Alzheimer's drugs may help patients with glaucoma

Drugs which slow the progress of Alzheimer's disease may also protect patients at risk of eye damage from glaucoma, according to researchers at the University College London (UCL), UK.

By examining nerve cell damage in the retina, the researchers discovered that the protein beta-amyloid, which causes damaging plaques in the brains of Alzheimer's patients, is also responsible for harm to the optic nerve. Drugs that reverse the build-up of beta-amyloid plaques were then used on rats and it was found that they reduced the rate of nerve cell death in the eye.

The UCL team, led by Francesca Cordeiro, stressed that despite the strong similarities between the two conditions, people with glaucoma are not at higher risk of developing Alzheimer's and vice versa.

Microsurgical lab testing is a reliable method for assessing ophthalmology resident's surgical skills, according to a report published online ahead of print by the British Journal of Ophthalmology.

Jennifer Taylor from the Children's Hospital of Philadelphia and colleagues from the University of California and the University of Pennsylvania, USA conducted a study to determine the inter-rate reliability and construct validity of the Eye Surgical Skills Assessment Test (ESSAT).

ESSAT is a laboratory-based surgical skills 'obstacle course' which was developed in response to the need for improved tools for the assessment of surgical skills during residency.

Twenty-seven content experts (programme directors and faculty members involved in resident surgical training) watched videos of junior and senior residents completing the three ESSAT stations (skin suturing, muscle recession and phacoemulsification: wound construction & suturing technique) and filled out assessment forms, task specific checklists and a global rating scale of performance.

ESSAT demonstrated good inter-rate reliability for determining whether residents "passed" each section. In addition, at each station the senior resident was consistently rated above the pass threshold whereas the junior residents were more often rated below.

It is the conclusion of the authors that ESSAT is a useful tool that should be integrated into all residency programmes.

Too many cataract operations being performed

The doctors believe that primary care trusts are now paying for unnecessary operations. Mike Dixon from the NHS Alliance agrees, remarking that some operations could wait until symptoms worsen, freeing the money for more essential procedures.

Faced with an ageing population, the British government signed numerous contracts for cataract operations to be performed by private providers running Independent Sector Treatment Centres. It is argued that the outsourcing of these operations could make it more difficult for hospitals to train ophthalmologists for more complex cases in the future.

C3 gene linked to AMD

The gene, complement C3, has been identified as playing an important role in the pathogenesis of age-related macular degeneration (AMD), according to a study published in the August issue of the New England Journal of Medicine.

John R.W. Yates and colleagues from the Genetic Factors in AMD Study Group, tested for an association between AMD and 13 single-nucleotide polymorphisms (SNPs) spanning the complement genes C3 and C5 in case subjects and control subjects from the South East region of England. Each subject was examined by an ophthalmologist and had independent grading of fundus photographs to confirm their disease status. To test for replication of the most significant findings, Scottish cases and controls were genotyped.

It was discovered that the common functional polymorphism rs2230199 in the C3 gene, corresponding to the electrophoretic variants C3S (slow) and C3F (fast), was strongly associated with AMD in both the English group (603 cases and 350 controls; p=5.9x10^-5 ) and the Scottish group (244 cases and 251 controls; p=5.0x10^-5 ).