Orally Active Multi-Functional Antioxidants Are Neuroprotective in a Rat Model of Light-Induced Retinal Damage

Progression of age-related macular degeneration has been linked to iron dysregulation and oxidative stress that induce apoptosis of neural retinal cells. Since both antioxidants and chelating agents have been reported to reduce the progression of retinal lesions associated with AMD in experimental animals, the present study evaluates the ability of multi-functional antioxidants containing functional groups that can independently chelate redox metals and quench free radicals to protect the retina against light-induced retinal degeneration, a rat model of dry atrophic AMD.Proof of concept studies were conducted to evaluate the ability of 4-(5-hydroxypyrimidin-2-yl)-N,N-dimethyl-3,5-dioxopiperazine-1-sulfonamide (compound 4) and 4-(5-hydroxy-4,6-dimethoxypyrimidin-2-yl)-N,N-dimethyl-3,5-dioxopiperazine-1-sulfonamide (compound 8) to reduce retinal damage in 2-week dark adapted Wistar rats exposed to 1000 lx of light for 3 hours. Assessment of the oxidative stress markers 4- hydroxynonenal and nitrotyrosine modified proteins and Thioredoxin by ELISA and Western blots indicated that these compounds reduced the oxidative insult caused by light exposure. The beneficial antioxidant effects of these compounds in providing significant functional and structural protection were confirmed by electroretinography and quantitative histology of the retina.The present study suggests that multi-functional compounds may be effective candidates for preventive therapy of AMD

Acupuncture for dry eye: a multicentre randomised controlled trial with active comparison intervention (artificial tear drop) using a mixed method approach protocol

<p>Abstract</p> <p>Background</p> <p>Previous studies of acupuncture show favourable results for both subjective and objective outcomes of dry eye. However, firm conclusions could not be drawn from these studies because the quality of the trials was too low to establish concrete evidence. Therefore, this study was designed both to avoid the flaws of the existing trials and to assess the effectiveness, cost-effectiveness and qualitative characteristics of acupuncture treatment for dry eye.</p> <p>Methods/design</p> <p>One hundred fifty participants with dry eye will be recruited into three independent hospitals from different areas: Korea Institute of Oriental Medicine, DongGuk University Ilsan Oriental Hospital and Dongshin University Gwangju Oriental Hospital. The number of participants required was calculated from the data of a previous, relevant study. These patients will be randomly allocated into acupuncture treatment or artificial tear groups. Either 17 acupuncture points (bilateral BL2, GB14, TE 23, Ex1, ST1, GB20, LI4, LI11 and single GV23) will be used 3 times a week or disposable artificial tear drops (Refresh Plus^®, ALLERGAN) will be provided for use at least once a day for 4 weeks. The ocular surface disease index (OSDI), tear film break-up time (TFBUT), Schirmer I test, visual analogue scale (VAS) for self-assessment of ocular discomfort, general assessment (by both acupuncture practitioners and participants) and quality of life (QOL) through the Measure Yourself Medical Outcome Profile-2 (MYMOP-2) will be assessed for approximately 3-months for each study participant. In addition, qualitative study and cost-effectiveness of acupuncture treatment will be conducted.</p> <p>Trial registration</p> <p>ClinicalTrials.gov (Identifier: NCT01105221).</p

Acupuncture for the Treatment of Dry Eye: A Multicenter Randomised Controlled Trial with Active Comparison Intervention (Artificial Teardrops)

To evaluate the effects of acupuncture compared to a control group using artificial tears.multicenter randomised controlled trial (three local research hospitals of South Korea).150 patients with moderate to severe dry eye.Participants were randomly allocated into four weeks of acupuncture treatment (bilateral BL2, GB14, TE 23, Ex1, ST1, GB20, LI4, LI11 and single GV23) or to the artificial tears group (sodium carboxymethylcellulose).The ocular surface disease index (OSDI), tear film break-up time (TFBUT), Schirmer Ι test, visual analogue scale (VAS) for self-assessment of ocular discomfort, general assessment (by both acupuncture practitioners and participants) and quality of life (QOL) through the Measure Yourself Medical Outcome Profile-2 (MYMOP-2).There was no statistically significant difference between two groups for the improvement of dry eye symptoms as measured by OSDI (MD -16.11, 95% CI [-20.91, -11.32] with acupuncture and -15.37, 95% CI [-19.57, -11.16] with artificial tears; P = 0.419), VAS (acupuncture: -23.84 [-29.59, -18.09]; artificial tears: -22.2 [-27.24, -17.16], P = 0.530) or quality of life (acupuncture: -1.32 [-1.65, -0.99]; artificial tears: -0.96 [-1.32, -0.6], P = 0.42) immediately after treatment. However, compared with artificial tears group, the OSDI (acupuncture: -16.15 [-21.38, -10.92]; artificial tears: -10.76 [-15.25, -6.27], P = 0.030) and VAS (acupuncture: -23.88 [-30.9, -16.86]; artificial tears: -14.71 [-20.86, -8.55], P = 0.018) were significantly improved in the acupuncture group at 8 weeks after the end of acupuncture treatment. TFBUT measurements increased significantly in the acupuncture group after treatment.Acupuncture may have benefits on the mid-term outcomes related to dry eye syndrome compared with artificial tears.ClinicalTrials.gov NCT01105221

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet&rsquo;s stripping endothelial keratoplasty

Bryan S Lee,1,2 David R Hardten21Department of Ophthalmology, University of Washington, Seattle, WA, 2Minnesota Eye Consultants, Minneapolis, MN, USABackground: Patients with endothelial disease also often have scarring or surface corneal disease. This study examined the outcomes of phototherapeutic keratectomy (PTK) performed in patients with prior Descemet&rsquo;s stripping endothelial keratoplasty (DSEK).Methods: This retrospective case series examined all patients undergoing PTK after DSEK in a single private practice. The primary outcome was best-corrected visual acuity, with secondary outcomes of change in spherical equivalent versus targeted change, change in endothelial cell count, improvement in corneal topography, and subjective satisfaction with vision.Results: For the ten patients who met the inclusion criteria, mean best-corrected visual acuity improved from logarithm of the minimum angle of resolution (logMAR) 0.43 to 0.36 (P=0.24) at the most recent postoperative visit. PTK treatments that included a refractive component showed good predictability of 1.13 diopters spherical equivalent/diopter attempted. There was no evidence of a decrease in endothelial cell count from PTK, even with the use of mitomycin C (P=0.95). Subjectively, 80% of patients noted improvement in their vision. Conclusion: PTK after DSEK has the potential to improve patients&rsquo; vision with high levels of patient satisfaction, even though many patients had significant ocular comorbidities. Surgeons should consider using PTK to treat anterior corneal pathology following DSEK.Keywords: phototherapeutic keratectomy, Descemet&rsquo;s stripping endothelial keratoplasty, anterior basement membrane dystrophy, irregular astigmatis

Toric intraocular lens orientation and residual refractive astigmatism: an analysis

Rick Potvin,1 Brent A Kramer,2 David R Hardten,3 John P Berdahl4 1Science in Vision, Akron, NY, 2University of Iowa Carver College of Medicine, Iowa City, IA, 3Minnesota Eye Consultants, Minnetonka, MN, 4Vance Thompson Vision, Sioux Falls, SD, USA Purpose: To analyze intraocular lens (IOL) orientation data from an online toric back-calculator (astigmatismfix.com) for determining if differences were apparent by lens type.Methods: A retrospective review of&nbsp;astigmatismfix.com&nbsp;toric back-calculations that included IOL identification and intended orientation axis.Results: Of 12,812 total validated calculation records, 8,229 included intended orientation and lens identification data. Of the latter, 5,674 calculations (69%) involved lenses oriented 5&deg; or more from their intended position. Using estimated toric lens usage data, the percentage of lenses with orientation &ge;5&deg; from intended was 0.89% overall, but the percentage varied significantly between specific toric lens brands (P&lt;0.05). The percentage of back-calculations related to lenses that were not oriented as intended was also statistically significantly different by lens brand (P&lt;0.05). When IOLs were misoriented, they were significantly more likely to be misoriented in a counterclockwise direction (P&lt;0.05). This was found to be due to a bias toward counterclockwise orientation observed with one specific brand, a bias that was not observed with the other three brands analyzed here.Conclusion: The percentage of eyes with lens orientation &ge;5&deg; from intended in the Toric Results Analyzer data set was &lt;1% of toric IOLs in general, with the relative percentage of Tecnis&reg; Toric IOLs significantly higher than AcrySof&reg; Toric IOLs. Both of these had higher rates than the Staar&reg; Toric and Trulign&reg; Toric lenses, with the availability of higher Tecnis and AcrySof cylinder powers a likely contributing factor. The AcrySof Toric IOL appears to be less likely than the Tecnis Toric IOL to cause residual astigmatism as a result of misorientation. The Tecnis Toric IOL appears more likely to be misoriented in a counterclockwise direction; no such bias was observed with the AcrySof Toric, the Trulign&reg; Toric, or the Staar Toric IOLs. Keywords: rotation, AcrySof, Tecnis, toric back-calculator, cylinde