration

2006-07-04T10:41:00.000-04:00

Good news for our ARMD patients:

Lucentis approved for use in United States

SOUTH SAN FRANCISCO, Calif. — The Food and Drug Administration approved Lucentis for treatment of wet age-related macular degeneration on Friday, following a 6-month priority review.

According to a press release from Genentech, Inc., developers of Lucentis (ranibizumab), 95% of patients treated with the drug maintained vision in phase 3 clinical trials. About 40% of patients had vision improvement by at least three lines at 1 year, and up to 40% of patients achieved vision of 20/40 or better, the release said.

“In my opinion, the Lucentis approval stands out as one of the most important medical developments in ophthalmology during my 25 years in the field because it has the potential to reverse vision loss associated with wet AMD,” Eugene de Juan, MD, said in the press release. “We are pleased that Lucentis has been approved by the FDA and look forward to working with Genentech to provide retina specialists in the United States with access to Lucentis for patients as quickly and smoothly as possible.”

The FDA approval was based on data collected from two large phase 3 clinical trials, the MARINA and ANCHOR studies, the release stated. In the MARINA study (Minimally Classic/Occult Trial of the Anti-VEGF Antibody Ranibizumab In the Treatment of Neovascular AMD), patients experienced an average improvement of 6.6 letters from baseline at 2 years, compared to a loss of 14.9 letters in the sham group.

In the ANCHOR study (Anti-VEGF Antibody for Treatment of Predominantly Classic Choroidal Neovascularization in AMD), patients on average experienced an 11.3 letter gain from baseline at 1 year, compared to a loss of 9.5 letters in patients treated with photodynamic therapy, the release stated.

The most common adverse reactions in the trials included conjunctival hemorrhage, eye pain, vitreous floaters, increased IOP and intraocular inflammation. Serious adverse events, including endophthalmitis, retinal detachments and traumatic cataracts, occurred in less than 0.1% of patients who received the injections, according to the release. The drug is contraindicated in patients with hypersensitivity and ocular or periocular infections, the release stated.

Link to Dr. Martinelli's Photo Blog

2006-07-02T12:44:00.000-04:00

Beginning 6/28/06, please use this link to view all photos including LASIK...

http://www.flickr.com/photos/jrmod/