Vision Gains for Retinal Vein Occlusion Patients

Posted on May 30, 2022 by Dawn Kaplan

Retinal vein occlusion is one of the most common blinding conditions in the United States; without treatment, central retinal vein occlusion (CRVO), the most severe type of retinal vein occlusion often leads to significant and permanent vision loss. New research shows that a treatment for retinal vein occlusion yields long-lasting vision gains, with visual acuity remaining significantly above baseline at five years. However, many patients require ongoing treatment. A report on five-year outcomes of the Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2), was published April 21 in American Journal of Ophthalmology. SCORE2 was funded in part by the National Eye Institute (NEI), a part of the National Institutes of Health.

Retinal vein occlusion is caused by a blockage of the veins carrying blood away from the retina, the light-sensitive tissue at the back of the eye. This blockage can lead to macular edema where fluid becomes trapped within and under the retina, leading to rapid and severe loss of visual acuity. Without treatment, this condition typically leads to permanent loss of vision. The most effective treatment, injections of anti- vascular endothelial growth factor (VEGF) drugs, helps control blood vessel leakage and swelling in the retina.

“While anti-VEGF therapy is associated with significant improvement in both retinal swelling and visual acuity in patients with central or hemi-retinal vein occlusion, our findings show that most of the patients followed still required treatment to control the macular edema for at least five years,” said Ingrid U. Scott, M.D., M.P.H., Penn State College of Medicine, Hershey, chair of the study. “This demonstrates the importance of continued monitoring of these patients.”

In 2017, SCORE2 clinical trial investigators reported that two types of anti-VEGF treatment were equally effective at improving visual acuity in people with macular edema due to CRVO or hemi-retinal vein occlusion (HRVO). CRVO affects the entire retina, while HRVO generally affects about half of the retina. Half of the study participants had been given Avastin (bevacizumab) while the other half received Eylea (aflibercept). At the six-month mark, the vision of participants in both groups had, on average, improved over three lines on an eye chart.

At five years, many participants in both groups had lost some visual acuity when compared to their acuity at the 6 and 12-month marks; however, they retained on average three lines of improvement, compared to their acuity at the beginning of the study.

“It was surprising to us that despite many participants still needing treatment after five years, their visual acuity outcome remained very good,” said Michael Ip, M.D., co-chair of the study from Doheny Eye Institute, University of California Los Angeles. “In comparison to this treatment for wet age-related macular degeneration, where initial vision improvements fade over time, these results are quite favorable.”

“This five-year study tells us a lot about what’s happening with retinal vein occlusion patients in the real world,” said Scott. “Prior to this study, retinal vein occlusion was widely considered an acute illness. This study shows that RVO is a chronic disease. It also underscores the importance of disease monitoring and individualized treatment to achieve the best possible vision.”

“The SCORE2 study provides invaluable data to guide clinicians and their patients toward informed decisions regarding treatment for retinal vein occlusion,” said NEI Director Michael F. Chiang, M.D.

To read the original article click here: https://www.sciencedaily.com/releases/2022/04/220421105507.htm

Could following the Mediterranean diet prevent blindness?

Posted on April 28, 2019 by Dawn Kaplan

The evidence is in and it shows that a poor diet plays a big role in the development of age-related macular degeneration (AMD), a leading cause of blindness in the US. A large collaboration of researchers from the EU investigated the connection between genes and lifestyle on the development of AMD has found that people who followed a Mediterranean diet cut their risk of late-stage AMD by 41% This research expanded on previous studies and suggests that such a diet is beneficial for everyone, whether you already have the disease or are at risk of developing it.

A Mediterranean diet emphasizes eating less meat and more fish, vegetables, fruits, legumes, unrefined grains, and olive oil. Previous research had linked it to a longer lifespan and a reduced incidence of heart disease and cognitive decline. Previous studies also showed following this diet can help with certain types of AMD, but only focused on different stages of the disease.

By combining this earlier research on AMD with the latest data, a clear picture emerges: Diet has the potential to prevent a blinding disease.

AMD is a degenerative eye disease. It causes loss of central vision, which is crucial for simple everyday activities, such as the ability to see faces, drive, read, and write. It’s a leading cause of vision loss among people age 50 and older, affecting 1.8 million Americans. By 2020, that number is expected to climb to nearly 3 million.

In this study, researchers analyzed food-frequency questionnaires from nearly 5,000 people who participated in two previous investigations — the Rotterdam Study, which evaluated disease risk in people age 55 and older, and the Alienor Study, which assessed the association between eye diseases and nutritional factors in people aged 73 and older. Patients in the Rotterdam study were examined and completed food questionnaires every five years over a 21-year period, while patients in the Alienor Study were seen every two years over a 4-year period. The researchers found that those who closely followed the diet were 41% less likely to develop AMD compared with those who did not follow the diet.

They also found that none of the individual components of a Mediterranean diet on their own — fish, fruit, vegetables, etc. — lowered the risk of AMD. Rather, it was the entire pattern of eating a nutrient-rich diet that significantly reduced the risk of late AMD.

There are two kinds of AMD — dry and wet. The dry type affects about 80 to 90 percent of people with AMD. In dry AMD, small white or yellowish deposits, called drusen, form on the retina, causing it to deteriorate over time. In the wet form, blood vessels grow under the retina and leak. While there is an effective treatment available for the wet type, there is no treatment available for dry AMD.

So remember you are what you eat!

To read the original article in its entirety, click here. https://www.sciencedaily.com/releases/2018/10/181001101940.htm

Biomarkers could aid in early detection of glaucoma

Posted on April 21, 2019 by Dawn Kaplan

Researchers bred mice in which the gene PTP-Meg2 (protein tyrosine phosphatase megakaryocyte 2) was mutated. As a result, the animals suffered from chronic intraocular pressure elevation. The research team successfully demonstrated that, in their model, the intraocular pressure elevation was associated with a loss of optic nerve fibers and retinal cells. They also observed that retinal cells were unable to function properly. They further discovered glial cells and certain components of the immune system showed a reaction in the animals’ optic nerve and retina. As both aspects may be relevant for neurodegeneration, specific and early intervention into these cellular mechanisms could inhibit glaucoma.

By making use of a genetic screening, the researchers identified new potential biomarkers for glaucoma, which in the future, may facilitate early detection. As a result, it will be possible to start therapy at an earlier stage, before the optic nerve and retina are damaged. The glaucoma-mouse model may, moreover, be used to test new therapy options. So far intraocular pressure was reduced and nerve cells were retained in the mice if they were given a drug that has been used to treat human patients.

With more than 60 million patients, Glaucoma is a leading cause of blindness worldwide. In Germany alone, there are one million patients — and the estimated number of unknown cases is likely to be much higher, due to the fact that symptoms often remain undetected during the early stage of the disease. In glaucoma patients, the optic nerve and the retinal nerve cells are damaged beyond repair.

To read the original article in its entirety, click here. https://www.sciencedaily.com/releases/2018/10/181025103308.htm