Longitudinal Stability of Optical Coherence Tomography Measures of Peripapillary Retinal Nerve Fiber Layer Thickness, Macular Thickness, and Macular Volume in Control and Glaucomatous Eyes of Children

Background/Aims: To document baseline and longitudinal values for peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness, and macular volume as measured by optical coherence tomography(OCT) in glaucomatous and control eyes of children, followed prospectively for a mean of 2.4 years (range 0.5-5.3 years). Methods: OCT measurements (Fast RNFL 3.4 Thickness, Fast RNFL Map, and Fast Macular Thickness Map protocols; StratusOCT, Carl-Zeiss-Meditech, Dublin,CA) were obtained at baseline and on follow-up in 27 control and 19 glaucoma participants at the Duke University Eye Center Pediatric Clinic. Longitudinal changes were compared between groups with a two-sample-t-test and multiple linear regression analysis of covariance model adjusting for age, race, and baseline refractive error. Results: Eyes with glaucoma exhibited reduced baseline macular thickness, macular volume, and RNFL thickness, and increased myopia, compared to control eyes (eg. macular volume 6.54 vs. 7.03 mm3, p=0.006; RNFL 3.4 thickness 87.8 vs. 110.6μm, p=0.02). All OCT parameters studied showed minimal change over time, and rates of change were similar between groups. Conclusion: Baseline differences and longitudinal stability of OCT parameters were seen in normal and clinically stable glaucomatous eyes of children. These findings support continued study of OCT as an easily performed clinical adjunct in evaluation and management of children with glaucoma.Master of Public Healt

Peripheral myopization using a dominant design multifocal contact lens

Purpose: The purpose of this study was to characterize the central and peripheral refraction across the horizontal meridian of the visual fi eld without and with a multifocal dominant design soft contact lens of different add powers (+1.00 D to +4.00 D) in emmetropic eyes. Methods: Twenty right eyes from 20 emmetropic patients (mean spherical equivalent central refraction —0.06 ± 0.54 D) with a mean age of 21.6 ± 2.3 years were fi tted with Proclear Multifocal dominant design (Coopervision, Pleasanton, CA, USA). Lenses had add powers from +1.00 to +4.00 D in 1.00 D steps. The central and peripheral refraction was measured along the horizontal meridian up to 35º of eccentricity in the nasal and temporal retinal area in 5º steps using a open-fi eld autorefractometer. Results: Only the +3.00 and +4.00 D add powers generated a signifi cant change in the peripheral refractive pattern compared to central refraction and compared with the no-lens wearing situation. The average myopic increase with these lenses was —3.00 D and —5.00 (p < 0.001) at the margins of inspected nasal and temporal visual fi eld, respectively. Conclusions: Multifocal dominant design soft contact lenses are able to change the peripheral refractive profi le in emmetropic eyes increasing relative peripheral myopia. Lenses with +3.00 D add power seem to be the best option to create such effect due to signifi cant peripheral myopization.Objetivo: El objetivo de este estudio fue caracterizar la refracción central y periférica a través del meridiano horizontal del campo visual con y sin lente de contacto blanda multifocal de diseño dominante de diferentes adiciones (+1,00 D a +4,00 D) en ojos emétropes. Métodos: Se colocaron lentes multifocales de diseño dominante Proclear (Coopervision, Pleasanton, Estados Unidos) en 20 ojos derechos de 20 pacientes emétropes (media del equivalente esférico de refracción central, —0,06 ± 0,54 D) con una media de edad de 21,6 ± 2,3 años. Las lentes tenían adiciones desde +1,00 hasta +4,00 D en pasos de 1,00 D. Se evaluó la refracción periférica a través del meridiano horizontal hasta 35º de excentricidad en el campo retiniano nasal y temporal en pasos de 5º utilizando un autorrefractómetro de campo abierto. Resultados: Solamente las potencias de +3,00 y +4,00 D produjeron un cambio signifi cativo en el patrón de refracción periférica en comparación con la refracción central y en comparación con la evaluación sin lente. El aumento medio de la miopía con estas lentes fue de —3,00 D y —5,00 (p < 0,001) en los límites de los campos visuales nasal y temporal explorados, respectivamente. Conclusiones: Las lentes de contacto blandas, multifocales y de diseño dominante tienen la capacidad de cambiar el perfi l de refracción periférica en ojos emétropes incrementando la miopía relativa periférica. Aparentemente, las lentes con potencia de +3,00 D serían la mejor opción para generar ese efecto debido a la miopización periférica significativaMRIS -Ministry of Research, Innovation and Science(SAF2008-01114-E

PAX6 Haplotypes Are Associated with High Myopia in Han Chinese

Author name used in this publication: Maurice K. H. Yap2010-2011 > Academic research: refereed > Publication in refereed journalpublished_fina

Drug discovery in ophthalmology: past success, present challenges, and future opportunities

BACKGROUND: Drug discovery has undergone major transformations in the last century, progressing from the recognition and refinement of natural products with therapeutic benefit, to the systematic screening of molecular libraries on whole organisms or cell lines and more recently to a more target-based approach driven by greater knowledge of the physiological and pathological pathways involved. Despite this evolution increasing challenges within the drug discovery industry are causing escalating rates of failure of development pipelines. DISCUSSION: We review the challenges facing the drug discovery industry, and discuss what attempts are being made to increase the productivity of drug development, including a refocusing on the study of the basic biology of the disease, and an embracing of the concept of ‘translational research’. We consider what ophthalmic drug discovery can learn from the sector in general and discuss strategies to overcome the present limitations. This includes advances in the understanding of the pathogenesis of disease; improvements in animal models of human disease; improvements in ophthalmic drug delivery and attempts at patient stratification within clinical trials. SUMMARY: As we look to the future, we argue that investment in ophthalmic drug development must continue to cover the whole translational spectrum (from ‘bench to bedside and back again’) with recognition that both biological discovery and clinical understanding will drive drug discovery, providing safe and effective therapies for ocular disease

The genetics of myopia

Myopia is the most common eye condition worldwide and its prevalence is increasing. While changes in environment, such as time spent outdoors, have driven myopia rates, within populations myopia is highly heritable. Genes are estimated to explain up to 80% of the variance in refractive error. Initial attempts to identify myopia genes relied on family studies using linkage analysis or candidate gene approaches with limited progress. More genome-wide association study (GWAS) approaches have taken over, ultimately resulting in the identification of hundreds of genes for refractive error and myopia, providing new insights into its molecular machinery. These studies showed myopia is a complex trait, with many genetic variants of small effect influencing retinal signaling, eye growth and the normal process of emmetropization. The genetic architecture and its molecular mechanisms are still to be clarified and while genetic risk score prediction models are improving, this knowledge must be expanded to have impact on clinical practice