Volume 5, Number 49
Monday, December 12, 2005



In this issue: (click heading to view article)
Differences in Visual Function and Optic Nerve Structure Between Eyes of Blacks and Whites
Retinal Arterial Macroaneurysms: Risk Factors of Poor Visual Outcome
Effects of Caffeine on IOP
Briefly











Differences in Visual Function and Optic Nerve Structure Between Eyes of Blacks and Whites

Race may significantly affect optic disc topography and superior and inferior retinal nerve fiber layer (RNFL) thickness measurements in healthy eyes, according to a study by the University of California. The racial differences observed for intraocular pressure (IOP) could theoretically increase after correcting for central corneal thickness (CCT).

The study aimed to investigate racial differences in visual function, optic disc topography and RNFL thickness. Investigators assessed visual function in healthy eyes of 50 blacks and 50 whites using standard automated perimetry, short-wavelength automated perimetry and frequency doubling technology perimetry. They measured optic disc topography and RNFL thickness using the Heidelberg Retina Tomograph and the optical coherence tomograph.

Mean standard automated perimetry deviations were within the normal range for both groups. Blacks had worse mean deviation values than whites using frequency doubling technology perimetry (mean +/- SD, -1.8 +/- 3.2 dB vs. -0.1 +/- 2.4 dB) and blacks had larger optic disc areas than whites using the Heidelberg Retina Tomograph (mean +/- SD, 2.1 +/- 0.4 mm2 vs. 1.7 +/- 0.4 mm2). The RNFL of blacks was thicker than that of whites by 16.91 microns superiorly and 10.10 microns inferiorly using optical coherence tomography, and blacks had slightly higher IOPs than whites (mean +/- SD, 16.5 +/- 2.5 mmHg vs. 15.2 +/- 3.2 mmHg) and thinner central corneas (mean +/- SD, 540.5 +/- 43.2 microns vs. 560.9 +/- 35.5 microns). No racial differences were evident in mean RNFL thickness, pattern standard deviation on all tests or any of the short-wavelength automated perimetry variables. The authors believe that prospective studies are needed to further investigate their findings.

SOURCE: Racette L, Boden C, Kleinhandler SL, et al. Differences in visual function and optic nerve structure between healthy eyes of blacks and whites. Arch Ophthalmol. 2005;123(11):1547-53. 		Table of Contents











Retinal Arterial Macroaneurysms: Risk Factors of Poor Visual Outcome

This Taiwan study evaluated the long-term natural course and identified risk factors of poor visual outcome in patients with retinal arterial macroaneurysms (MA).

In an observational case series, researchers retrospectively evaluated consecutive patients with MA at their institution over a 17-year period. They compared visual outcomes of the different types of MA, presented as predominantly hemorrhagic or exudative. A total of 31 patients with 46 confirmed MA were identified. The ocular manifestations of MA included retinal hemorrhage (96.7 percent), retinal exudate (61.3 percent), macular involvement (77.4 percent) and vitreous hemorrhage (12.9 percent).

Among the 10 cases of hemorrhagic-type MA, visual acuity improved by two or more lines in nine (90 percent) and decreased in one patient (10 percent). In the 15 cases of exudative-type MA, four improved (26.7 percent), eight remained stationary (53.3 percent) and three had decreased visual acuity (20 percent). The average vision change in the minimum angle of resolution improved by 0.59 log units in hemorrhagic MA and decreased by 0.07 log units in exudative MA. The eyes with hemorrhagic-type MA showed greater improvement in vision than those with the exudative type, but the final visual outcome did not differ in the two groups. Foveal exudate was a statistically significant risk factor for final vision equal to or worse than 20/100.

The authors concluded that in the majority of MA, there is gradual and spontaneous involution. However, poor visual outcome may occur secondary to foveal exudates and subfoveal hemorrhage.

SOURCE: Yang CS, Tsai DC, Lee FL, Hsu WM. Retinal arterial macroaneurysms: risk factors of poor visual outcome. Ophthalmologica. 2005;219(6):366-72.		 Table of Contents





Effects of Caffeine on IOP

Australia’s Center for Vision Research and Westmead Millennium Institute at the University of Sydney examined the relationship between coffee and caffeine intakes and intraocular pressure (IOP) using participants in the Blue Mountains Eye Study.

The Blue Mountains Eye Study examined 3,654 participants aged 49 years and older in an area west of Sydney. Investigators used a detailed medical history questionnaire that included average daily intakes of coffee and tea. The eye examination included Goldmann applanation tonometry and automated perimetry. Participants using glaucoma medications or those who had previous cataract or glaucoma surgery or signs of pigmentary glaucoma/pigment dispersion were excluded. Mean and maximum IOP calculations were used.

Participants with open-angle glaucoma (OAG) who reported regular coffee drinking had significantly higher mean IOP (19.63 mmHg) than participants who said that they did not drink coffee (16.84 mmHg), after multivariate adjustment. Participants consuming 200 mg or more of caffeine daily had higher mean IOP (19.47 mmHg) than those consuming less than 200 mg caffeine daily (17.11 mmHg), after adjusting for age, sex and systolic blood pressure. This association did not reach statistical significance after multivariate adjustment. No association between coffee or caffeine consumption and higher IOP was found in participants with ocular hypertension and those without open-angle glaucoma.

SOURCE: Chandrasekaran S, Rochtchina E, Mitchell P. Effects of caffeine on intraocular pressure: the Blue Mountains Eye Study. J Glaucoma. 2005;14(6):504-7.		 Table of Contents

 




BRIEFLY
  • B&L ANNOUNCES LICENSING AGREEMENTS FOR NOVEL ANTI- ANGIOGENESIS COMPOUNDS. Bausch & Lomb has announced agreements with two biopharmaceutical companies to license anti-angiogenesis compounds for possible ophthalmic treatments. PTC Therapeutics, Inc., a privately held company, has entered into an exclusive option agreement with B&L in which B&L will license selected PTC compounds as development candidates for therapeutic use in ophthalmology. PTC’s anti-angiogenesis program was developed through its proprietary Gene Expression Modulation by Small Molecules (GEMS) technology. The goal of the collaboration is to develop compounds that provide therapies for diseases of ocular neovascularization, such as macular degeneration. In another agreement, B&L will also gain exclusive worldwide licensing from Cephalon, Inc. (Frazer, PA), to develop, market and sell ophthalmic products containing small-molecule angiogenesis inhibitors for treatment of neovascularization diseases of the eye. Under the terms of this agreement, B&L will be responsible for preclinical and clinical development of compounds for ophthalmic use, will make a milestone payment to Cephalon upon regulatory acceptance of a New Drug Application, and will pay royalties based on product sales. Financial details of the agreements were not disclosed.
  • HYBRID CONTACT LENSES FOR KERATOCONUS RECEIVE MARKET CLEARANCE. SynergEyes KC (paflufocon D hem-iberfilcon A) hybrid contact lenses for keratoconus have received 510 market clearance from the FDA for use in correcting vision in eyes with refractive errors such as hyperopia and myopia that manifest irregular astigmatism, in aphakic and not aphakic, and otherwise non-diseased eyes. The lenses are indicated for daily wear for correction of up to +20.00D and 20.00D in eyes with irregular astigmatism up to 6.00D. SynergEyes KC lenses must be disinfected using only a chemical disinfecting system compatible with both hydrogel and rigid gas permeable lenses. For more information, call 877-733-2012 or go to www.synergeyes.com.
  • INSITE VISION ANNOUNCES POSITIVE RESULTS OF AZASITE TRIAL. InSite Vision has announced positive top-line results from a pivotal Phase III clinical trial of AzaSite, a sterile, topical ophthalmic anti-infective solution containing 1% azithromycin formulated in DuraSite (the Company"s patented drug delivery system). In an international, controlled clinical trial, subjects with bacterial conjunctivitis were treated with either AzaSite dosed twice a day for the first two days followed by once a day for the next three days, or 0.3% tobramycin dosed four times a day for five days. AzaSite demonstrated a clinical resolution rate of 80 percent, compared to 78 percent for tobramycin. This result shows that the clinical resolution rate of AzaSite is equivalent to tobramycin, the primary efficacy endpoint of the study, according to statistical criteria were previously agreed upon by the FDA. The bacterial eradication rate was also equivalent for both groups. There were no reports of systemic drug sensitivity from the study medication and no serious adverse events were reported by the clinical sites.


Table of Contents



Check Yearly. See Clearly. Open Your Eyes To the Opportunities.
It"s only been up and running a few short weeks. Yet, it"s already clear that the Check Yearly. See Clearly.(SM) marketing campaign is opening consumers" eyes to the benefits of regular eye exams. Call the Vision Council of America at 800-424-8422 today or visit checkyearly.com for your free promotional materials.





Subscriptions: Review of Ophthalmology Online is provided free of charge as a service of Jobson Publishing, LLC. If you enjoy reading Review of Ophthalmology Online, please tell a friend or colleague about it. Forward this newsletter or send this address: [email protected]. To change your subscription, reply to this message and give us your old address and your new address; type "Change of Address" in the subject line. If you do not want to receive Review of Ophthalmology Online, reply to this message and type "Unsubscribe: Review of Ophthalmology Online" in the subject line.

Advertising: For information on advertising in this e-mail newsletter or other creative advertising opportunities with Review of Ophthalmology, please contact publisher Rick Bay, or sales managers James Henne, Michele Barrett or Kimberly McCarthy.

News: To submit news, send an e-mail, or FAX your news to 610.492.1049