TAG: "Eye care"

Donor age not a factor in most corneal transplants

Study shows “most corneal transplants have remarkable longevity regardless of donor age.”

The cornea is the clear window that allows light into the eye and helps focus it. Scarring, swelling or other damage to the cornea can lead to blurred vision. Such damage can occur after injuries or infections, from inherited conditions, or as a complication of cataract surgery.

The cornea is the clear window that allows light into the eye and helps focus it. Scarring, swelling or other damage to the cornea can lead to blurred vision. Such damage can occur after injuries or infections, from inherited conditions, or as a complication of cataract surgery.

Ten years after a transplant, a cornea from a 71-year-old donor is likely to remain as healthy as a cornea from a donor half that age, and corneas from donors over 71 perform slightly less well but still remain healthy for most transplant recipients, according to a study funded by the National Eye Institute (NEI) and led by the UC Davis Health System Eye Center and the University of Cincinnati Eye Institute.

The results were published online in Ophthalmology on Nov. 15, and presented on the same day in New Orleans at a joint meeting of the Eye Bank Association of America and the Cornea Society.

The Cornea Donor Study found that 10-year success rates remained steady at 75 percent for corneal transplants from donors 34 to 71 years old. It also found slightly higher success rates for donors under 34, and somewhat lower rates for donors over 71.

In the U.S., three-fourths of cornea donors are within the 34 to 71 age range, with one-third of donors at the upper end of the range, from 61 to 70 years old. When the study began in 2000, many surgeons would not accept corneas from donors over 65.

“The findings clearly demonstrate that most corneal transplants have remarkable longevity regardless of donor age,” said Mark Mannis, chair of ophthalmology and vision sciences, director of UC Davis Health System’s Eye Center and co-chair of the study. “The majority of patients continued to do well after 10 years, even those who received corneas from the oldest donors.”

The Corneal Donor Study  “supports continued expansion of the corneal donor pool beyond age 65,” said study co-chair Edward J. Holland, professor of ophthalmology at the University of Cincinnati and director of the Cornea Service at the Cincinnati Eye Institute.

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Free health care clinic

UCLA health care staff help treat thousands at Care Harbor clinic.

A team of more than 200 UCLA health professionals helped staff a free health care clinic last week that provided vital basic medical services to approximately 3,000 uninsured and underserved people in Los Angeles.

They were among the nearly 3,000 medical and general volunteers at Care Harbor’s annual urban health clinic — held Oct. 31 through Nov. 3 at the Los Angeles Sports Arena just south of downtown Los Angeles — who provided more than 5,700 medical, dental and vision exams.

“To me it’s part of the mission of being a physician to care for people,” said Dr. Colin McCannel, a UCLA ophthalmologist. ” It’s part of what I should be doing so doing it makes me feel like I’m doing what I’m supposed to.”

There were 16 volunteers from UCLA Jules Stein Eye Institute, who conducted eye exams, donated 10 free cataract surgeries and prescribed free eye glasses. UCLA’s team also included seven doctors from family medicine, 17 general internists, and one physician from internal medicine/pediatrics, as well as some specialists and medical students.

The Care Harbor clinic provides a wide range of services for people who lack the means to get medical care on a regular basis. The health professionals screened for diabetes and hypertension, administered immunizations, offered mental health counseling and provided teeth cleanings, among many other basic services. For those patients who had more severe problems or conditions that required longer term care, the volunteers provided referrals to followup services.

The UCLA School of Dentistry staffed 10 dental chairs providing oral hygiene services for hundreds of patients.

“Service is part of the core missions and I want to take every opportunity I can to give back,” said Dr. Edmond Hewlett, a professor in the school of dentistry.

In addition to the doctors, UCLA volunteers included nearly 80 nurses from Ronald Reagan UCLA and Santa Monica medical centers; six clinical lab scientists and a pathologist from the department of pathology who interpreted the pap smears; and six nurse practitioners.

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NIH awards $1.7M to neuroscientist for visual perception research

Work by UC Riverside professor holds promise of new therapies for people with low vision.

Aaron Seitz, UC Riverside

Aaron Seitz, UC Riverside

A UC Riverside neuroscientist has been awarded a five-year, $1.7 million grant by the National Institutes of Health to continue groundbreaking research that may lead to new therapies for individuals with amblyopia (lazy eye), dry macular degeneration and cataracts.

Research by Aaron Seitz, associate professor of psychology, already is influencing what scientists know about perceptual learning as it relates to low vision. Perceptual learning – a field of research that emerged about 30 years ago – is important to understanding brain processes, mechanisms of learning, the development of training techniques for tasks requiring specialized sensory skills, and the development of clinical applications to rehabilitate patients with sensory deficits.

His NIH research grant, “Integrating Perceptual Learning Approaches into Effective Therapies for Low Vision,” will support further study of how different mechanisms of perceptual learning interact, and will explore better treatment options for individuals with visual defects. This integrated approach into understanding brain plasticity — how the brain changes physically, chemically and functionally due to aging, injury or disease — and perceptual learning so far has been lacking in neuroscience research.

“Science research typically examines isolated processes,” he said. “Taking a broader, integrated view requires totally different tools. We need to develop a new model that combines multiple processes or mechanisms for perceptual learning. With this grant I hope we will better understand how these mechanisms can be tuned to train the brain to be more effective.”

Earlier research by Seitz challenged the popular assumption that adults learn only by paying attention to something. He found that pairing a visual stimulus with a reward is enough to cause learning, even when an individual is unaware of the stimulus paired with the reward.

“I’m truly excited about this research,” said Seitz, who joined the UCR faculty in 2008. “The science is fascinating and has tremendous potential to help people.”

Working with Dr. Stacy Pineles at the Jules Stein Eye Institute at UCLA, Dr. Pinakin Davey at the College of Optometry at Western University College of Health Sciences in Pomona and Peggy Seriès at the Institute for Adaptive and Neural Computation at University of Edinburgh, Seitz hopes to develop new therapies involving brain training to improve vision of individuals with amblyopia (lazy eye), dry macular degeneration and cataracts.

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$6.4M grant funds glaucoma study in African Americans

Study focuses on genetics of the disease in people of African descent.



A study led by Robert N. Weinreb, chairman and Distinguished Professor of Ophthalmology at the UC San Diego School of Medicine, has received a $6.4 million, 5-year grant from the National Eye Institute, part of the National Institutes of Health, to elucidate the genetics of glaucoma in persons of African descent.

Glaucoma is the leading cause of blindness in African Americans. It is four to five times more likely to occur in persons of African descent, and up to 15 times more likely to cause meaningful visual impairment in this group compared to those of European descent.

The overall goal of the study, “ADAGES III: contribution of genotype to glaucoma phenotype in African-Americans,” is to identify glaucoma genes in this high-risk, minority population, particularly persons who have rapidly worsening vision. Weinreb has teamed with Jerry Rotter, M.D., Distinguished Professor of Pediatrics, Medicine and Human Genetics at Harbor-UCLA Medical Center, a renowned genetics expert, to identify relevant genes, develop predictive models for glaucoma diagnosis and progression and discover new drug targets for therapies to reduce the visual impact of glaucoma blindness.

Glaucoma results in vision loss due to damage to the optic nerve, which is irreversible if undetected or untreated.  The most common form of glaucoma is called primary open angle glaucoma (POAG). The number of persons with diagnosed POAG in the United States is expected to be more 3.3 million by 2020, with millions more undiagnosed.  While glaucoma affects all races, persons of African descent are disproportionately affected.

“The lack of understanding about the cause of this disease impedes our ability to identify and treat it early in its development,” said Weinreb, who is also director of the Shiley Eye Center, part of the UC San Diego Health System. “Evidence of genetic contribution in the pathogenesis of POAG is well established. Since POAG tends to run in families, it is critical to identify the genetic basis of the disease in order to develop effective therapies for early intervention.”

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New UC Berkeley eye clinic to target youth

Rise in nearsightedness attributed partly to overuse of handheld electronics.

oo much time spent with handheld electronics could increase the risk of nearsightedness especially among children.

Too much time spent with handheld electronics could increase the risk of nearsightedness especially among children.

Eye doctors at the University of California, Berkeley, are opening a new clinic to help combat an alarming rise in myopia, or nearsightedness, which they attribute partly to the overuse of handheld electronics.

“There are a number of factors involved in the increase of myopia, but I have no doubt that changes in lifestyle over the past several decades that include more time spent indoors and the early use of handheld computers play a big role,” said Dr. Maria Liu, head of the new Myopia Control Clinic at UC Berkeley’s School of Optometry. “The problem with smartphones and iPads is that kids often hold them closer to their eyes than they would a book, and they can become totally absorbed for hours at a time. The working distance for handheld devices is much closer than it is for laptops and TV.”

Liu noted that young children are particularly vulnerable because their eyes are still developing. She added that, in particular, nearsighted children under 10 could benefit most from early intervention.

Admittedly, the overuse of handheld electronics by young children is not the only culprit for the rise in myopia. It may be that myopia is simply a byproduct of modern, urban life, said the researchers, who noted that nearsightedness rates are relatively low in agricultural regions and nations. High rates of myopia among children in East Asian countries have been attributed to long hours spent reading indoors.

A study funded by the National Eye Institute, or NEI, found that the prevalence of myopia increased 66 percent for those aged 12 to 54 years in the United States between 1971-1972 and 1999-2004.

Notably, NEI data shows that severe myopia was twice as prevalent among younger adults as for the elderly. For those aged 20 to 39, 7.4 percent had severe myopia compared with 3.1 percent for those 60 and older.

The goal of UC Berkeley’s new Myopia Control Clinic, which will operate Thursdays and Sundays, is to slow down the progression of myopia while it is still in its early phase of development. In addition to providing conventional glasses to correct myopia, doctors will be offering treatments for controlling the condition’s progression, ranging from special contact lenses to prescription eye drops.

“The early onset of myopia can have effects beyond corrective lenses,” said Liu. “The earlier the myopia starts, the longer the disorder has to develop into something more severe. It’s relatively rare, but in pathological myopia, the excessive elongation of the eyeball dramatically increases the risk for retinal detachment, growth of abnormal blood vessels and other complications, which can lead to irreversible vision loss.”

Patients can get more information or schedule appointments at the myopia clinic by calling (510) 642-2020, or by sending an email to myopiacontrol@gmail.com.

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A vision realized

New home of UC Irvine’s Gavin Herbert Eye Institute has been years in the making.

The Gavin Herbert Eye Institute “offers patients from both the local community and around the world access to clinically advanced eye care from internationally renowned ophthalmologists in a thoughtfully planned physical environment,” says UC Irvine Chancellor Michael Drake. (Photo by Steve Zylius, UC Irvine)

The Gavin Herbert Eye Institute “offers patients from both the local community and around the world access to clinically advanced eye care from internationally renowned ophthalmologists in a thoughtfully planned physical environment,” says UC Irvine Chancellor Michael Drake.

When the Gavin Herbert Eye Institute opens its new 70,000-square-foot home on the UC Irvine campus in September, the community will gain access to a leading-edge center for the preservation of sight, with services ranging from eyeglass fittings to refractive surgeries to clinical trials of new therapies.

The comprehensive eye health institute, which is part of UC Irvine Health, includes 34 patient exam rooms with the latest in optical equipment, an optical shop, faculty offices and conference space. A dedicated pediatric area has play areas, video entertainment screens, kid-friendly restrooms and other features to make the experience more comfortable for the youngest patients, many with special needs. The interior design reflects recommendations from the Braille Institute that make it easier for low-vision patients to navigate around the building.

“This institute offers patients from both the local community and around the world access to clinically advanced eye care from internationally renowned ophthalmologists in a thoughtfully planned physical environment,” says UC Irvine Chancellor Michael Drake. “The Gavin Herbert Eye Institute is strategically located within walking distance of two major biomedical research centers and at the epicenter of the largest concentration of eye technology companies in the world. It’s well positioned to pursue its ambitious research goal of ending blindness by 2020.”

Ten Gavin Herbert Eye Institute physicians grace Best Doctors Inc.’s list of “Best Doctors in America,” including the institute’s founding director, Dr. Roger Steinert. An internationally recognized authority on cataract, cornea and refractive surgery, he is UC Irvine’s Irving H. Leopold Chair in Ophthalmology and a professor of both ophthalmology and biomedical engineering.

“I am fortunate to lead a talented team of 24 clinicians and researchers who are dedicated to making life better for people with vision issues,” Steinert says. “The Gavin Herbert Eye Institute has attracted the best and the brightest – ophthalmologists who are eager to be part of an institute that works at the edge of science, collaborating with medical peers and eye industry professionals to develop innovative technologies and clinical practices that improve sight. It’s rewarding to be able to see our patients from the local community and around the globe benefit from these advances.”

Gavin Herbert Eye Institute physicians are known for pioneering such medical procedures as refractive and corneal transplant surgery performed with femtosecond lasers and next-generation medical therapies for age-related macular degeneration. Research teams are investigating such advanced treatments as stem cell therapies to preserve and restore sight for individuals with retinitis pigmentosa and macular degeneration; infused contact lenses that replace eye drops to treat cystinosis; and a vaccine for ocular herpes, a leading cause of blindness.

The $39 million building is the first on the UC Irvine campus to be funded entirely through local corporate, foundation and individual philanthropic gifts; no government funding was required.

James V. “Jim” Mazzo, an operating partner with Newport Beach-based Versant Ventures and a UC Irvine Foundation trustee, led the very successful community campaign. The initial naming gift came in 2007 from Gavin Herbert, founder and chairman emeritus of Allergan Inc.; his wife, Ninetta; and his mother, Josephine Herbert Gleis.

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Study reveals new approach to remedying childhood visual disorders

UC Irvine, UCLA researchers identify key inhibitory neurons critical for vision development.

Xiangmin Xu, UC Irvine

Xiangmin Xu, UC Irvine

By discovering the role of key neurons that mediate an important part of vision development, UC Irvine and UCLA neurobiologists have revealed a new approach to correcting visual disorders in children who suffer from early cataracts or amblyopia, also known as lazy eye.

Such youngsters can have permanent defects in vision, even after surgery to remove cataracts or correct lazy eye. These flaws are often a result of improper brain development due to visual deprivation during childhood. In contrast, when cataracts in adults are surgically corrected, normal vision is usually restored.

Xiangmin Xu, assistant professor of anatomy & neurobiology at UC Irvine, and Josh Trachtenberg, associate professor of neurobiology at UCLA, found that this phenomenon is caused by a specific class of inhibitory neurons that control the time window, or “critical period,” in early vision development, generally before age 7. The results of their study appeared online Aug. 25 in Nature.

The researchers discovered that improper functioning of these key neurons during the critical period of development is responsible for these vision defects. Additionally, in tests on mice, they used an experimental drug compound to reopen this critical-period window and treat the neuronal defects associated with temporary loss of vision in one eye during early development.

Their work suggests that drugs targeted to the critical period-regulating neurons can correct central vision disorders in children who’ve suffered from amblyopia or early cataracts.

“The specific type of neurons that mediate the critical-period window during childhood development have not been well understood until now,” Xu said. “Our breakthrough outlines a new path for treatments that can restore normal vision in children who have had early vision disorders.”

Nicholas Olivas and Taruna Ikrar of UC Irvine and Sandra Kuhlman and Elaine Tring of UCLA contributed to the study, which received support from the National Eye Institute (grant EY016052) and the National Institute for Neurological Disorders & Stroke (grant NS078434).

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Discovery Eye Foundation makes $3M gift to Gavin Herbert Eye Institute

Award supports completion of campus home for UC Irvine Health facility, research.

Roger Steinert, UC Irvine

Roger Steinert, UC Irvine

The Discovery Eye Foundation – a Los Angeles-based organization that supports research, education, advocacy and treatment related to sight-threatening eye diseases – has awarded $3 million to the Gavin Herbert Eye Institute, a part of UC Irvine Health. The gift provides $2 million to complete the UC Irvine campus facility, which opens in September, and $1 million to establish the Discovery Center for Eye Research within it.

“The goal of the building donation is to establish a home for this world-class eye institute – a place where ongoing research funded by the Discovery Eye Foundation will be translated into sight-saving treatments,” said Jack Schoellerman, chairman of the foundation board.

The Discovery Center for Eye Research is a novel collaboration between a private entity, the Discovery Eye Foundation, and the university-based Gavin Herbert Eye Institute. Schoellerman will serve as chair of the center, helping to define its role in sustaining current investigations and kick-starting promising new research. The center also plans to launch ophthalmology conferences at which research findings can be shared and new ideas stimulated.

“The Discovery Eye Foundation has funded the progress of many patient-oriented Gavin Herbert Eye Institute research programs, from a potential cure for ocular herpes to a proposed stem cell treatment for age-related macular degeneration,” said Dr. Roger Steinert, founding director of the institute. “We are grateful to the foundation for its generous investment in the future of eye health and look forward to exploring what we can accomplish together through the Discovery Center for Eye Research.”

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Guide to buying sunglasses

Berkeley Wellness offers tips for what to look for in sunglasses.

Woman wearing sunglassesMany people choose sunglasses by how they look and feel. But the most important feature to consider is how well they shield your eyes from ultraviolet rays (high-frequency invisible energy emitted by the sun), as well as blue light (high-frequency visible light).

Chronic ultraviolet (UV) exposure is implicated in a range of eye conditions, including cataracts, benign growths on the surface of the eye, skin cancer on the eyelid and around the eyes and even melanoma of the eye itself. Blue light is particularly damaging to internal eye tissues and over time may permanently damage the retina, leading to macular degeneration.

Sun damage is cumulative, so the more time you spend outdoors with your eyes unprotected, the greater your lifetime risk. The good news is that it’s not hard to find affordable sunglasses that are fashion-forward and protective.

Read tips from Berkeley Wellness.

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Water flow in eye cells essential to lens health

UC Irvine study provides new insights into molecular mechanisms that can lead to cataracts.

CorneaBy understanding how water flows in and out of eye lens cells, UC Irvine and Howard Hughes Medical Institute researchers are providing new insights into the underlying molecular mechanisms that can lead to cataracts.

James Hall, professor of physiology & biophysics, and colleagues identified how two proteins – aquaporin zero and calmodulin – interact to throw a molecular switch that controls the flow of water through the cell membrane, working much like a gate valve in a plumbing fixture.

Proper hydration of the membrane helps assure good cell health, and any disruption in this flow or its regulation results in cataract formation.

“We know that defects in aquaporin zero lead to congenital cataracts. Our study makes a step toward understanding how cataracts form and, we hope, learning how to prevent or delay them,” said Hall. He teamed with HHMI’s Tamir Gonen to lead the study, which appears online in Nature Structural & Molecular Biology.

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Eye specialist to develop novel eye imaging technologies

UC Davis scientist receives award from Research to Prevent Blindness.

Ala Moshiri, UC Davis

Ala Moshiri, UC Davis

UC Davis Health System’s Eye Center has received a $250,000 Career Development Award from Research to Prevent Blindness to support the research of Ala Moshiri, an assistant professor of ophthalmology and director of electrophysiology services at the Eye Center.

Moshiri is a specialist in all diseases of the retina, the complex tissue in the back of the eye that contains specialized photoreceptor cells called rods and cones. These photoreceptors connect to a network of nerve cells for processing visual information that is decoded by the brain into visual images.

The retina is susceptible to a variety of diseases, including age-related macular degeneration, retinal detachment, diabetic retinopathy, retinitis pigmentosa and other inherited retinal degenerations, each of which can lead to vision loss or complete blindness. Malfunctioning and death of rod and cone photoreceptor cells is at the core of all of these retinal conditions.

According to the National Eye Institute, one of the major achievements in biology has been defining the cellular events involved in the process of visual transduction — the process by which photoreceptor cells in the eye capture light and initiate the electrical signals utilized by the brain in processing visual information.

As part of his Research to Prevent Blindness Career Development Award, Moshiri will develop novel technologies in functional imaging of photoreceptor diseases in animal models and humans. He will focus on developing molecular fluorescence resonance energy transfer sensors to capture signals in the cycle of vision to assess retinoid function under healthy and diseased conditions.

“At this point, there is no technology to directly assess the health and function of rod and cone photoreceptors,” said Moshiri. “The ongoing work in the lab is aimed at developing these molecular sensors in order to detect and confirm the health of photoreceptor cells and to verify that they are sensing light in a healthy way. This technology will give us more information about all diseases of the retina and will help pave the way to develop and test new therapies, including stem cell therapies, for virtually all retinal problems.”

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Researchers develop easy, effective therapy to restore sight

New procedure is quick and surgically non-invasive.

David Schaffer, UC Berkeley

Researchers at UC Berkeley have developed an easier and more effective method for inserting genes into eye cells that could greatly expand gene therapy to help restore sight to patients with blinding diseases ranging from inherited defects like retinitis pigmentosa to degenerative illnesses of old age, such as macular degeneration.

Unlike current treatments, the new procedure is quick and surgically non-invasive, and it delivers normal genes to hard-to-reach cells throughout the entire retina.

Over the last six years, several groups have successfully treated people with a rare inherited eye disease by injecting a virus with a normal gene directly into the retina of an eye with a defective gene. Despite the invasive process, the virus with the normal gene was not capable of reaching all the retinal cells that needed fixing.

“Sticking a needle through the retina and injecting the engineered virus behind the retina is a risky surgical procedure,” said David Schaffer, professor of chemical and biomolecular engineering and director of the Berkeley Stem Cell Center at UC Berkeley. “But doctors have no choice, because none of the gene delivery viruses can travel all the way through the back of the eye to reach the photoreceptors – the light sensitive cells that need the therapeutic gene.

“Building upon 14 years of research, we have now created a virus that you just inject into the liquid vitreous humor inside the eye, and it delivers genes to a very difficult-to-reach population of delicate cells in a way that is surgically non-invasive and safe. “It’s a 15-minute procedure, and you can likely go home that day.”

The engineered virus works far better than current therapies in rodent models of two human degenerative eye diseases, and can penetrate photoreceptor cells in monkeys’ eyes, which are like those of humans.

Schaffer said he and his team are now collaborating with physicians to identify the patients most likely to benefit from this gene delivery technique and, after some preclinical development, hope soon to head into clinical trials.

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