Retina

For most patients with choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD), triple therapy offers significant and sustained visual improvement after just one cycle of treatment.

Retinal specialists have a new therapy in their armoury: on January 24th 2007, the European Commission approved ranibizumab (Lucentis, Novartis) for the treatment of patients with wet age-related macular degeneration (AMD).

Why is it that education & training are sometimes regarded as a chore and an unnecessary obligation?

Outlined of a four-point scale that may help to simplify the assessment of a patient's risk of developing age-related macular degeneration (AMD).

New technology is allowing clinicians, for the first time, to study the subtle structural changes that cause progression of this disease.

The FDA has accepted iCoTherapeutics' Investigational New Drug (IND) application for iCo-007.

OccuLogix has received Investigational Device Exemption (IDE) clearance from the FDA to begin a pivotal Phase III study of the RHEO procedure to treat dry age-related macular degeneration (AMD).

Who could ignore the biggest news story of the last few weeks - the European approval of Lucentis? Whether you are a retina specialist or not, it would have been virtually impossible to miss this announcement. In fact, the press coverage received by this approval has been quite incredible. Certainly in the UK, we have seen headlines splashed across the pages of many of the major national newspapers. The entry of Lucentis into Europe marks a significant milestone in the treatment of wet AMD. This agent has actually been shown to improve vision in wet AMD sufferers; something that has never been done before. Now all wet AMD sufferers are eligible for treatment, which means retinologists now need to question how they will cope with the sudden surge of patients. Time will tell but we do hope to provide you with a guide on how to manage your clinic and patients in the new era of wet AMD therapy in upcoming issues.

Boston Micromachines Corporation has developed an enhanced deformable mirror capable of meeting the criteria for ultra-high resolution retinal imaging.

Patients with retinitis pigmentosa (RP) could benefit from continued treatment with a topical form of carbonic anhydrase inhibitor.

I have been disappointed by the outcomes of anti-VEGF monotherapy. I feel that far too many retreatments are required with no clear specified endpoint

Its almost time to close the door on 2006 and welcome another new year. But, before we do that we wanted to take you on a journey through the highs and lows of the past twelve months by reflecting on some of the most significant events to shape your industry this year.

TargeGen has initiated a phase I trial of TG100801, a small molecule, topically applied multi-targeted kinase inhibitor for the treatment of age-related macular degeneration (AMD) and other degenerative eye diseases.

Pseudoxanthoma elasticum (PXE) is an inherited metabolic disease with many systemic manifestations. Although the skin changes are striking, the eye and cardiovascular lesions can be most devastating to the patient.

Retinal venous occlusions (RVO) are the most common visually disabling retinopathy after diabetes and age-related macular disease.1 The pathogenesis of RVO is multifactorial with both local factors and systemic diseases being etiologically important. It is essential that each individual contributing mechanism is established so that a beneficial treatment protocol can be developed to treat this debilitating condition.

Diabetes Mellitus (DM) is a chronic disorder of metabolism in which a defective or deficient insulin secretory response results in impaired glucose utilization and subsequent hyperglycaemia.

Last year, Philip Rosenfeld of the Bascom Palmer Eye Institute in Miami, USA, announced some findings that made the ophthalmology community stand to attention. He claimed that intravitreal administration of the cancer agent, Avastin (bevacizumab), in wet age-related macular degeneration (AMD) patients yielded very positive results. Since then, industry journals have been inundated with reports of the benefits of this agent in an ophthalmic setting.

The high incidence of neurodegenerative retinal diseases that lead to visual impairment and blindness has given rise to new technological and biological advances in the field of ophthalmology. Electronic retinal prostheses are among the most eagerly anticipated, yet complex devices to be developed. The expertise of retinal specialists, surgeons and engineers has been combined to thoroughly research the effect of electrical stimulation on retinal neurons, to develop micro-electronic chips, investigate new encapsulation methods that are bio-compatible and to develop methods of powering the subretinal devices.

Many ophthalmic disorders give rise to neovascularization of the iris and neovascular glaucoma. Almost all of these disorders are characterized by retinal hypoxia and retinal capillary nonperfusion, the same factors involved in the development of retinal neovascularization. One of the most common causes is central retinal vein occlusion (CRVO), which is a visually disabling disease that is second in prevalence only to diabetic retinopathy.

Cataract surgery and AMD: there?s no link

Until recently, treatment options for neovascular (wet) AMD have been limited. Thermal laser photocoagulation - a destructive mode of therapy - was indicated in a minority of neovascular cases, including extrafoveal and some cases of juxtafoveal choroidal neovascularization (CNV). Photodynamic therapy with verteporfin (PDT) marked a new era in the treatment of exudative AMD, since subfoveal lesions were no longer excluded from treatment. However, it remains that not all lesions are eligible for treatment and the beneficial effect of PDT has only been clearly evident in predominantly classic lesions.

Age-related macular degeneration (AMD) is the worldwide leading cause of blindness. The severe form, choroidal neovascularisation (CNV), faces revolutionary times as new treatment modalities are introduced. Whereas one decade ago argon laser coagulation represented the standard treatment method, nowadays different treatments come into our clinical setting: classic CNV responds well to photodynamic therapy (PDT) with "off label" triamcinolone, and now occult CNV can be successfully treated with an array of treatment modalities: PDT, transpupillary thermotherapy (TTT), subretinal surgery, macular translocation, or anti-angiogenic therapy.

What tasks are more important for the ophthalmologist than dealing with a disease that is the second most common cause of blindness overall and the number one blinding disease in the working population?

Research, development, innovation and the quest for excellence go hand in hand with the evolution of the ophthalmology industry. With the new wave of phakic IOLs entering the market, each with its own unique offering and capabilities, it's hard to know which lenses will suit you and your patient best. Furthermore, does the introduction of these new refractive correctors threaten the position of the lasers that we have all come to grow to love? It seems that the laser refractive surgery industry is still going from strength to strength.

A high dietary intake of vitamin E and zinc reduced the risk of AMD.

We need stronger evidence to support the combination of PDT with anti-VEGF therapy or corticosteroids before combination therapy becomes standard care for many of these lesions.

In an exciting time for the treatment of patients with exudative age-related macular degeneration, several new pharmaceutical options are being tested. Most compounds target vascular endothelial growth factor (VEGF), which is implicated in the proliferation of choroidal neovascularization. However, the effects of VEGF can be blocked at different levels.

Meticulous wound closure is key to success with this implant, as well as patients having realistic expectations about visual acuity outcomes after implantation

Use of intravitreal triamcinolone acetonide (IVTA) has increased significantly over the past four years as a consequence of successful reporting of the agent's efficacy in the treatment of cystoid macular oedema resulting from uveitis, birdshot retinochoroidopathy, central retinal vein occlusion and diabetic macular oedema.1-6

The role of vitrectomy must be defined and compared with intravitreal triamcinolone and laser treatment, but vitrectomy may provide a more permanent solution for some eyes