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Volume
1, Number 3 |
November
2005
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Inside
This Issue
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PRESIDENT'S
MESSAGE
This is the third edition
of the Optometric Retina Society Electronic Newsletter. We hope that
you have found the previous two editions helpful and informative. If
it is your first perusal, welcome to the world of vitreoretinal disorders.
Always feel free to make any comments on the contents and how we can
make it better.
We encourage you to attend the next meeting at the Radisson Hotel in
downtown Boston's theater district. I just visited the hotel last week
and it is a fine hotel in a great area of Boston with many theaters
and fine restaurants. I'm excited about the next ORS meeting and I'm
looking forward to seeing you there.
Sincerely,
William L. Jones, O.D.
President
FROM
THE DESK OF THE EDITOR
This December the American Academy of Optometry
meeting will be held in San Diego, CA. For those of you who have never
attended an Academy meeting, the education is top-notch, with some of
the biggest names in optometry lecturing. Among the members of the ORS
that will be lecturing are myself, Andy Gurwood, Maynard Pohl, Joe Sowka,
Leo Semes, Rex Ballinger, Mark Dunbar, Diana Shechtman, Bill Jones, and
Jerry Sherman. The lectures encompass a wide array of ocular disease,
with an emphasis on the retina. Also, if you have any questions regarding
the ORS or would like more information about joining the ORS, please make
sure you stop and ask one of us. Look forward to seeing you in San Diego!!
Speaking of top notch continuing education, don’t forget to attend
the ORS Annual Meeting, March 24-26, 2006, in Boston!
Steven Ferrucci, O.D., F.A.A.O.
Editor in Chief
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IMPORTANT:
DATE CHANGE
The date of the Third Annual ORS Conference has been changed to
March 24-26, 2006, in Historic Boston MA. The theme of this program
will remain Retinal Manifestations of Vascular and Related Systemic
Disease, and will focus on vascular diseases, such as diabetes,
and how they affect the retina.
Stay tuned for more information!!
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YOU
MAKE THE DIAGNOSIS
Answer appears later in newsletter.
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CLINICAL
PEARLS
Management
of Acute Posterior Vitreous Detachments
By Joseph Sowka, O.D., F.A.A.O.
Patients with acute posterior vitreous detachment (PVD) with a small
amount of pre-retinal or vitreous hemorrhage without an observable
retinal break need a detailed peripheral exam using scleral indentation
as well as 3-mirror and/or non-contact fundus lens biomicroscopy.
If no retinal break is detected, the patient needs repeat evaluation
every two weeks for six weeks to look for an occult break not found
upon the initial exam. If no retinal break is detected after six
weeks, by exclusion the blood can likely be attributed to torn retinal
or disc capillaries, with the patient considered to be removed from
immediate danger. However, if this complication exceeds your comfort
level, it never hurts to get a second opinion.
Only patients experiencing PVD associated with multiple floaters,
a curtain or cloud, hemorrhages (retinal or vitreous), or Shafer’s
sign at the initial examination should be scheduled for re-examination.
All other patients should be instructed to return only if the number
of floaters increases or vision decreases.
Diagnosing
Retinitis Pigmentosa
By Diana Shechtman, O.D., F.A.A.O.
Retinitis pigmentosa is the most common inherited retinal disease.
While the typical triad includes perivascular bone spicules, attenuation
of retinal vessels, and waxy pallor of the optic nerve, these ocular
manifestations may not be present early in the disease (or in some
atypical cases they may not be present at all). Early diagnosis
of the disease may help with early intervention. In order to help
with early diagnosis, understanding ocular pathophysiology is imperative.
RP develops as a progressive degeneration of the photoreceptors,
initially manifesting in the mid-periphery. Patients typically complain
of visual field loss and night blindness in the early stages of
the disease. In addition RPE atrophy may be a subtle and early sign
seen in most patients with RP. This manifestation is typically described
as a "grainy change in texture." When in doubt the ERG
will help confirm the diagnosis.
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JOURNAL
ABSTRACTS
Phillip J. Rosenfeld, MD, PhD, Andrew
A. Moshfeghi, MD, Carmen A. Puliafito, MD, MBA. Case Report: Optical Coherence
Tomography Findings after Intravitreal Injection of Bevacizumab (Avastin)
for Neovascular Age-Related Macular Degeneration. Ophthalmic Surgery:
Lasers & Imaging, July/August 2005;v36 n4:331-335.
Reviewed by Paul Collins, O.D., Optometric Resident, Bascom Palmer
Eye Institute
VEGF has been implicated and studied as the major angiogenic stimulus
responsible for neovascularization. Pegaptanib Sodium (Macugen) was the
first anti-VEGF medication approved by the FDA for the treatment of CNVM.
Ranibizumab is another inhibitor of VEGF, and it is derived from a larger
molecule Bevacizumab (Avastin). Avastin was originally designed as an
anti-angiogenic drug for oncology. This case report describes a patient
who received a single intravitreal injection of Avastin as a treatment
after having experienced disease progression following PDT (photodynamic
therapy) with intravitreal triamcinolone acetonide and pegaptanib therapies.
Within one week after being injected with Avastin, OCT (Optical Coherence
Tomography) revealed resolution of the subretinal fluid. Before the injection,
central foveal thickness (normal thickness between 190-210 microns) measured
582 microns, 1 week post-injection macular thickness measured 180 microns,
and week 4 post-injection was 193 microns. ETDRS Visual acuity measured
Snellen equivalent of 20/125 pre-injection, and 20/125 at the 4 week post-injection
visit (no acuity loss) with the patient reporting that the visual distortion
in her eye had resolved. Her examination at that visit revealed no ocular
inflammation and OCT revealed complete resolution of subretinal fluid
while Fluoresein Angiography showed no evidence or signs of angiographic
leakage. This treatment modality shows promise for the future treatment
of wet-ARMD patients and shows considerable cost savings as one injection
of a 1mg intravitreal dose is a modest $5.50 compared to the FDA approved
treatment dose of 5mg/kg intravenous Avastin with prices hovering around
$2,200 for an average sized 70-80 kg patient.
Thompson, John T, Epiretinal membrane removal in eyes with good visual
acuities. Retina Vol.25(7), October/November 2005;875-882.
Reviewed by James Fabian, O.D., Optometric Resident, Bascom Palmer
Eye Institute
Vitrectomy has become a common procedure for the treatment of visual loss
due to epiretinal membranes. This retrospective study evaluates the results
and complications of vitrectomy preformed by a single surgeon for ERM
in 40 eyes with visual acuity of 20/50 or better.
The mean preoperative visual acuity was 20/50 + 2. The mean visual acuity
improved to 20/40 + 2 at a mean of 2.4 years following surgery. Twenty-one
eyes were phakic preoperatively and 14 of these eyes had cataract surgery
by final examination. The 7 eyes which were phakic at the final examination
had a decrease in VA from 20/50 to 20/50 -2. Of the phakic eyes 29% lost
2 or more lines and only 14% gained 2 or more lines. Lens changes correlate
with the visual results of surgery. The 33 eyes which were pseudophakic
by the final examination had VA increase from 20/50 + 2 to 20/32 -2. Vitrectomy
for epiretinal membranes is safe in eyes with relatively good preoperative
visual acuities but cataract surgery is necessary in phakic eyes to achieve
long-term visual acuity improvement. There were no serious complications
only one eye developed recurrent ERM. This study suggests that the threshold
for ERM surgery may be reevaluated.
Patelli, Fabio, et al., Time course with and without previous macular
laser treatment. Retina Vol.25(7), October/November 2005;840-845.
Reviewed by James Fabian, O.D., Optometric Resident, Bascom Palmer
Eye Institute
The use of intravitreal triamcinolone acetonide (IVTA) treatment of macular
edema is increasing. This study evaluated the temporal characteristics
of the changes in retinal thickness and VA after IVTA for diffuse DME.
A total of 23 eyes with clinically significant DME received intravitreal
injection of triamcinolone acetonide, VA and changes in macular thickening
shown by OCT were evaluated 48 hours after injection, every 7 days for
1 month, then 3 and 6 mo. 12 eyes had previous macular laser and 11 eyes
IVTA as primary therapy. The results of the study showed IVTA was effective
in reducing clinically significant DME and improving visual acuity in
90% of the eyes with and without previous laser treatment. Its action
was maximal in the 7 days and gradually decreased in the 3 months after
IVTA injection. There was clear evidence of recurrent edema at 6 months
in most eyes. The effect of IVTA on retinal thickness and VA was similar
and significant in both previously laser treated and primary Triamcinilone
injected eyes. This information will be helpful in developing injection
strategies and will permit comparison with other therapies.
The VEGF inhibition study in ocular neovascularization (V.I.S.I.O.N.)
Clinical Trial Group. Enhanced efficacy associated with early treatment
of neovascular ARMD with Pegaptanib Sodium: An Exploratory Analysis
Vol.25(7), October/November 2005;815-827.
Reviewed by James Fabian, O.D., Optometric Resident, Bascom Palmer
Eye Institute
The V.I.S.I.O.N. study demonstrated that treatment with pegaptanib was
associated with an early and sustained treatment. On the basis of these
results, the U.S. FDA approved pegaptanib sodium for the treatment of
neovascular AMD.
This exploratory study consisted of retrospective analyses of selected
subgroups of patients enrolled in the V.I.S.I.O.N. study; for the purpose
of hypothesis generation. (These results must be interpreted with caution)
The hypothesis being studied is if early treatment is beneficial. The
54 week results were Pegaptanib responder rates (loss of <15 letters
of visual acuity) were 76% and 80% in treatment Groups versus 50% and
57% for usual care Groups. Subjects assigned to usual care (which included
PDT) were almost 10 times more likely to have severe vision loss than
were those treated with pegaptanib. Although there is no universally accepted
definition of early disease, internal consistency was demonstrated across
the two definitions of early disease and the results presented suggest
benefits of early detection and treatment.
Arun D. Singh, MD, Partho Kalyani, BS, Allan
Topham, BA. Estimating the risk of malignant transformation of a choroidal
nevus. Ophthalmology October 2005;v112:1784-1789.
Reviewed by Paul Collins, O.D., Optometric Resident, Bascom Palmer
Eye Institute
This study performed by the Cole Eye Institute in Cleveland, gives us
insight as to the incidence, prevalence, and rates of transformation of
a small choroidal nevus to a choroidal melanoma. According to the COMS
study (Collaborative Ocular Melanoma Study) a melanocytic choroidal lesion
that is less than or equal to 5mm in the largest basal diameter and less
than or equal to l mm in height is considered a choroidal nevus. Studies
place the prevalence of these lesions to between 4.6% and 7.9%
with incidence of approximately 3.6 per 1,000,000. The number of individuals
with choroidal melanoma in the corresponding age and race-matched US (Caucasian)
population ranged from 989 to 1008 affected per year. This places the
annual rate of malignant transformation of a choroidal nevus at 1 in 8845.
The annual rate of transformation for each 5 year age group of the US
white population, was 1 in 269,565 for the youngest age group (15-19 years)
and highest (1 in 3664) for the older age group (80-84 years) showing
greater transformation with increasing age. This estimated risk reported
in this study applies only to small choroidal melanocytic lesions, and
the study expects that the risk is higher for so-called suspicious and/or
atypical nevi.
Kuppermann BD, Thomas EL, De Smet MD, Grilone LR, The vitrase for vitreous
hemorrhage study groups. Pooled efficacy results from two multinational
randomized controlled clinical trials of a single intravitreous injection
of highly purified ovine hyaluronidase (vitrase) for the management of
vitreous hemorrhage. Am J Ophthalmol 2005;140:573-584.
Reviewed by Shao (Jeff) Huang O.D., Optometric Resident, Bascom Palmer
Eye Institute
1,125 patients with persistent vitreous hemorrhage were recruited in two
prospective, multinational studies to determine if a single intravitreous
injection of ovine hyaluronidase (Vitrsae) would clear the vitreous hemorrhage
more rapidly. Three hundred and thirty, 355, and 361 patients were randomized
to receive varying doses of intravitreal (Vitrsae) versus saline. At entry
to the study, the mean duration of vitreous hemorrhage was 120.4 days.
Primary efficacy endpoint was the clearance of hemorrhage sufficient to
see the underlying pathology and completion of treatment when indicated.
Secondary endpoints were greater than or equal to 3-line improvement in
BCVA; hemorrhage density reduction; and therapeutic utility assessment
(clearance of VH sufficient to diagnose the underlying pathology, and
plan treatment, if necessary.) At baseline, 858 (76.3%) patients had
diabetes and 1180 (90.4%) were not able to read any letters on the
eye chart.
Current treatments for VH are limited to observation or vitrectomy. This
study showed that intravitreal injection of 55 IU Vitrase can help clear
VH earlier compared to saline injection. Treatment effect was greatest
at 1-month due to clearance of drug from the vitreous. Earlier clearance
of VH allows earlier diagnosis of the underlying pathology, as well as
limiting the potential for complications from prolonged VH.
Jonas et al. Predictive Factors for Visual Acuity After Intravitreal
Triamcinolone Treatment for Diabetic Macular Edema. Arch Ophthalmol
2005;123:1338-1343.
Reviewed by Noemi Zubizarreta, O.D., Optometric Resident, Bascom Palmer
Eye Institute
The purpose of this study was to determine which factors most influence
best corrected visual acuity (BCVA) after treatment with intravitreal
triamcinolone acetonide (IVTA) for diabetic macular edema (DME). A total
of 53 eyes with DME were treated with 20 mg of IVTA during this prospective
clinical intervention study. After 6 months, 57% of the eyes showed
an improvement in BCVA and 25% of the eyes showed a decline in BCVA.
It was found that baseline (pre-injection) visual acuity and the degree
of macular ischemia, as determined by fundus fluorescein angiography,
were negatively correlated with the resultant BCVA. This suggests that
BCVA after IVTA for DME is limited by the degree of ischemia of the underlying
macula. On the other hand, the degree of macular edema prior to the injection
was positively correlated with the resultant BCVA. This observation may
reflect the ability of IVTA to almost entirely resolve macula edema and
restore normal macular and foveal contour in the months following injection.
However, side effects, including post-injection increase in IOP and cataract
formation, need to be considered when selecting patients for this treatment.
More studies are needed to determine the dosage that will give maximum
result with minimal side effects, as well as to determine IVTA’s
duration of action.
Kim SH, Choi MY, Yu YS, Huh JW. Peripapillary Staphyloma: Clinical
Features and Visual Outcome in 19 Cases. Arch Ophthalmol 2005;123:1371-1376.
Reviewed by Noemi Zubizarreta, O.D., Optometric Resident, Bascom Palmer
Eye Institute
Peripapillary staphylomas are rare, congenital anomalies of the optic
disc with no known pattern of inheritance. It presents as an area of excavation
of the fundus surrounding a normal appearing optic disc. Most cases are
unilateral, although some bilateral cases have been reported. This study
investigated the visual outcome of 21 eyes with peripapillary staphylomas.
Nineteen patients were studied; 2 of them had bilateral staphylomas. For
those patients with unilateral staphylomas, patching therapy was recommended
in an attempt to treat the concomitant amblyopia. Part-time occlusion
was recommended to avoid reverse amblyopia. A total of 13 patients complied
with the occlusion regimen during a mean duration of 30 months. At the
conclusion of the study, only 2 eyes had visual acuities better than 20/200.
Seven eyes had myopia greater than 6 diopters. Only 1 of the patients
having undergone occlusion therapy achieved improvement in visual acuity.
Three of the eyes studied had total retinal detachments, one of which
left the eye with no light perception. In summary, the visual prognosis
of eyes with a peripapillary staphyloma is generally poor. Furthermore,
the study was the first to report a case of total retinal detachment in
an eye with peripapillary staphyloma. It also showed the need to further
investigate the role of occlusion therapy in these patients in order to
treat their concomitant amblyopia.
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ANSWER
TO "YOU MAKE THE DIAGNOSIS"
This lesion represents a paramacular coloboma. A paramacular coloboma
is an atypical coloboma that is thought to arise from incomplete
closure of the horizontal raphe during development. It produces
a characteristic shape, often described as football shaped, fish-like,
or torpedo shaped. Pigmentation within the lesion may vary from
mild to varying degrees of pigment epithelial clumping. They typically
present unilaterally but can be seen bilaterally in rare instances.
Typically patients are asymptomatic, with the lesion found during
routine exam. Visual acuity is unaffected, but a visual field
defect or absolute scotoma corresponding to the size of the lesion
may be noted by a very astute observer.
The risk of sub retinal neovascular membrane formation is very
rare, as Bruch’s membrane remains intact with a paramacular
coloboma. Therefore, these patients can be followed routinely,
with yearly exams and dilations. It is important, however, to
rule out more serious etiologies with similar appearance, such
as presumed ocular histoplasmosis, age-related macular degeneration,
choroidal nevi or melanoma, and drug toxicity as seen with hydroxychloroquine,
for example. This can be done with the aid of careful history,
serial photos, and fluorescein angiography and/or ocular coherence
topography for highly suspicious lesions.
Steven Ferrucci, O.D., F.A.A.O.
ORS Fellow
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IN THE
NEWS
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Central retinal thickness
was reduced in patients with age-related macular degeneration
as early as 1 day after treatment with Lucentis (ranibizumab,
Genentech), a VEGF-inhibiting drug, according to study results
reported at the American Society of Retina Specialists conference
in Montreal. Vision also improved in the patients by day 14, with
the first 30 patients in the study showed an average gain of 5.5
letters by day 14. Similar results were found in all CNV lesion
subtypes, according to the study.
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Almost one-third
of patients treated with Lucentis (ranibizumab, Genentech) for
age-related macular degeneration in a clinical trial gained 15
letters from baseline visual acuity at the one year follow-up
mark, said Joan W. Miller, MD, speaking at the American Society
of Retina Specialists meeting in Montreal. These results were
the first released from the MARINA Study, a phase 3, multicenter,
randomized, double-masked, sham-injection-controlled study in
subjects with subfoveal neovascular AMD.
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A drug in development
for treatment of diabetic retinopathy reduced the occurrence of
vision loss in a clinical trial, according to drug maker Eli Lilly
and Co. The drug, ruboxistaurin mesylate, a specific protein kinase
C beta inhibitor, will be submitted to the Food and Drug Administration
for premarket approval by the end of the year, according to a
press release from the company. The Lilly statement said phase
3 trial data indicate that ruboxistaurin -- tentatively to be
brand-named Arxxant -- reduced the occurrence of vision loss in
patients with diabetic retinopathy in the phase 3 trial.
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A higher dose of
intravitreal triamcinolone had a longer treatment effect and a
stronger effect on visual acuity improvement than two lower doses,
according to a study published in the August issue of the British
Journal of Ophthalmology.
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OSI Pharmaceuticals
plans to purchase Eyetech Pharmaceuticals for $935 million in
cash and stock, according to a press release from the two companies.
With the acquisition, OSI will focus on three therapeutic areas:
oncology, ophthalmology and diabetes. OSI plans to continue co-marketing
Macugen (pegaptanib sodium), for the treatment of age-related
macular degeneration, with Pfizer, the press release said. Under
the merger agreement, OSI will acquire all outstanding shares
of Eyetech for $20 a share, a 43% premium over Eyetech’s
closing market price last week, the press release said.
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Patients with chronic
diabetic macular edema who were unresponsive to conventional laser
treatment experienced short-term visual acuity improvement after
intravitreal injections of triamcinolone, a group of British researchers
reported in the July issue of Eye.
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A new implant that
gradually releases dexamethasone, named the Posurdex implant manufactured
by Allergan, into the vitreous cavity is demonstrating safety
and efficacy in the treatment of macular edema in a recent phase
2 study, according to the company.
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A combination of
photodynamic therapy with intravitreal triamcinolone is showing
efficacy in the management of all subtypes of age-related macular
degeneration, according to a clinician speaking at the Ocular
Surgery News Symposium in New York. The combination, dubbed
"PDT-plus", consists of photodynamic therapy using Visudyne
(verteporfin for injection, Novartis/QLT) followed immediately
by an intravitreal injection of 4 mg of Kenalog (triamcinolone
acetate, Bristol-Myers Squibb).
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Ista Pharmaceuticals
announced that the results of two phase 3 trials evaluating its
product Vitrase (ovine hyaluronidase) for the treatment of vitreous
hemorrhage have been published in the American Journal of Ophthalmology.
According to Ista, in the pooled data from the two phase 3 trials,
the drug demonstrated a statistically significant reduction in
vitreous hemorrhage at 1 month after a single intravitreous injection,
compared to a single injection of saline.
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A combination of
two treatments for age-related macular degeneration demonstrated
safety when administered concomitantly, according to results of
an exploratory clinical trial. A phase 2 trial of Evizon (squalamine
lactate, Genaera) plus photodynamic therapy with Visudyne (verteporfin
for injection, QLT/Novartis) met its primary end point of demonstrating
safety when the two treatments are administered concomitantly,
according to a press release from Genaera. No serious drug-related
adverse events have been reported in the trial to date, the press
release said.
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With the NEI’s
Age-Related Eye Disease Study now complete, a proposed AREDS 2
is scheduled to begin in 2006. The objective of the study will
be to evaluate treatment outcomes using lutein, zeaxanthin and
omega-3 fatty acids, as well as a combination of the treatments.
The design of the AREDS 2 will be similar to the original AREDS,
with 25% of patients taking placebo, 25% taking a supplement
containing lutein and zeaxanthin, 25% taking a supplement
containing omega-3 fatty acids and 25% taking a combination
of the two, according to the NEI.
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MEET
THE FELLOWS
In each issue, a Fellow
of the Optometric Retinal Society will be highlighted. In this issue,
Dr. Jerome Sherman, Vice President and one of the Founding Fellows
of the Optometric Retinal Society will be highlighted.
A graduate of Pennsylvania College of Optometry, Dr. Sherman currently
holds the position of Distinguished Teaching Professor at the State
University of New York and the Schnurmacher Institute of Vision Research
at SUNY. He is currently in Private Practice at the Eye Institute &
Laser Center in New York City.
Perhaps one of optometry’s most prolific writers, Dr. Sherman has
published over 625 clinical articles, research manuscripts, book chapters
and two CD’s. He has also delivered over 3000 lectures both nationally
and internationally during his career. Further, he is a founding member
of the Optometric Retinal Society as well as the International Foundation
for Optic Nerve Disease. Currently he serves as Vice President of the
Optometric Retinal Society.
Dr. Sherman resides in Bedford, NY with his wife and two sons, one of
whom attends the University of Michigan.
WHY
BECOME AN ORS MEMBER?
By Rex Ballinger, O.D., F.A.A.O.
Chair, Membership Committee
Membership in the Society can provide several benefits; 1.) You
may receive discounts at annual meetings. 2.) You’ll receive
regular newsletters on new and exciting updates on retinal disease
diagnosis and management as well as other newsy items of interest.
3.) You’ll be associated with a body of knowledge and resources
which can help you in many other ways. So consider membership
in the Society. It will be worth your while in your quest for
better understanding of the retina.
If your interests extend beyond the general, if you want to become
part of the dynamic team involved in the Society to share your
interest and enthusiasm with your colleagues consider becoming
a Fellow member. Details and applications can be found at www.optometricretinasociety.org
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SPONSOR
NEWS
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plus the added benefit of lutein and zeaxanthin, the primary carotenoids
found in the retina and lens of the eye.
ICaps
AREDS Eye Vitamin and Mineral Supplement formula matches the combination
of vitamins and minerals established by the AREDS trial as effective
in delaying the progression of AMD.
For more information, go to www.icapsvitamins.com
 OFFICEMATE
- Retinal Examination and Documentation
Retinal examination and documentation couldn’t be easier and more
complete using ExamWRITER electronic health record. Finally, retinal
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Meditec HFA II i are both captured, stored and reviewed from within
the electronic patient chart via ExamWRITER’s seamless instrument
interface.
Designed exclusively as an eyecare medical program by eyecare professionals,
ExamWRITER integrates with OfficeMate software and enables doctors and
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by utilizing standardized controls and customizable templates that follow
the SOAP protocol.
ExamWRITER electronic health records brings a new level of efficiency
and accuracy into your practice by giving you the ability to create,
edit, store, and access complete and comprehensive patient exam records.
For additional information contact us at 800.269.3666 or visit our website
at www.officemate.net.
 OPTOS
- Multi-Center Study Concludes Optomap and BIO When Used in Tandem Provides
Improved Detection of Retinal Disorders
The results of an Optos sponsored study conducted at the University
of Houston, UC, Berkeley and Pennsylvania College of Optometry were
presented at the 2005 Association for Research in Vision and Ophthalmology
meeting (ARVO).
Both Standard (subject looking straight ahead) and Steered (subject
looking 15 degrees eccentrically at 12, 3, 6 and 9 o’clock positions)
Optomap Retinal Exams compare favorably with the BIO in detecting clinically
important abnormalities posterior to the equator. Both Optomap Standard
and BIO examination of the entire retina failed to detect a small but
significant percentage of findings compared to the referee gold standard
(when discrepancies between exams were noted, a referee examiner, performed
BIO and re-evaluated the Optomap Images). Given that the types of findings
missed were different between techniques, it is suggested that the combination
of Optomap with BIO provides improved detection of retinal abnormalities.
For more information, go to www.optos.com.
 VOLK’s
New Digital Wide Field Lens Balances Magnification and Field of View
When choosing a lens, doctors traditionally have had to choose between
wide field of view or high magnification. The Digital Wide Field lens
offers the widest field of view available in a non-contact lens, combined
with excellent small pupil capability and a .72x magnification--similar
to Volk’s popular 90D lens. The unique digital lens design and
coating reduce glare and reflections while maintaining high-resolution
images for improved retinal diagnosis and slit lamp photography. Like
most Volk lenses, the Digital Wide Field is constructed with patented
double-aspheric glass optics, resulting in an undistorted image across
the entire lens surface.
For more information, go to www.volk.com.
 ZEISS
- A Breakthrough in Early Detection of Wet AMD
The PreView PHP is a new perimeter used to detect recent-onset neovascular
(“wet”) AMD, and differentiate it from the intermediate (“dry”)
stage of the disease, often before signs or symptoms are noticed by
the patient or the doctor. Validated in multi-center clinical studies,
this new technology will allow earlier detection of the advanced, blinding
form of AMD, allowing treatment before the patient has suffered irreversible
vision loss.
For more information, go to www.meditec.zeiss.com.
|
Editor
in Chief
Steven Ferrucci, OD, FAAO
Co-Editor
Mark T. Dunbar, OD, FAAO
|
Journal
Reviewers
Paul Collins, OD
James Fabian, OD
Jeffrey S. Huang, OD
Noemi Zubizarreta, OD
Art/Production Director
Joe Morris
Project Coordinator
Janice Miller
|
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