An Australian research team led by Flinders University researchers has discovered two new genes that could open the way to new treatments for blinding glaucoma.
jamie-craig-and-kathryn-burdon-020511
Their findings are published online this week in the prestigious international science journal, Nature Genetics.
The study established that 18 per cent of the population carry risk variants at these two genes, making them up to three times more likely to develop severe glaucoma than those that don’t.
Other unknown factors also influence the overall risk for an individual.
The team, headed by Associate Professor Jamie Craig and Research Fellow Dr Kathryn Burdon (pictured) from the Department of Ophthalmology at Flinders University, involved groups from five other Australian universities on the ground-breaking survey of 4500 patients from every state in Australia and New Zealand.
“Although open angle glaucoma is the most common form of the disease, it is poorly understood and difficult to diagnose in its early stages,” Associate Professor Craig said.
“Many cases still remain undiagnosed until irreversible loss of vision has occurred,” he said.
“Our discovery will help replace routine monitoring and hit-and-miss treatment for glaucoma, by identifying patients at the highest risk of going blind. It opens the pathway to developing completely new ways of treating patients that could delay disease progression and prevent blindness.”
Glaucoma is the collective name for eye diseases causing irreversible loss of peripheral vision, often associated with too much pressure developing inside the eyeball. It is the leading cause of irreversible blindness worldwide, affecting an estimated 300,000 people in Australia, of which half are currently undiagnosed.
“This study is the culmination of five years’ work. Before anyone else in the world, our South Australian team achieved these outstanding results,” Associate Professor Craig said.
Dr Burdon said that as part of its ongoing research, the team will examine how these genes relate to other biological measures that are relevant to glaucoma.
“By combining genetics with a better understanding of factors such as the pressure in the eye and how the optic nerve looks, we may be able to develop earlier diagnostics for glaucoma,” Dr Burdon said.
Thursday, May 26, 2011
Dedicated ophthalmic surgeon with a lifelong interest in all things artistic
DENIS WILSON: DENIS WILSON, who has died aged 89, was an ophthalmic surgeon who practised in Cork for more than four decades and was the father of Fiona Shaw, one of the leading classical actors of our time.
A highly cultured and courteous man of the old Cork school, Dr Wilson (FRC Ophthal) shared with his wife Mary a lifelong interest in the arts, music and theatre. Their home at Montenotte, overlooking the city, was a venue for private poetry readings, operatic evenings and musical recitals, pursuits that were to have a significant bearing on Fiona’s decision to embark on a career on the stage.
However, while totally supportive of her decision to take up acting, he was also acutely aware of the uncertainties of life in the theatre and insisted she first do a degree at UCC, thereby ensuring she had an academic background before going on to study at Rada.
Though quietly reserved at those Montenotte soirees, he was a fine raconteur with a hearty laugh and a fund of entertaining stories about his boyhood days in Cobh. Educated at the local Presentation College he went on to study medicine at UCC. He played rugby for UCC and for the Combined Universities, and was capped for Munster. He subsequently worked for a short time as a GP in London and later back in Cobh before qualifying as an ophthalmologist at the Manchester Royal Eye Infirmary in 1960.
Returning to Cork, he was appointed to the Eye Ear and Throat Hospital as a consultant, and worked there until his retirement at 65, which coincided with the transfer of the unit to Cork University Hospital.
Constantly keeping abreast with developments in eye surgery, he was awarded an honorary fellowship in ophthalmology by his peers in London. He also taught at UCC and at the Royal College of Surgeons in Dublin.
As a doctor he had a way of putting patients at their ease and built up a substantial practice in Cork down the years. In retirement, he continued working as a consultant at CUH and also had a busy private consultancy practice for many years.
After retiring he wrote De Iron Trote, an excellent history of the old Cork Eye, Ear and Throat Hospital on the Western Road. Turning his interest in the arts to good effect, he also studied for a Diploma in Art History at UCC.
An enthusiastic golfer he played in a regular four-ball at Cork Golf Club. Three years ago he suffered a stroke. He is survived by his wife, Mary, daughter Fiona, sons John and Mark, grandson Jim, and sister Kathleen. He was predeceased by his son Peter.
Denis Wilson: born February 22nd, 1922; died April 25th, 2011
A highly cultured and courteous man of the old Cork school, Dr Wilson (FRC Ophthal) shared with his wife Mary a lifelong interest in the arts, music and theatre. Their home at Montenotte, overlooking the city, was a venue for private poetry readings, operatic evenings and musical recitals, pursuits that were to have a significant bearing on Fiona’s decision to embark on a career on the stage.
However, while totally supportive of her decision to take up acting, he was also acutely aware of the uncertainties of life in the theatre and insisted she first do a degree at UCC, thereby ensuring she had an academic background before going on to study at Rada.
Though quietly reserved at those Montenotte soirees, he was a fine raconteur with a hearty laugh and a fund of entertaining stories about his boyhood days in Cobh. Educated at the local Presentation College he went on to study medicine at UCC. He played rugby for UCC and for the Combined Universities, and was capped for Munster. He subsequently worked for a short time as a GP in London and later back in Cobh before qualifying as an ophthalmologist at the Manchester Royal Eye Infirmary in 1960.
Returning to Cork, he was appointed to the Eye Ear and Throat Hospital as a consultant, and worked there until his retirement at 65, which coincided with the transfer of the unit to Cork University Hospital.
Constantly keeping abreast with developments in eye surgery, he was awarded an honorary fellowship in ophthalmology by his peers in London. He also taught at UCC and at the Royal College of Surgeons in Dublin.
As a doctor he had a way of putting patients at their ease and built up a substantial practice in Cork down the years. In retirement, he continued working as a consultant at CUH and also had a busy private consultancy practice for many years.
After retiring he wrote De Iron Trote, an excellent history of the old Cork Eye, Ear and Throat Hospital on the Western Road. Turning his interest in the arts to good effect, he also studied for a Diploma in Art History at UCC.
An enthusiastic golfer he played in a regular four-ball at Cork Golf Club. Three years ago he suffered a stroke. He is survived by his wife, Mary, daughter Fiona, sons John and Mark, grandson Jim, and sister Kathleen. He was predeceased by his son Peter.
Denis Wilson: born February 22nd, 1922; died April 25th, 2011
Dry eye in children requires careful diagnosis
PARIS — Dry eye is a rare condition in children that often goes unrecognized because children do not report symptoms, according to a clinician speaking here.
"There is no reason to worry about a transient ocular discomfort, effectively managed with a few eye drops. But when symptoms persist, a proper diagnosis is mandatory," Dominique Brémond-Gignac, MD, OSN Europe Edition Editorial Board Member, said at the meeting of the French Society of Ophthalmology.
Possible causes are benign ocular surface disorders such as allergic conjunctivitis as well as more severe disorders, such as ocular rosacea with meibomian gland dysfunction or atopic keratoconjunctivitis, not commonly described in children. Other forms of dry eye may be observed in conjunction with systemic diseases or viral infections such as varicella zoster. More rarely, it can be a sign of specific and rare congenital disorders such as alacrima.
"Like in adults, tear substitutes and lubricants are first-line treatment in all cases. I recommend the use of the more viscous type of tear substitutes that remain in the eye for longer," Dr. Brémond-Gignac said.
Compliance can be a problem but tends to improve once children discover that drops can alleviate symptoms, according to Dr. Brémond-Gignac.
Cyclosporine can also be helpful in pediatric cases, she said.
* Disclosure: No products or companies are mentioned that would require financial disclosure.
"There is no reason to worry about a transient ocular discomfort, effectively managed with a few eye drops. But when symptoms persist, a proper diagnosis is mandatory," Dominique Brémond-Gignac, MD, OSN Europe Edition Editorial Board Member, said at the meeting of the French Society of Ophthalmology.
Possible causes are benign ocular surface disorders such as allergic conjunctivitis as well as more severe disorders, such as ocular rosacea with meibomian gland dysfunction or atopic keratoconjunctivitis, not commonly described in children. Other forms of dry eye may be observed in conjunction with systemic diseases or viral infections such as varicella zoster. More rarely, it can be a sign of specific and rare congenital disorders such as alacrima.
"Like in adults, tear substitutes and lubricants are first-line treatment in all cases. I recommend the use of the more viscous type of tear substitutes that remain in the eye for longer," Dr. Brémond-Gignac said.
Compliance can be a problem but tends to improve once children discover that drops can alleviate symptoms, according to Dr. Brémond-Gignac.
Cyclosporine can also be helpful in pediatric cases, she said.
* Disclosure: No products or companies are mentioned that would require financial disclosure.
Vitamin D May Preserve Your Eyesight
Getting more vitamin D may help stave off age-related macular degeneration (AMD), according to a new study from Archives of Ophthalmology. A leading cause of blindness in the United States, AMD gradually destroys your central vision.
Looking at data on 1,313 women, researchers found that higher levels of vitamin D were linked to a significantly decreased AMD risk among study members age 75 and younger. For instance, women in that age group who consumed the most vitamin D had a 59 percent lower risk of developing AMD (compared to age-matched women who took in the least vitamin D).
Although vitamin D is available in some foods and produced naturally by your body during exposure to the sun's UVB rays, many medical experts recommend increasing your vitamin D levels by taking a daily supplement. Past research suggests that vitamin D may also protect against high blood pressure, heart disease, depression, and certain types of cancer.
Looking at data on 1,313 women, researchers found that higher levels of vitamin D were linked to a significantly decreased AMD risk among study members age 75 and younger. For instance, women in that age group who consumed the most vitamin D had a 59 percent lower risk of developing AMD (compared to age-matched women who took in the least vitamin D).
Although vitamin D is available in some foods and produced naturally by your body during exposure to the sun's UVB rays, many medical experts recommend increasing your vitamin D levels by taking a daily supplement. Past research suggests that vitamin D may also protect against high blood pressure, heart disease, depression, and certain types of cancer.
James sees the light ahead
He and his wife Betty, both in their 70s, have had to make numerous trips to Brisbane for treatment.
By the end of the year the Sunshine Coast should be able to offer the same treatment thanks to a fund raising initiative of the Wishlist Foundation.
“That’s how much of a relief it is,” Mr Willis said as he brushed away the tears.
Mr Willis has been on a waiting list for surgery for more than three years. He said the condition had made even simple activities difficult.
“It makes it difficult to walk. When I look down at the ground, all I see is a big blur,” he said.
“You don’t know where the dips are or where the hills are. If I fall down I can’t get back up.”
Wishlist is the Sunshine Coast’s leading charity and has raised more than $9 million to purchase medical equipment and support local public hospitals.
The latest project will raise funds to improve and expand the Coast’s ophthalmology services through Wishlist House.
In conjunction with Ausmar Homes and Stockland, a home will be built from scratch using donated goods and services. It will then be auctioned, with all proceeds going towards helping people like Mr Willis.
Ausmar Homes director Tim Hendy said it was a project in which the award-winning building company was keen to be involved.
Ausmar will manage the project from start to finish and will liaise with local businesses to organise all the supplies, equipment, labour and subcontractors free of charge.
Wishlist is urging the community to get behind the cause.
For more information or to donate, contact Ausmar on 5442 6413
Wednesday, May 25, 2011
Statistical method may help detect corneas at risk for iatrogenic ectasia
PARIS — A new statistical method may be a valid tool for detecting corneas at risk of developing iatrogenic ectasia.
"Beware of false negatives, particularly in patients who have manifest keratoconus in the contralateral eye," Alain Saad, MD, of Fondation Rothschild, said at the meeting of the French Society of Ophthalmology.
Single topographic indices are often insufficient for classifying a patient and drawing reliable diagnostic conclusions.
"We need a statistical method with a discriminating power that might be useful in clinical situations," he said.
The new method that Dr. Saad proposed uses the Orbscan IIz (Bausch + Lomb) to obtain topographic and tomographic indices, a corneal thickness spatial profile, and anterior and posterior curvature spatial profiles. A specific calculation method is then used to determine the percentage of increase in thickness from the thinnest point to the periphery of the cornea. It also measures the percentage of variation in anterior and posterior curvature.
"In a large retrospective study, we were able to prove the validity of our method. Two indices in particular, the percentage of thickness increase and the variation of anterior and posterior curvature, had a high power to discriminate between normal corneas and corneas at risk of developing ectasia following refractive surgery," Dr. Saad said.
* Disclosure: Dr. Saad has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.
"Beware of false negatives, particularly in patients who have manifest keratoconus in the contralateral eye," Alain Saad, MD, of Fondation Rothschild, said at the meeting of the French Society of Ophthalmology.
Single topographic indices are often insufficient for classifying a patient and drawing reliable diagnostic conclusions.
"We need a statistical method with a discriminating power that might be useful in clinical situations," he said.
The new method that Dr. Saad proposed uses the Orbscan IIz (Bausch + Lomb) to obtain topographic and tomographic indices, a corneal thickness spatial profile, and anterior and posterior curvature spatial profiles. A specific calculation method is then used to determine the percentage of increase in thickness from the thinnest point to the periphery of the cornea. It also measures the percentage of variation in anterior and posterior curvature.
"In a large retrospective study, we were able to prove the validity of our method. Two indices in particular, the percentage of thickness increase and the variation of anterior and posterior curvature, had a high power to discriminate between normal corneas and corneas at risk of developing ectasia following refractive surgery," Dr. Saad said.
* Disclosure: Dr. Saad has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.
Drs. Gary Reiter, Henry Bikhazi Appointed to Leadership Positions of California's Renaissance Surgical Arts at Newport Harbor
Renaissance Surgical Arts at Newport Harbor in Costa Mesa, Calif., has announced Gary S. Reiter, MD, has been appointed medical director and Henry B. Bikhazi, MD, has been named president of the medical executive committee.
In his role as medical director, Dr. Reiter will oversee patient care and serve as a liaison between Renaissance management and physicians, according to a news release from the ambulatory surgery center.
As president of the MEC, Dr. Bikhazi will lead a physician committee which reviews physician credentialing and ensures that each specialty is being properly supported.
Dr. Reiter is a board-certified ophthalmologist and diplomate of the American Board of Ophthalmology. He has provided comprehensive surgical eye care for more than 30 years. Dr. Bikhazi, who was a founding physician member of Renaissance Surgical Arts, is an ENT surgeon and is board certified in otolaryngology.
Renaissance Surgical Arts features eight ORs, two procedure rooms and performs procedures in 12 specialties.
Read the news release about the appointments of Drs. Gary Reiter and Henry Bikhazi to leadership positions at Renaissance Surgical Arts at Newport Harbor.
In his role as medical director, Dr. Reiter will oversee patient care and serve as a liaison between Renaissance management and physicians, according to a news release from the ambulatory surgery center.
As president of the MEC, Dr. Bikhazi will lead a physician committee which reviews physician credentialing and ensures that each specialty is being properly supported.
Dr. Reiter is a board-certified ophthalmologist and diplomate of the American Board of Ophthalmology. He has provided comprehensive surgical eye care for more than 30 years. Dr. Bikhazi, who was a founding physician member of Renaissance Surgical Arts, is an ENT surgeon and is board certified in otolaryngology.
Renaissance Surgical Arts features eight ORs, two procedure rooms and performs procedures in 12 specialties.
Read the news release about the appointments of Drs. Gary Reiter and Henry Bikhazi to leadership positions at Renaissance Surgical Arts at Newport Harbor.
Artificial Retina Lets There Be Light, Object Discrimination
It's a far cry from replacing the human eye, but an implantable retinal prosthesis (Argus II, Second Sight Medical, Sylmar, California) has allowed 30 legally blind patients to see light as phosphenes, and has helped some improve their orientation and mobility in daily tasks, investigators reported here at the Association for Research in Vision and Ophthalmology 2011 Annual Meeting.
"The experience with Argus II subjects implanted is up to 73.4 years cumulatively, and the tests demonstrate that the Argus II, like the Argus I, continues to withstand long-term implants that allow us to study this interface," said Mark Humayun, MD, from the Doheny Eye Institute at the University of Southern California in Los Angeles.
"Our subjects are able to detect light and do well with certain performance parameters. We're continuing to study this in their daily lives and develop it into a rehabilitation program," he added.
The Argus II retinal prosthesis system couples a 60-electrode grid implanted in the retina with a spectacle-worn video camera and a visual processing unit that users can wear around the neck or waist. The visual information is sent wirelessly from the camera to the processing unit, which converts the information into pattern stimulation.
As of February 2011, 30 patients had received the device (9 women and 21 men; median age at time of implant, 58 ± 10 years [range, 28 to 77]). Of the 30, 29 have retinitis pigmentosa; the remaining subject has choroideremia. The average time patients have lived with the device is 2.4 years.
One of the devices required explantation at 14 months for recurrent conjunctival erosions; 1 had a communication failure at 10 months but is still in place.
"One of the things that concerned us very early on — and that we have addressed now — was the rate of endophthalmitis," Dr. Humayun said. "This was related to how you managed this device intraoperatively, as well as sterile practice techniques."
Visual Acuity Improved
With the 16-electrode Argus I device, the best visual acuity was about 20/4000. With the second-generation device, 27% of participants achieved a best visual acuity of 20/1260 with the system on (none achieved it with the system off).
In a grating visual acuity test in which patients are asked to touch a screen displaying an image of a square grating superimposed on black and white vertical bars, 8 subjects showed an improvement with the system switched on; with the switched system off, none did.
When asked to identify letters or numbers in 4 groups of increasing difficulty (L,T,E,J,F,H,I,U), 95.2% of subjects correctly identified the displayed character (shown 9.8 inches high on a screen) more often than chance with the system on in the first group; with the system off, 9.5% did. On/off performance with the other 3 groups of characters was, respectively, 78.9% vs 5.3%, 80.0% vs 10.0%, and 87.5% vs 0.0%.
In a test of orientation in which patients were told to follow a line on the floor by sight, all test runs were significantly better with the system switched on than when it was off. The line was painted on rather than taped to reduce the possibility that patients could feel their way along the course.
Users of the device have reported being able to find utensils on a table, locate parked and moving cars, find doors, avoid bumping into door frames, and navigate around new places in good lighting.
Dr. Humayun showed videos in which some patients were able to cross a street and negotiate a curb, and perceive colors on a screen. The videos included test runs in a variety of lighting and contrast situations.
Devices Evolving
A researcher working on a different device, the Boston Retinal Implant, told Medscape Medical News that although retinal prostheses are rapidly improving, they are still not ready for prime time.
"The field has moved forward in a very positive way, I think that each of these stylized testing methods demonstrate individual functional capacities, but for no group has it really yet been translated into practical day-to-day capabilities. The field just hasn't gotten there yet, but I think it's reasonably likely that it will," said Joseph Rizzo, MD, from the Massachusetts Eye and Ear Infirmary and Harvard Medical School in Boston.
The Argus II device has received approval for marketing in Europe; an application is pending in the United States.
The study is supported by Second Sight Medical Products. Dr. Humayun reports receiving research funding, holding a patent, and having a personal financial interest in the Argus II device. His coauthors report receiving either financial support or honoraria from the company. Dr. Rizzo has disclosed no relevant financial relationships.
Association for Research in Vision and Ophthalmology (ARVO) 2011 Annual Meeting. Abstract 2594. Presented May 3, 2011.
"The experience with Argus II subjects implanted is up to 73.4 years cumulatively, and the tests demonstrate that the Argus II, like the Argus I, continues to withstand long-term implants that allow us to study this interface," said Mark Humayun, MD, from the Doheny Eye Institute at the University of Southern California in Los Angeles.
"Our subjects are able to detect light and do well with certain performance parameters. We're continuing to study this in their daily lives and develop it into a rehabilitation program," he added.
The Argus II retinal prosthesis system couples a 60-electrode grid implanted in the retina with a spectacle-worn video camera and a visual processing unit that users can wear around the neck or waist. The visual information is sent wirelessly from the camera to the processing unit, which converts the information into pattern stimulation.
As of February 2011, 30 patients had received the device (9 women and 21 men; median age at time of implant, 58 ± 10 years [range, 28 to 77]). Of the 30, 29 have retinitis pigmentosa; the remaining subject has choroideremia. The average time patients have lived with the device is 2.4 years.
One of the devices required explantation at 14 months for recurrent conjunctival erosions; 1 had a communication failure at 10 months but is still in place.
"One of the things that concerned us very early on — and that we have addressed now — was the rate of endophthalmitis," Dr. Humayun said. "This was related to how you managed this device intraoperatively, as well as sterile practice techniques."
Visual Acuity Improved
With the 16-electrode Argus I device, the best visual acuity was about 20/4000. With the second-generation device, 27% of participants achieved a best visual acuity of 20/1260 with the system on (none achieved it with the system off).
In a grating visual acuity test in which patients are asked to touch a screen displaying an image of a square grating superimposed on black and white vertical bars, 8 subjects showed an improvement with the system switched on; with the switched system off, none did.
When asked to identify letters or numbers in 4 groups of increasing difficulty (L,T,E,J,F,H,I,U), 95.2% of subjects correctly identified the displayed character (shown 9.8 inches high on a screen) more often than chance with the system on in the first group; with the system off, 9.5% did. On/off performance with the other 3 groups of characters was, respectively, 78.9% vs 5.3%, 80.0% vs 10.0%, and 87.5% vs 0.0%.
In a test of orientation in which patients were told to follow a line on the floor by sight, all test runs were significantly better with the system switched on than when it was off. The line was painted on rather than taped to reduce the possibility that patients could feel their way along the course.
Users of the device have reported being able to find utensils on a table, locate parked and moving cars, find doors, avoid bumping into door frames, and navigate around new places in good lighting.
Dr. Humayun showed videos in which some patients were able to cross a street and negotiate a curb, and perceive colors on a screen. The videos included test runs in a variety of lighting and contrast situations.
Devices Evolving
A researcher working on a different device, the Boston Retinal Implant, told Medscape Medical News that although retinal prostheses are rapidly improving, they are still not ready for prime time.
"The field has moved forward in a very positive way, I think that each of these stylized testing methods demonstrate individual functional capacities, but for no group has it really yet been translated into practical day-to-day capabilities. The field just hasn't gotten there yet, but I think it's reasonably likely that it will," said Joseph Rizzo, MD, from the Massachusetts Eye and Ear Infirmary and Harvard Medical School in Boston.
The Argus II device has received approval for marketing in Europe; an application is pending in the United States.
The study is supported by Second Sight Medical Products. Dr. Humayun reports receiving research funding, holding a patent, and having a personal financial interest in the Argus II device. His coauthors report receiving either financial support or honoraria from the company. Dr. Rizzo has disclosed no relevant financial relationships.
Association for Research in Vision and Ophthalmology (ARVO) 2011 Annual Meeting. Abstract 2594. Presented May 3, 2011.
Russians offer more help, technology for eye surgery
VietNamNet Bridge – The head of Russia's S.N. Fyodorov Eye Micro Surgery Complex promised here yesterday to transfer more high quality technology and services to Viet Nam's ophthalmological industry.
Professor Khristo Takhchidi told President Nguyen Minh Triet on the first day of a five-day visit this included setting up the Excimer Laser Department to treat refractive eye disorders at the Viet Nam-Russia Ophthalmology Hospital in Ha Noi and the transfer of technology for treatment of children's amblyopia.
The hospital has provided medical check-ups and treatment for 31,000 patients during the past two years.
"The Fyodorov Eye Micro-surgery Complex will do its best to supply services based on high technology," the Russian ophthalmologist said.
Takhchidi's visit was welcomed by President Triet as a considerable contribution to stronger medical relations between the two countries.
Triet said Russia was a strategic partner and a loyal friend to the Vietnamese people, highlighting the training of many generations of Vietnamese medical doctors in that nation.
He said services provided by the Ophthalmology Hospital had benefited thousands of Vietnamese patients.
The hospital's humanitarian services had also helped disadvantaged patients otherwise unable to afford high-quality medical services.
The State leader warmly welcomed the initiative to set up another joint-venture ophthalmological hospital in HCM City. He also called for joint ventures in other cities.
Professor Khristo Takhchidi told President Nguyen Minh Triet on the first day of a five-day visit this included setting up the Excimer Laser Department to treat refractive eye disorders at the Viet Nam-Russia Ophthalmology Hospital in Ha Noi and the transfer of technology for treatment of children's amblyopia.
The hospital has provided medical check-ups and treatment for 31,000 patients during the past two years.
"The Fyodorov Eye Micro-surgery Complex will do its best to supply services based on high technology," the Russian ophthalmologist said.
Takhchidi's visit was welcomed by President Triet as a considerable contribution to stronger medical relations between the two countries.
Triet said Russia was a strategic partner and a loyal friend to the Vietnamese people, highlighting the training of many generations of Vietnamese medical doctors in that nation.
He said services provided by the Ophthalmology Hospital had benefited thousands of Vietnamese patients.
The hospital's humanitarian services had also helped disadvantaged patients otherwise unable to afford high-quality medical services.
The State leader warmly welcomed the initiative to set up another joint-venture ophthalmological hospital in HCM City. He also called for joint ventures in other cities.
Study: Off-Label Bevacizumab Is "Equivalent" to Ranibizumab for Treatment of Neovascular AMD
Government research suggests $50-a-dose Avastin is safe alternative to $2,000-a-dose Lucentis.
Intravitreal injections with bevacizumab (at about $50 a dose) are just as safe and effective as injections with ranibizumab ($2,000 a dose) in treating neovascular age-related macular degeneration, according to the 1-year results of a government study comparing the molecularly similar drugs.
Despite the similar outcomes associated with them, there are 2 major differences between bevacizumab (brand name Avastin) and ranibizumab (Lucentis): The former is a cancer drug not FDA-approved for the treatment of "wet" age-related macular degeneration (AMD), while ranibizumab is designed and approved expressly for that purpose. And, of course, bevacizumab is 40 times less expensive.
Off-label use of the much-cheaper bevacizumab to treat neovasclar AMD is relatively common in the United States, according to Paul Sieving, MD, PhD, director of the National Eye Institute, which sponsored the multicenter, single-blind, noninferiority trial.
The study's 1-year results, published last month in the New England Journal of Medicine, show equivalent changes in visual acuity among patients injected monthly with bevacizumab (8.0 letters gained) and those injected monthly with ranibizumab (8.5 letters gained). Results were also comparable when patients were administered the drugs as needed: 5.9 letters gained in bevacizumab group vs. 6.8 letters gained in ranibizumab group.
The rates of death, myocardial infarction and stroke were similar in the 2 groups, but a higher proportion of bevacizumab patients (24.1%) had "serious systemic adverse events (primarily hospitalization)" compared to the ranibizumab group (19%). The researchers conclude that further study is needed to account for this difference in the rate of serious adverse events.
"Lucentis and Avastin were equivalent — in fact, virtually identical for visual acuity at all time points — when administered in the same dosing regimen," said lead author Daniel Martin, MD, of the Cleveland Clinic Cole Eye Institute, while reporting 2-year study data at the annual meeting of the Association for Research in Vision and Ophthalmology earlier this month. "I have seen nothing so far regarding adverse events that would concern me greatly, and I would probably start with Avastin," Dr. Martin continued when asked whether he'd recommend 1 drug over another for a family member suffering from AMD.
Genentech, the company that markets both drugs, maintains that they are "different medicines" and that the National Eye Institute study adds to "an emerging body of evidence from much larger analyses that suggest risk of systemic adverse events may be higher when injecting Avastin into a person's eye compared to Lucentis."
Intravitreal injections with bevacizumab (at about $50 a dose) are just as safe and effective as injections with ranibizumab ($2,000 a dose) in treating neovascular age-related macular degeneration, according to the 1-year results of a government study comparing the molecularly similar drugs.
Despite the similar outcomes associated with them, there are 2 major differences between bevacizumab (brand name Avastin) and ranibizumab (Lucentis): The former is a cancer drug not FDA-approved for the treatment of "wet" age-related macular degeneration (AMD), while ranibizumab is designed and approved expressly for that purpose. And, of course, bevacizumab is 40 times less expensive.
Off-label use of the much-cheaper bevacizumab to treat neovasclar AMD is relatively common in the United States, according to Paul Sieving, MD, PhD, director of the National Eye Institute, which sponsored the multicenter, single-blind, noninferiority trial.
The study's 1-year results, published last month in the New England Journal of Medicine, show equivalent changes in visual acuity among patients injected monthly with bevacizumab (8.0 letters gained) and those injected monthly with ranibizumab (8.5 letters gained). Results were also comparable when patients were administered the drugs as needed: 5.9 letters gained in bevacizumab group vs. 6.8 letters gained in ranibizumab group.
The rates of death, myocardial infarction and stroke were similar in the 2 groups, but a higher proportion of bevacizumab patients (24.1%) had "serious systemic adverse events (primarily hospitalization)" compared to the ranibizumab group (19%). The researchers conclude that further study is needed to account for this difference in the rate of serious adverse events.
"Lucentis and Avastin were equivalent — in fact, virtually identical for visual acuity at all time points — when administered in the same dosing regimen," said lead author Daniel Martin, MD, of the Cleveland Clinic Cole Eye Institute, while reporting 2-year study data at the annual meeting of the Association for Research in Vision and Ophthalmology earlier this month. "I have seen nothing so far regarding adverse events that would concern me greatly, and I would probably start with Avastin," Dr. Martin continued when asked whether he'd recommend 1 drug over another for a family member suffering from AMD.
Genentech, the company that markets both drugs, maintains that they are "different medicines" and that the National Eye Institute study adds to "an emerging body of evidence from much larger analyses that suggest risk of systemic adverse events may be higher when injecting Avastin into a person's eye compared to Lucentis."
IOL surface alterations have multiple causes, expert says
PARIS — Surface alterations such as discoloration, opacification and glistening may occur at different time points after implantation of IOLs and could lead, in the worst cases, to explantation.
In presenting an extensive analysis of explanted IOLs at the meeting of the French Society of Ophthalmology, Liliana Werner, MD, PhD, said that all materials are susceptible to one of these complications, although some may be more typical of one lens than another.
“Glistening can potentially occur with all IOL types but is more commonly reported with hydrophobic acrylic," she said. "Calcification is mostly related to hydrophilic acrylic lenses, but can occur in special cases in association with silicone lenses, as in eyes with asteroid hyalosis. Snowflake degeneration is characteristic of PMMA IOLs.”
Dr. Werner said that a variety of factors are involved in IOL surface alterations, ranging from coexisting pathologic conditions, manufacturing or storage procedures, surgical adjuvants, and the use of dyes or medications. A combination of different causes is often involved, she said.
The use of ophthalmic ointments was found to likely be the cause of silicone IOL opacification in some cases. The use of amiodarone, a commonly used antiarrhythmic agent, and rifabutin, an antibiotic, were found to have caused IOL discoloration. Lens storage in rooms where sprays containing insecticides, disinfectants or other volatile substances are used can cause contamination through semipermeable packages. Several factors related to hydration, such as manufacturing and packaging processes, and patient conditions entailing breakdown of the blood-aqueous barrier might contribute to glistening formation.
"With the increasing number of IOLs introduced in the market, constant vigilance is necessary," Dr. Werner said.
* Disclosure: Dr. Werner is a consultant for AMO.
In presenting an extensive analysis of explanted IOLs at the meeting of the French Society of Ophthalmology, Liliana Werner, MD, PhD, said that all materials are susceptible to one of these complications, although some may be more typical of one lens than another.
“Glistening can potentially occur with all IOL types but is more commonly reported with hydrophobic acrylic," she said. "Calcification is mostly related to hydrophilic acrylic lenses, but can occur in special cases in association with silicone lenses, as in eyes with asteroid hyalosis. Snowflake degeneration is characteristic of PMMA IOLs.”
Dr. Werner said that a variety of factors are involved in IOL surface alterations, ranging from coexisting pathologic conditions, manufacturing or storage procedures, surgical adjuvants, and the use of dyes or medications. A combination of different causes is often involved, she said.
The use of ophthalmic ointments was found to likely be the cause of silicone IOL opacification in some cases. The use of amiodarone, a commonly used antiarrhythmic agent, and rifabutin, an antibiotic, were found to have caused IOL discoloration. Lens storage in rooms where sprays containing insecticides, disinfectants or other volatile substances are used can cause contamination through semipermeable packages. Several factors related to hydration, such as manufacturing and packaging processes, and patient conditions entailing breakdown of the blood-aqueous barrier might contribute to glistening formation.
"With the increasing number of IOLs introduced in the market, constant vigilance is necessary," Dr. Werner said.
* Disclosure: Dr. Werner is a consultant for AMO.
Tuesday, May 24, 2011
New Laser procedure at local eye center
In the low-lit room, a monitor showed a human eye. It took only a few seconds for a laser to move across the eye, leaving behind an explosion of bubbles. Around the room, nurses went about their work, and Dr. Marnix Heersink focused on his patient.
Heersink has performed LASIK surgery since the 1990s and cataract surgery since the 1980s. But this particular procedure was a fairly new experience for the Dothan eye doctor. Instead of using a blade, this LASIK procedure was done only with lasers.
“The laser is so precise,” Heersink said. “You get a very precise, perfectly aligned cleaner cut.”
All-laser LASIK, or bladeless LASIK, has been around for several years. The potential outcome is basically the same as traditional LASIK, an acronym for laser-assisted in situ keratomileusis. But it seems to be another step in the evolution of a procedure that has become more and more common.
At 29, Charla Rhodes had considered LASIK for years, but cost and fear about the outcome kept her from having the surgery. As the mother of three young children ages 3, 4 and 6, the elective surgery wasn’t a priority.
“I couldn’t even see the ‘E’ on the eye chart,” Rhodes said of her vision.
When Rhodes’ contact lens and eyeglass prescriptions reached a point that her lenses had to be special ordered and cost more, her husband suggested she reconsider the vision correction surgery. On April 28, Rhodes became part of Eye Center South’s study of the bladeless LASIK.
Heersink and Dr. Tyler Hall are using the all-laser technique for 60 days to look at patients’ outcomes and determine whether they want to continue using the technology. The particular bladeless technology Eye Center South is using is iLASIK (the brand name given by the company that markets that particular laser).
Rhodes’ vision was really cloudy for a couple of days after surgery. But she could see.
“I was able to see right away,” Rhodes said.
Since the 1970s, the number of Americans with myopia, or nearsightedness, has increased 66 percent, according the National Eye Institute. But even before the 1970s, eye surgeons have been trying to correct people’s vision problems.
The earliest vision correction surgery to reach the masses was radial keratotomy, or RK, in the 1980s. RK involved a diamond knife used to cut slits into the cornea and was followed by other vision correction techniques, such as photorefractive keratectomy, or PRK. But in 1998, the Food and Drug Administration approved the first laser for the vision correction surgery commonly called LASIK. Today, as many as 700,000 Americans have LASIK each year.
The cost varies with the surgeon and technology, but can range from $1,400 to $2,000 per eye. That hasn’t stopped patients who want more freedom from glasses or contacts.
No matter the type of technology, LASIK procedures are basically the same. A thin flap is created on the outer part of the cornea with a hinge left so the flap can be folded back. An excimer laser is then used to reshape the corneal surface under the flap. The surgeon replaces the flap, which basically heals itself over time without stitches.
Creating the flap is what differentiates one laser technique from another. In traditional LASIK, a microkeratome blade is used. In bladeless LASIK, the flap is created with a laser keratome, which is different from the excimer laser used to reshape the cornea.
Use of the second laser adds to the cost of the procedure and requires the doctor to move the patient from one laser to another during surgery. But Heersink said he’s hopeful that the future will bring one laser that can create the flap and repair vision.
Both Hall and Heersink said they have been impressed with the outcomes of the all-laser LASIK. Patients have been healing faster, with less pain and gaining vision quicker, Heersink said.
“It’s really about the expectations the patients have,” Hall said.
LASIK has a high success rate, but like any surgery there are risks. Patients could experience glare, halos or starbursts around lights and increased sensitivity to light, according to the American Academy of Ophthalmology. Other side effects include hazy vision, poor night vision, and dryness of the eyes and reduced sharpness of vision. There’s a small chance that a patient’s vision will not be as good after surgery even with glasses or contacts. Patients may still need glasses later as their vision changes with age, and some people may not be good candidates for LASIK.
The Food and Drug Administration has partnered with the National Eye Institute and the Department of Defense for the LASIK Quality of Life Project to examine patient outcomes. The project is currently in its third phase and should assist doctors and patients in making better decisions about the surgery.
While the FDA only regulates the lasers and not their use, the agency does provide information on its website to help consumers decide if LASIK is right for them.
“The success of LASIK both in its aggressive marketing and in its success creates an impression of its infallibility that does not exist,” said Glenn Hagele, executive director of the Council for Refractive Surgery Quality Assurance.
The council certifies doctors and provides consumer information on LASIK and other vision correction surgeries. Hagele himself had PRK done to correct his own vision but describes the council as neutral when it comes to whether or not people should have such procedures.
In a survey conducted by the council, 99 percent of LASIK patients said their quality of life after LASIK was as good as or better than expected, and 98 percent would recommend the surgery to family and friends. Ninety-seven percent would have the surgery again, and 96 percent reported that their overall vision without corrective lenses was as good as or better than expected compared to their vision before surgery.
The all-laser LASIK is more appealing to patients who fear the blade, Hagele said, but its higher price tag could keep it out of reach for many patients. The responsibility lies with doctors, Hagele said, to make sure patients understand the risks and have realistic expectations.
“Every good surgeon has had a bad outcome,” Hagele said. “There is always going to be an element of risk, although relatively small.”
Charla Rhodes is happy with her results. The day after her surgery, she drove herself from her home in Fort Rucker to her follow-up appointment in Dothan. Not even a month after her surgery, the cloudiness in her vision has continued to improve. She wakes up with dry eyes and uses drops in the mornings. She compares the dryness to waking up after falling asleep in her contact lenses.
“Every morning I think, ‘Darn it, I slept in my contacts again,’” Rhodes said. “I just can’t get over the fact I don’t need them anymore. And I still reach for my glasses in the morning.”
In Mexico, doctor 'fixes broken eyes'
Dr. Sarah S. Levy recently traveled to a small rural town in Mexico where most of the people make their living from agriculture, and the major crops are cocoa, corn, beans and various tropical products. Sounds pastoral.
But there wasn't anything bucolic about the doctor's time off from South County Hospital and Seacoast Eye Associates, where she is an ophthalmologist and surgeon.
While in Mexico, Dr. Levy, 34, performed dozens of eye surgeries as a member of a medical team made up of doctors from various parts of the United States. They worked in the heat of Tulipan, a town not far from the equator.
The East Greenwich resident offered her ophthalmology skills by way of Medical Ministry International, a group "committed to meet the need for medical care among the world's poor with lasting solutions through excellence in medicine, patient care, and health education," notes its Web site, adding that it mobilizes volunteers for one- and two-week medical projects.
This was the second mission trip for Dr. Levy, and it probably won't be her last.
"This is one of those trips where you come back and truly realize how lucky and how fortunate you are," she said. "You go there and you realize these patients are truly amazing, they are so appreciative, so stoic.
"The people have to travel quite a bit for their health care. It is a fairly poor community," she said, but a center has been constructed there by way of the mission organization she worked with.
"The surgery we performed down there is pretty much what we would perform in the United States," she explained, though in much tighter quarters. Five physicians made the trip, "and all of us came with different experiences. There was a glaucoma specialist, a cataract specialist, someone with retina background," she said.
Three surgeons worked within one room, and two in another, and they all arrived with donations of supplies and equipment from representative hospitals and companies, including South County Hospital.
"We operated for four and half days," Dr. Levy said. They treated approximately 200 people and were scheduled to do more but some surgeries had to be canceled because of the potential risk of complications for some patients.
Sometimes the surgeons would work until 9 or 10 at night and get up the next morning and do it all over again for a waiting crowd of patients.
Entire families would arrive at the center, sometimes all of them on a bike or moped, she said, recalling an 80-year-old woman perched on a bike with other people.
Not many have access to cars so they would do whatever was needed to get to the center, she said.
Dr. Levy said she was seeing cataracts very different from those she sees in the United States.
"The reason why there is such a huge need is because it is close to the equator and a lot of people work outdoors all day." The sun is a lot stronger, she said, and sunglasses aren't a common accessory.
She said for the population there, cataracts surface at a younger age, and some people can be close to being sightless by the age of 60.
Levy said the clinic is "fabulous, incredibly organized. You go there and do the surgery and are able to bring your skills and focus on the people." People pay some amount if they are able, she said. If they are not able, then they don't.
Levy said while she "doesn't speak a word of Spanish and my assistant didn't speak a word of English, she knew what she was doing I knew what I was doing."
It was the same thing with the patients.
"It's all about body language," she said, explaining how she would hold their hands for reassurance, tap their shoulders, walk them down the hall holding their arm.
Dr. Levy and her husband, Naveh, also a physician, have three children, Eli, 7, Liam, 3, and David, 2. She grew up in Boston and went to Brown University, Harvard University and George Washington University School of Medicine.
Before returning to Rhode Island in 2009, she worked at the Kellogg Eye Center in Michigan.
Taking on a mission trip, while working as a physician and surgeon and being a mother of three, is possible, she said, "because I have an amazing husband.
"I was a little hesitant to go, especially with the kids so young, but my husband was like 'Go, go, go,' and my mom came over. She's a physician, too."
Both Levy and her husband come from families made up of several generations of physicians, so the busy lifestyle was what she witnessed growing up.
"There was never a question," she said of not combining family and career. "You mesh it together." Her 7-year-old was especially cognizant of her mission trip, saying his mom was going away "to fix broken eyes."
Levy said she hopes her own children are able someday to provide similar help in underdeveloped countries, and she knows she will return, too.
"She has a very busy career and family life. I think it's great she was able to give of herself to go on this mission bringing something to the people that is as basic as clear vision," said Martha Murphy, manager of South County Hospital's marketing and communications department and a hospital spokeswoman.
"In general, there is not much access to health care, period. It's truly amazing that there is an eye hospital there," Levy said of the rural town located in the municipality of Comalcalco. On the drive to the town, "there isn't much and then you come to this beautiful white building," which is the center.
The first time she made the trip, she said, she worked in a converted town hall.
"Electricity was iffy, there was not enough power for air conditioning and the cataract machines," she said, so in 90-degree heat, "we were drenched, I mean wet. It was very, very warm."
A patient who had surgery at the beginning of the week returned before the team left to "give us a hug and tell us we had given him his life is back," she said.
Almost all physicians who attend mission trips return, she said.
"Once you go almost everybody goes back. There's almost no reason not to. It's an expense of money and time but the goodness that you are doing, it's so rewarding.
"It sort of takes you back to your reason for being a doctor. You go there and you are not dealing with insurances, not dealing with any of those other things like paperwork, you're there to treat and to give support. You can just be a doctor, which is really nice."
But there wasn't anything bucolic about the doctor's time off from South County Hospital and Seacoast Eye Associates, where she is an ophthalmologist and surgeon.
While in Mexico, Dr. Levy, 34, performed dozens of eye surgeries as a member of a medical team made up of doctors from various parts of the United States. They worked in the heat of Tulipan, a town not far from the equator.
The East Greenwich resident offered her ophthalmology skills by way of Medical Ministry International, a group "committed to meet the need for medical care among the world's poor with lasting solutions through excellence in medicine, patient care, and health education," notes its Web site, adding that it mobilizes volunteers for one- and two-week medical projects.
This was the second mission trip for Dr. Levy, and it probably won't be her last.
"This is one of those trips where you come back and truly realize how lucky and how fortunate you are," she said. "You go there and you realize these patients are truly amazing, they are so appreciative, so stoic.
"The people have to travel quite a bit for their health care. It is a fairly poor community," she said, but a center has been constructed there by way of the mission organization she worked with.
"The surgery we performed down there is pretty much what we would perform in the United States," she explained, though in much tighter quarters. Five physicians made the trip, "and all of us came with different experiences. There was a glaucoma specialist, a cataract specialist, someone with retina background," she said.
Three surgeons worked within one room, and two in another, and they all arrived with donations of supplies and equipment from representative hospitals and companies, including South County Hospital.
"We operated for four and half days," Dr. Levy said. They treated approximately 200 people and were scheduled to do more but some surgeries had to be canceled because of the potential risk of complications for some patients.
Sometimes the surgeons would work until 9 or 10 at night and get up the next morning and do it all over again for a waiting crowd of patients.
Entire families would arrive at the center, sometimes all of them on a bike or moped, she said, recalling an 80-year-old woman perched on a bike with other people.
Not many have access to cars so they would do whatever was needed to get to the center, she said.
Dr. Levy said she was seeing cataracts very different from those she sees in the United States.
"The reason why there is such a huge need is because it is close to the equator and a lot of people work outdoors all day." The sun is a lot stronger, she said, and sunglasses aren't a common accessory.
She said for the population there, cataracts surface at a younger age, and some people can be close to being sightless by the age of 60.
Levy said the clinic is "fabulous, incredibly organized. You go there and do the surgery and are able to bring your skills and focus on the people." People pay some amount if they are able, she said. If they are not able, then they don't.
Levy said while she "doesn't speak a word of Spanish and my assistant didn't speak a word of English, she knew what she was doing I knew what I was doing."
It was the same thing with the patients.
"It's all about body language," she said, explaining how she would hold their hands for reassurance, tap their shoulders, walk them down the hall holding their arm.
Dr. Levy and her husband, Naveh, also a physician, have three children, Eli, 7, Liam, 3, and David, 2. She grew up in Boston and went to Brown University, Harvard University and George Washington University School of Medicine.
Before returning to Rhode Island in 2009, she worked at the Kellogg Eye Center in Michigan.
Taking on a mission trip, while working as a physician and surgeon and being a mother of three, is possible, she said, "because I have an amazing husband.
"I was a little hesitant to go, especially with the kids so young, but my husband was like 'Go, go, go,' and my mom came over. She's a physician, too."
Both Levy and her husband come from families made up of several generations of physicians, so the busy lifestyle was what she witnessed growing up.
"There was never a question," she said of not combining family and career. "You mesh it together." Her 7-year-old was especially cognizant of her mission trip, saying his mom was going away "to fix broken eyes."
Levy said she hopes her own children are able someday to provide similar help in underdeveloped countries, and she knows she will return, too.
"She has a very busy career and family life. I think it's great she was able to give of herself to go on this mission bringing something to the people that is as basic as clear vision," said Martha Murphy, manager of South County Hospital's marketing and communications department and a hospital spokeswoman.
"In general, there is not much access to health care, period. It's truly amazing that there is an eye hospital there," Levy said of the rural town located in the municipality of Comalcalco. On the drive to the town, "there isn't much and then you come to this beautiful white building," which is the center.
The first time she made the trip, she said, she worked in a converted town hall.
"Electricity was iffy, there was not enough power for air conditioning and the cataract machines," she said, so in 90-degree heat, "we were drenched, I mean wet. It was very, very warm."
A patient who had surgery at the beginning of the week returned before the team left to "give us a hug and tell us we had given him his life is back," she said.
Almost all physicians who attend mission trips return, she said.
"Once you go almost everybody goes back. There's almost no reason not to. It's an expense of money and time but the goodness that you are doing, it's so rewarding.
"It sort of takes you back to your reason for being a doctor. You go there and you are not dealing with insurances, not dealing with any of those other things like paperwork, you're there to treat and to give support. You can just be a doctor, which is really nice."
Study Demonstrates Electrical Stimulation Therapy Safe And Well-Tolerated In Early Stage Retinitis Pigmentosa Patients
Okuvision GmbH, an innovator in the field of electrical stimulation therapy (EST) for early and intermediate stage retinitis pigmentosa patients, today announced the presentation of data from the company's first sham-controlled pilot study at the Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting. The study included 24 patients suffering from early and intermediate stage retinitis pigmentosa who were separated into three groups and received EST at varying strengths for 30 minutes once a week for six weeks. The presentation was delivered by lead author, Dr. Florian Gekeler of the Centre for Ophthalmology, Tuebingen University Eye Hospital, and is one of four Okuvision-related presentations being given at the 2011 ARVO Annual Meeting convening May 1-5 in Fort Lauderdale, Fla.
Dr. Gekeler's poster presentation titled, "Transcorneal Electrical Stimulation in Patients with Retinitis Pigmentosa," highlights findings from Okuvision's first clinical trial which began in 2007 using a thread electrode to stimulate the retina with small amounts of current. Twenty-four patients with early and intermediate stage retinitis pigmentosa were randomized and separated into three different groups. Each group received different levels of stimulation-the first was treated without electrical current, the second with 67 percent of the individual threshold, and the third with 150 percent of the patient's threshold for 30 minutes a week for six weeks. Final evaluation showed a +20 percent statistically significant improvement in the field of vision by patients who received the 150 percent stimulation. The findings from this study emphasize that electrical stimulation of the retina liberates growth factors which may be able to delay retinal degeneration.
"Our team began this study with the goal of determining whether electrical stimulation therapy could safely and effectively preserve vision for early stage retinitis pigmentosa patients," said Dr. Florian Gekeler, consultant at the Centre for Ophthalmology of the University of Tuebingen, Germany. "The visual results achieved surpassed our initial expectations and it is our hope that these results will be the first step in ensuring that EST is considered a viable treatment option to slow the degenerative progress for retinitis pigmentosa patients."
Retinitis pigmentosa (RP) is one of the most common forms of inherited retinal degeneration that grows worse over time. Affecting approximately 300,000 people in the world, this progressive condition typically causes severe vision problems in adulthood, often resulting in complete blindness. While there are no approved treatment options that can slow the onset of RP, this study presents patients with a promise of hope in delaying the degeneration of the eye.
"The results of our study show promise that a treatment option, while not a cure for retinitis pigmentosa, could be available in the future," said Dr. Walter-G. Wrobel, chairman and founder, Okuvision GmbH. "While much is still unknown about EST technology, the results of the study are a great step toward determining efficacy of this treatment and we look forward to conducting further studies to potentially reach out to those who are hopeful in delaying the effects of retinitis pigmentosa."
The study findings were also reported online on April 5, 2011 in Investigative Ophthalmology & Visual Science, the official journal of ARVO (A.Schatz et.al., IOVS Papers in Press. Published on April 5, 2011 as Manuscript iovs.10-6932).
The Okuvision therapy device is not for sale in the United States.
Source:
Okuvision GmbH
Dr. Gekeler's poster presentation titled, "Transcorneal Electrical Stimulation in Patients with Retinitis Pigmentosa," highlights findings from Okuvision's first clinical trial which began in 2007 using a thread electrode to stimulate the retina with small amounts of current. Twenty-four patients with early and intermediate stage retinitis pigmentosa were randomized and separated into three different groups. Each group received different levels of stimulation-the first was treated without electrical current, the second with 67 percent of the individual threshold, and the third with 150 percent of the patient's threshold for 30 minutes a week for six weeks. Final evaluation showed a +20 percent statistically significant improvement in the field of vision by patients who received the 150 percent stimulation. The findings from this study emphasize that electrical stimulation of the retina liberates growth factors which may be able to delay retinal degeneration.
"Our team began this study with the goal of determining whether electrical stimulation therapy could safely and effectively preserve vision for early stage retinitis pigmentosa patients," said Dr. Florian Gekeler, consultant at the Centre for Ophthalmology of the University of Tuebingen, Germany. "The visual results achieved surpassed our initial expectations and it is our hope that these results will be the first step in ensuring that EST is considered a viable treatment option to slow the degenerative progress for retinitis pigmentosa patients."
Retinitis pigmentosa (RP) is one of the most common forms of inherited retinal degeneration that grows worse over time. Affecting approximately 300,000 people in the world, this progressive condition typically causes severe vision problems in adulthood, often resulting in complete blindness. While there are no approved treatment options that can slow the onset of RP, this study presents patients with a promise of hope in delaying the degeneration of the eye.
"The results of our study show promise that a treatment option, while not a cure for retinitis pigmentosa, could be available in the future," said Dr. Walter-G. Wrobel, chairman and founder, Okuvision GmbH. "While much is still unknown about EST technology, the results of the study are a great step toward determining efficacy of this treatment and we look forward to conducting further studies to potentially reach out to those who are hopeful in delaying the effects of retinitis pigmentosa."
The study findings were also reported online on April 5, 2011 in Investigative Ophthalmology & Visual Science, the official journal of ARVO (A.Schatz et.al., IOVS Papers in Press. Published on April 5, 2011 as Manuscript iovs.10-6932).
The Okuvision therapy device is not for sale in the United States.
Source:
Okuvision GmbH
Multifocal lenses sharpen one’s focus
These relatively new lenses can help correct both short- and long-range vision problems.
Carla Di-Gianni has the vision of a 20-year-old.
She is 57.
Her secret? Implants of multifocal lenses.
“Better than a car, or a house, these lenses are the best investment I’ve made in my life,” says Di Gianni, who first had the surgery in one eye and two months later in the other. “I can see up front and long range. In fact, to show my gratitude I would volunteer with the hospital to share the news with others.”
In 2006, when Di Gianni went to surgery, multifocal lenses were a novelty.
“The doctor was honest with me and told me there was not much she could tell me about the lenses because she was not too familiar with them, but I took the risk anyway.”
In the beginning, the operation had its side effects.
“Highway and automobile lights blew up 100-fold, but now all of that is gone and I see perfectly.”
Doctor Sonia H. Yoo, professor of ophthalmology at the University of Miami’s Bascom Palmer Institute, says that precisely because multifocal lenses can cause these glows, there is an alternative known as the crystal lens implant. But while it does not cause lights to glow, it is not as precise as the multifocal.
“They are two different lenses,” Yoo says. “The multifocal one has a series of rings that provide great diversity when focusing and seeing. The crystal lens, which has that name because it is made of silicone, is a lens that provides long-, middle- and short-range vision. However, for reading fine print you may at times have to resort to glasses.”
This surgery “moves back the optical clock 10 or 15 years,” says Yoo. “It’s like an optical lift,” she jokes.
Actually, these lenses were initially designed to correct cataracts. Today the implants have become a valid option to resolve optical deficiencies that Lasik cannot resolve.
“Lasik is not a surgery for everyone,” Yoo says. “With this lens you can see at a distance and up close without problems, besides absolutely correcting all optical deficiencies.”
For example, Di Gianni did not consider Lasik when she knew of her condition. She began to lose her short-range vision when she was about 45 and only then she went to the ophthalmologist. Thanks to the testing she learned that she not only had presbyopia, but also myopia, or nearsightedness, she had suffered all her life. “When a person has never seen well, whatever she sees seems normal to her,” said Di Gianni, who added that contact lenses were quite an odyssey.
“Take them off, put them back on, clean them, eyes were dry… In the end I thought the best option was the implants.”
The operation cost her $5,000 each eye.
Doctor Carol Karp, professor of ophthalmology at the University of Miami’s Bascom Palmer Institute, says the best candidates for this type of implant surgery are patients with cataracts, since their intraocular lens is opaque and an artificial lens is needed.
Generally, health insurance pays for the cataracts surgery and the monofocal lens, as does Medicare. However, it doesn’t pay for the multifocal lens, which cost an extra $2,500 for each eye.
Those who wish to correct both their short- and long-range vision without having to pay more for multifocal lenses can suggest to have a different implant correcting each condition in each eye, so that the sum of both makes for an almost perfect vision.
“Most patients get used to them to the point that they don’t know which eye they are reading with and which they are using to see long range,” Karp says.
“Cataract patients have no option and these implants are their salvation,” Yoo says. “However, you have to be aware that for those who do not suffer from this condition, the implant is an operation inside your eye and it has risks as any other surgery.”
She is 57.
Her secret? Implants of multifocal lenses.
“Better than a car, or a house, these lenses are the best investment I’ve made in my life,” says Di Gianni, who first had the surgery in one eye and two months later in the other. “I can see up front and long range. In fact, to show my gratitude I would volunteer with the hospital to share the news with others.”
In 2006, when Di Gianni went to surgery, multifocal lenses were a novelty.
“The doctor was honest with me and told me there was not much she could tell me about the lenses because she was not too familiar with them, but I took the risk anyway.”
In the beginning, the operation had its side effects.
“Highway and automobile lights blew up 100-fold, but now all of that is gone and I see perfectly.”
Doctor Sonia H. Yoo, professor of ophthalmology at the University of Miami’s Bascom Palmer Institute, says that precisely because multifocal lenses can cause these glows, there is an alternative known as the crystal lens implant. But while it does not cause lights to glow, it is not as precise as the multifocal.
“They are two different lenses,” Yoo says. “The multifocal one has a series of rings that provide great diversity when focusing and seeing. The crystal lens, which has that name because it is made of silicone, is a lens that provides long-, middle- and short-range vision. However, for reading fine print you may at times have to resort to glasses.”
This surgery “moves back the optical clock 10 or 15 years,” says Yoo. “It’s like an optical lift,” she jokes.
Actually, these lenses were initially designed to correct cataracts. Today the implants have become a valid option to resolve optical deficiencies that Lasik cannot resolve.
“Lasik is not a surgery for everyone,” Yoo says. “With this lens you can see at a distance and up close without problems, besides absolutely correcting all optical deficiencies.”
For example, Di Gianni did not consider Lasik when she knew of her condition. She began to lose her short-range vision when she was about 45 and only then she went to the ophthalmologist. Thanks to the testing she learned that she not only had presbyopia, but also myopia, or nearsightedness, she had suffered all her life. “When a person has never seen well, whatever she sees seems normal to her,” said Di Gianni, who added that contact lenses were quite an odyssey.
“Take them off, put them back on, clean them, eyes were dry… In the end I thought the best option was the implants.”
The operation cost her $5,000 each eye.
Doctor Carol Karp, professor of ophthalmology at the University of Miami’s Bascom Palmer Institute, says the best candidates for this type of implant surgery are patients with cataracts, since their intraocular lens is opaque and an artificial lens is needed.
Generally, health insurance pays for the cataracts surgery and the monofocal lens, as does Medicare. However, it doesn’t pay for the multifocal lens, which cost an extra $2,500 for each eye.
Those who wish to correct both their short- and long-range vision without having to pay more for multifocal lenses can suggest to have a different implant correcting each condition in each eye, so that the sum of both makes for an almost perfect vision.
“Most patients get used to them to the point that they don’t know which eye they are reading with and which they are using to see long range,” Karp says.
“Cataract patients have no option and these implants are their salvation,” Yoo says. “However, you have to be aware that for those who do not suffer from this condition, the implant is an operation inside your eye and it has risks as any other surgery.”
Japanese firms sue Lupin in US court over eye drug
Japan’s Senju Pharmaceutical and Kyorin Pharmaceutical along with US-based Allergan have sued Lupin alleging violation by the Indian firm in case of 0.3 per cent
Gatifloxacin ophthalmic
solution.
Crucial patents for Gatifloxacin, a synthetic broad-spectrum antibiotic, are held by the Japanese firms. Allergan produces an eye-drop formulation called Zymar, based on the same antibiotic being the exclusive licensee for eye applications.
In a court case filed last week in the District Court of Delaware, the firms have submitted that in the first week of April Lupin had filed for a drug master file for gatifloxacin. Then, Lupin or entities controlled by it had also submitted a generic drug application to the USFDA for approval to market a glatifloxacin ophthalmic solution with 0.3 per cent strength.
The firms have alleged that Lupin’s application is in infringement of US Patent Numbers 6,333,045 (Aqueous Liquid Pharmaceutical Composition Comprised of Gatifloxacin, issued December 25, 2001) and 5,880,283 (8-Alkoxyquinolonecarboxylic Acid Hydrate With Excellent Stability and Process for Producing the Same, issued March 9, 1999). The world-wide ophthalmology drugs market is expected to reach a size of $19.8 billion by the year 2014 growing at a CAGR of 4 per cent from 2009-2014. The US ophthalmic drug market has crossed $5 billion in 2008.
Lupin has filed a paragraph-IV application for the product, which means it intends to market its approved product before expiration of two important patents, the firms said in their court document that have been accessed by
Financial Chronicle.
The two patents in question expire during 2016 and 2020. The USFDA approved Zymar in 2003 for the treatment of bacterial conjunctivitis.
Gatifloxacin ophthalmic
solution.
Crucial patents for Gatifloxacin, a synthetic broad-spectrum antibiotic, are held by the Japanese firms. Allergan produces an eye-drop formulation called Zymar, based on the same antibiotic being the exclusive licensee for eye applications.
In a court case filed last week in the District Court of Delaware, the firms have submitted that in the first week of April Lupin had filed for a drug master file for gatifloxacin. Then, Lupin or entities controlled by it had also submitted a generic drug application to the USFDA for approval to market a glatifloxacin ophthalmic solution with 0.3 per cent strength.
The firms have alleged that Lupin’s application is in infringement of US Patent Numbers 6,333,045 (Aqueous Liquid Pharmaceutical Composition Comprised of Gatifloxacin, issued December 25, 2001) and 5,880,283 (8-Alkoxyquinolonecarboxylic Acid Hydrate With Excellent Stability and Process for Producing the Same, issued March 9, 1999). The world-wide ophthalmology drugs market is expected to reach a size of $19.8 billion by the year 2014 growing at a CAGR of 4 per cent from 2009-2014. The US ophthalmic drug market has crossed $5 billion in 2008.
Lupin has filed a paragraph-IV application for the product, which means it intends to market its approved product before expiration of two important patents, the firms said in their court document that have been accessed by
Financial Chronicle.
The two patents in question expire during 2016 and 2020. The USFDA approved Zymar in 2003 for the treatment of bacterial conjunctivitis.
Monday, May 23, 2011
Foetal Help for Stephens-Johnson
Prahalathan, founder of Bhumi, aims at reaching out to 3500 children
Ophthalmologist K K Prahalathan has set his eyes afar. In 2011, he wants to reach out to at least 3500 children in 40 centres across India through Bhumi, one of India’s largest youth enabled non-profit organizations. Started with just a handful of volunteers in 2006, today Bhumi has over 300 active volunteers teaching at learning centers for children in Chennai, Thiruvallur, Bengaluru and Chandigarh. Bhumi has 18 learning centers including nine orphanages, two schools, five slum and two village community centers. In 2009-2010, Bhumi’s programme benefited over 1,600 children.
Behind the success of Bhumi is the personal story of Prahalathan, who is also a resident in ophthalmology at a leading Eye Hospital in Chennai. Actually, he was preparing to go to UK for higher studies in 2005 when he joined an NGO in Chennai. It was there he met two other like-minded persons and the trio launched Bhumi with the motto: "Change today. Change tomorrow". Bhumi, which means earth, is a platform for socially conscious young men and women to contribute towards the nation’s progress by bridging societal gaps through education.
Some of the programmes they initiate at Bhumi include imparting computer skills, English communication, teaching Mathematical and Scientific concepts and leadership qualities to children from underprivileged sections.
For Prahalathan, social work runs in his veins. As a youngster, he had taken part in Lions Club activities with his father, a civil engineer. His mother, a high school teacher, used to run adult literacy programs for slum women.
Prahalathan has already won laurels. He was selected as one of Asia Pacific Emerging 100 youth social entrepreneurs by the Foundation for Youth Social Entrepreneurships in 2009 and as a Facilitator for Tata Jagirti Yatra 2010.
On his long time plans, Prahalathan says that seven to eight years down the line he would like Bhumi to start schools. But it all depends on how the Right to Education Act impacts society, he says.
As of now, he wants the youth to know that Bhumi offers them an opportunity to help the needy children. All that Bhumi expects from its volunteers is two hours in the weekend. One can be part of the mission to contribute for the welfare of society. Website: http://www.bhumi.org.in/
Behind the success of Bhumi is the personal story of Prahalathan, who is also a resident in ophthalmology at a leading Eye Hospital in Chennai. Actually, he was preparing to go to UK for higher studies in 2005 when he joined an NGO in Chennai. It was there he met two other like-minded persons and the trio launched Bhumi with the motto: "Change today. Change tomorrow". Bhumi, which means earth, is a platform for socially conscious young men and women to contribute towards the nation’s progress by bridging societal gaps through education.
Some of the programmes they initiate at Bhumi include imparting computer skills, English communication, teaching Mathematical and Scientific concepts and leadership qualities to children from underprivileged sections.
For Prahalathan, social work runs in his veins. As a youngster, he had taken part in Lions Club activities with his father, a civil engineer. His mother, a high school teacher, used to run adult literacy programs for slum women.
Prahalathan has already won laurels. He was selected as one of Asia Pacific Emerging 100 youth social entrepreneurs by the Foundation for Youth Social Entrepreneurships in 2009 and as a Facilitator for Tata Jagirti Yatra 2010.
On his long time plans, Prahalathan says that seven to eight years down the line he would like Bhumi to start schools. But it all depends on how the Right to Education Act impacts society, he says.
As of now, he wants the youth to know that Bhumi offers them an opportunity to help the needy children. All that Bhumi expects from its volunteers is two hours in the weekend. One can be part of the mission to contribute for the welfare of society. Website: http://www.bhumi.org.in/
Recent eye operation rare for Claxton-Hepburn
OGDENSBURG — Claxton-Hepburn Medical Center last week was the site of a delicate eye surgery not performed at the hospital in more than a decade.
Debra A. Koloms, a board-certified ophthalmologist residing and practicing in the Watertown area for the last 10 years, performed surgery to correct an instance of strabismus.
According to the American Academy of Ophthalmology, strabismus is a "visual problem in which the eyes are not aligned properly and point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward or downward."
She described the 30- to 40-minute procedure as something her colleagues seemingly "don't want to do." She attributed the lack of interest to the young age of typical strabismus patients and to the levels of treatment and follow-up.
Debra A. Koloms, a board-certified ophthalmologist residing and practicing in the Watertown area for the last 10 years, performed surgery to correct an instance of strabismus.
According to the American Academy of Ophthalmology, strabismus is a "visual problem in which the eyes are not aligned properly and point in different directions. One eye may look straight ahead, while the other eye turns inward, outward, upward or downward."
She described the 30- to 40-minute procedure as something her colleagues seemingly "don't want to do." She attributed the lack of interest to the young age of typical strabismus patients and to the levels of treatment and follow-up.
"It can be quite involved," Dr. Koloms said.
Patients have been traveling to Syracuse or Burlington, Vt., to receive the proper treatment for strabismus, she said.
She said the procedure entails shortening or lengthening the muscles attached to the young child's eyes, depending on how much the child's eyes are turned.
"It's time-consuming and intensive compared to cataract surgery," she said. "You want to do it when the child is young and the visual system is developing."
Patients have been traveling to Syracuse or Burlington, Vt., to receive the proper treatment for strabismus, she said.
She said the procedure entails shortening or lengthening the muscles attached to the young child's eyes, depending on how much the child's eyes are turned.
"It's time-consuming and intensive compared to cataract surgery," she said. "You want to do it when the child is young and the visual system is developing."
Corneal biomechanics different in glaucoma patients
PARIS — A prospective study showed that corneas of glaucoma patients have significantly different biomechanical properties than normal corneas.
"We found that glaucomatous corneas are more deformable and less elastic than normal corneas," Cédric Schweitzer, MD, said at the meeting of the French Society of Ophthalmology.
A total of 486 eyes of 273 patients were included in the study and divided into five groups: primary open-angle glaucoma (188 eyes), normal-tension glaucoma (65 eyes), ocular hypertension (22 eyes), high myopia (34 eyes) and controls (177 eyes). The study was conducted at the University of Bordeaux.
In all eyes, IOP and pachymetry were measured. Corneal hysteresis (CH) and corneal resistance factor (CRF), the two main indexes of corneal biomechanics, were measured with the Ocular Response Analyzer (Reichert) and compared between groups.
"After adjustment for corneal pachymetry, both CH and CRF were found to be different between the group of patients with glaucoma and those without glaucoma, including the group with ocular hypertension. The corneas of glaucomatous patients had higher CRF and a lower CH than other groups," Dr. Schweitzer said.
The study was granted an award at the meeting.
"We found that glaucomatous corneas are more deformable and less elastic than normal corneas," Cédric Schweitzer, MD, said at the meeting of the French Society of Ophthalmology.
A total of 486 eyes of 273 patients were included in the study and divided into five groups: primary open-angle glaucoma (188 eyes), normal-tension glaucoma (65 eyes), ocular hypertension (22 eyes), high myopia (34 eyes) and controls (177 eyes). The study was conducted at the University of Bordeaux.
In all eyes, IOP and pachymetry were measured. Corneal hysteresis (CH) and corneal resistance factor (CRF), the two main indexes of corneal biomechanics, were measured with the Ocular Response Analyzer (Reichert) and compared between groups.
"After adjustment for corneal pachymetry, both CH and CRF were found to be different between the group of patients with glaucoma and those without glaucoma, including the group with ocular hypertension. The corneas of glaucomatous patients had higher CRF and a lower CH than other groups," Dr. Schweitzer said.
The study was granted an award at the meeting.
- Disclosure: Dr. Schweitzer has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.
Private eye checks mooted by health board
Diabetes patients at risk of going blind may have more opportunities for checkups if a proposal to hand over screening services to private optometrists is adopted by MidCentral District Health Board.
Retinal screening services are used to detect diabetic retinopathy – a common complication of diabetes that can cause loss of sight.
People with diabetes are generally screened every two years. If they are high risk, they can be screened up to every six months and if any degeneration is detected, the patient is referred to the Ophthalmology Department at Palmerston North Hospital for treatment.
The DHB's community and public health advisory committee recommended changes be made to Palmerston North's screening service so private optometrists could carry out the screening process.
It is hoped the proposal will be adopted by the board on Tuesday.
In recent years, retinal screening services for the Tararua, Otaki and Horowhenua communities have been provided by private optometrists under a contract with Central PHO.
MidCentral is hoping to extend the same service to the Palmerston North and Manawatu communities, which have received their service from Palmerston North Hospital up to now.
MidCentral Health senior portfolio manager of primary healthcare Craig Johnston said the proposal would free up some of the hospital's already stretched resources.
"Using optometrists to provide retinal screening in the community will make for a more convenient service for patients. It will also free up capacity in the ophthalmology department at Palmerston North Hospital, allowing the department to focus on more specialised services."
Mr Johnston said the move would save money as well as create a larger pool of expertise.
"Combining all retinal screening services into one contract will also reduce administration costs and optimise accountability.
"Maintaining a quality service is very important. The MidCentral Health ophthalmology department will be involved in the selection and training of optometrists and will also provide oversight of the service on an ongoing basis," Mr Johnston said.
The proposed changes, which are outlined in the 2010-2011 Annual Plan and a business case, are hoped to be in place on October 1, and will be under a two-year contract.
Retinal screening services are used to detect diabetic retinopathy – a common complication of diabetes that can cause loss of sight.
People with diabetes are generally screened every two years. If they are high risk, they can be screened up to every six months and if any degeneration is detected, the patient is referred to the Ophthalmology Department at Palmerston North Hospital for treatment.
The DHB's community and public health advisory committee recommended changes be made to Palmerston North's screening service so private optometrists could carry out the screening process.
It is hoped the proposal will be adopted by the board on Tuesday.
In recent years, retinal screening services for the Tararua, Otaki and Horowhenua communities have been provided by private optometrists under a contract with Central PHO.
MidCentral is hoping to extend the same service to the Palmerston North and Manawatu communities, which have received their service from Palmerston North Hospital up to now.
MidCentral Health senior portfolio manager of primary healthcare Craig Johnston said the proposal would free up some of the hospital's already stretched resources.
"Using optometrists to provide retinal screening in the community will make for a more convenient service for patients. It will also free up capacity in the ophthalmology department at Palmerston North Hospital, allowing the department to focus on more specialised services."
Mr Johnston said the move would save money as well as create a larger pool of expertise.
"Combining all retinal screening services into one contract will also reduce administration costs and optimise accountability.
"Maintaining a quality service is very important. The MidCentral Health ophthalmology department will be involved in the selection and training of optometrists and will also provide oversight of the service on an ongoing basis," Mr Johnston said.
The proposed changes, which are outlined in the 2010-2011 Annual Plan and a business case, are hoped to be in place on October 1, and will be under a two-year contract.
How retinas develop
Studies by UC Santa Barbara researchers on expanding vision have revealed the basic biological understanding on how retinas develop.
"These studies individually demonstrate the genetic determinants of nerve cell number. Together, they show that different nerve cell types are modulated independent of one another," said Benjamin E. Reese, senior author and professor with the Neuroscience Research Institute and the Department of Psychological and Brain Sciences. he scientists used mice as a research model organism to show that the size of different populations of retinal neurons display wide-ranging variability among individuals.
In the PNAS article, they demonstrated a nearly two-fold variation in the number of interneurons called horizontal cells. In the IOVS article, they report a conspicuous variation in the number of cone photoreceptors.
The team explained that such natural variation in the ratio of nerve cells requires a degree of plasticity in the process of forming neural connectivity, to ensure that the entire visual field is served by neural circuits that mediate our visual abilities.
According to Resse, efforts to use genetic engineering and stem cell biology to repair diseased retinas depend upon a fuller appreciation of the developmental biology of the retina.
"These particular studies are just one contribution in an enormously complex process. Our fundamental interest is in the development the retina-how you 'build' this neural tissue that, when fully mature, will mediate our visual abilities." said Reese.
The studies are published in recent online versions of The Proceedings of the National Academy of Sciences (PNAS), and Investigative Ophthalmology and Visual Science (IOVS).
"These studies individually demonstrate the genetic determinants of nerve cell number. Together, they show that different nerve cell types are modulated independent of one another," said Benjamin E. Reese, senior author and professor with the Neuroscience Research Institute and the Department of Psychological and Brain Sciences. he scientists used mice as a research model organism to show that the size of different populations of retinal neurons display wide-ranging variability among individuals.
In the PNAS article, they demonstrated a nearly two-fold variation in the number of interneurons called horizontal cells. In the IOVS article, they report a conspicuous variation in the number of cone photoreceptors.
The team explained that such natural variation in the ratio of nerve cells requires a degree of plasticity in the process of forming neural connectivity, to ensure that the entire visual field is served by neural circuits that mediate our visual abilities.
According to Resse, efforts to use genetic engineering and stem cell biology to repair diseased retinas depend upon a fuller appreciation of the developmental biology of the retina.
"These particular studies are just one contribution in an enormously complex process. Our fundamental interest is in the development the retina-how you 'build' this neural tissue that, when fully mature, will mediate our visual abilities." said Reese.
The studies are published in recent online versions of The Proceedings of the National Academy of Sciences (PNAS), and Investigative Ophthalmology and Visual Science (IOVS).
Optometrists seek surgery rights in more states after Kentucky victory
In a move physician organizations say endangers patients, a recent law allows optometrists to perform some laser surgeries.
Optometrists are stepping up their fight to expand their scope of practice after the enactment of a Kentucky law this year, making it the second state to let optometrists perform certain surgeries.
Lawmakers in Nebraska, South Carolina and Texas are considering optometry legislation to allow surgery-related scope expansions.Oklahoma was the first state to enact such a law in 1998. Similar legislation has been considered in 25 states since, but none passed until this year, said Daniel Briceland, MD, secretary for state affairs for the American Academy of Ophthalmology.
The Better Access to Quality Eye Care Act was signed into law by Kentucky Gov. Steve Beshear on Feb. 24. It lets optometrists perform a range of new procedures, including Yag capsulotomy -- postcataract surgery -- and argon laser trabeculoplasty and selective laser trabeculoplasty -- both forms of glaucoma surgery.
Several physician organizations, including the American Medical Association, the American College of Surgeons and the AAO, have opposed such efforts, saying optometrists lack adequate medical education and training to perform surgeries and deal with potential complications. In Oklahoma, some patients have been harmed because of botched procedures by optometrists, said Cynthia Bradford, MD, AAO senior secretary for advocacy.
In 1998, Oklahoma became the first state to allow optometrists to perform some eye surgeries.
But proponents argue that optometrists have a strong safety record and that the Oklahoma and Kentucky laws expand needed services to people living in medically underserved areas.
"We must commit to redoubling our efforts," American Optometric Assn. President Joe E. Ellis, OD, said in a statement to members on the organization's website. "Now is the time for optometry to build upon this most recent victory and fight to ensure that our message ... is heard loud and clear in the nation's capital and in the statehouses across the country: ODs have the training and education to provide much-needed treatment now, but outdated laws and discriminatory practices are holding back greater patient access to quality optometric care."
American Optometric Assn. officials did not respond to multiple requests to be interviewed for this article. The Oklahoma Assn. of Optometric Physicians declined to comment.
A new precedent in Kentucky
The bills being considered in Nebraska and Texas would allow optometrists to remove skin lesions from eyelids and do some laser procedures, including capsulotomies and trabeculoplasties. The bills also would authorize optometry schools in those states to perform and teach such procedures.The bills in Nebraska and Texas and legislation in South Carolina would enable optometrists to make injections into the eyelid. The proposals in each state have been referred to legislative committees.
The Kentucky law sets a new precedent, Dr. Briceland said. In addition to expanding optometrists' scope of practice, it gives the Kentucky Board of Optometric Examiners full oversight to determine what training will be required of optometrists who want to perform laser surgeries.
"It's like the fox guarding the henhouse to have your regulation and discipline done by the same board" that also determines types of procedures and training guidelines, said Woodford VanMeter, MD, an ophthalmologist and president of the Kentucky Academy of Eye Physicians and Surgeons.
Opponents of the Kentucky legislation argued that they weren't given fair opportunity to debate it before passage.
"We are greatly concerned ... that SB 110 was pushed through the Kentucky House and Senate with barely more than a few hours of debate," AMA Executive Vice President and Chief Executive Officer Michael D. Maves, MD, MBA, said in a Feb. 22 letter to Kentucky's governor. "There has been more discussion of SB 110 on the radio and in newspapers."
In his March 2 statement, Ellis, of the American Optometric Assn., said the Kentucky law would expand access to essential health and vision services. "Importantly, it also allows the Board of Optometric Examiners sole authority to determine what constitutes the practice of optometry. Anti-optometry forces will have no power to define our profession," he said.
Optometrists are located in 106 out of 120 Kentucky counties while ophthalmologists practice in only about 40, said Ben Gaddie, OD, president of the Kentucky Optometric Assn.
"We have worked for decades in concert with ophthalmologists in the pre- and postsurgical care of patients, including the identification and monitoring of surgical and laser complications. We now will be able to fully utilize our training to the benefit of Kentucky patients," he said.
But Dr. VanMeter said there is no merit to the access-to-care argument, because there are enough ophthalmologists to meet demand. There's no waiting time for eye surgeries in the state, he said.
Dr. Bradford, of the American Academy of Ophthalmology, said quality of care should not be compromised for convenience.
Patient confusion adds to debate
Many people don't understand the difference between optometrists and ophthalmologists, physicians say. An AMA survey of 850 U.S. adults in 2010 found that 54% believe optometrists are medical doctors.Ophthalmologists have four years of medical or osteopathic education followed by three to seven years of residency and fellowship training, including surgical training. A doctor of optometry degree requires four years of doctoral-level study concentrating on the structure, function and disorders of the eye, according to the American Optometric Assn. website.
In Oklahoma, optometrists gained the ability to perform certain laser procedures under the 1998 law, with exceptions including laser-assisted in situ keratomileusis (LASIK), retina procedures and cosmetic lid surgeries. They can perform some scalpel surgeries, under provisions added to a pharmacy bill passed in 2004, said Dr. Bradford, who also is past president of the Oklahoma Academy of Ophthalmology.
Despite the scope expansions, Dr. Bradford said not many Oklahoma optometrists are performing surgeries, but there have been problems. In one case, an optometrist gave a patient multiple injections for a bump on her eyelid he mistook as a chalazion, or cyst, but it turned out to be a malignant skin cancer that was diagnosed too late, she said.
In another case, a patient experienced vision loss after an optometrist performed photorefractive keratectomy even though she was not a good candidate for the surgery. The patient sued, and the case was later settled.
"Once a law is passed, it's very hard to undo it," Dr. Bradford said. "We as physicians need to realize that nonphysicians are going to seek the right to practice medicine, and they're going to turn to legislation to do that."
Slideshow: People on the Move for May 23 Read more: Slideshow: People on the Move for May 23 | Atlanta Business Chronicle
- Emory-Adventist Hospital at Smyrna recently added Dr. Bryan Jefferies to the active medical staff. Dr. Jefferies is board-certified in ophthalmology and is a fellow of the American Academy of Ophthalmology. Dr. Jefferies received his Bachelor of Arts with Honors in Biology from Cedarville University in Ohio and his Doctor of Medicine from Indiana University School of Medicine.
- Jesse Walton Jr. was inducted as a new member of the 100 Black Men of Atlanta Inc. organization. Walton, a financial adviser and Certified Financial Planner (CFP) at Morgan Stanley Smith Barney in Alpharetta, is an active community volunteer. As an investment professional in the financial services industry since 2000 and Certified Financial Planner (CFP), Walton focuses on assisting high net worth families, businesses, and non-profit organizations with investment management, comprehensive financial planning and business solutions. His practice concentrates on retirement planning, income distribution planning and wealth protection strategies for pre-retiree and retirees. Raised in South DeKalb County, Walton earned a football scholarship to Howard University and graduated with a BBA degree in International Business. He furthered his studies and received an MSE degree from Georgia State University. Later, he earned an Executive Certificate in Financial Planning from Duke University, a Certified Investment Management Analyst (CIMA) designation, which is taught in conjunction with The Wharton School of Business, University of Pennsylvania and sponsored by the Investment Management Consulting Association.
- Sustainable Atlanta, a 501 (c)(3) nonprofit organization focused on sustainability policy and programs, hired Suzanne Burnes as its new executive director. A veteran with nearly two decades of environmental experience at both federal and state levels, Burnes will focus initially on fortifying partnerships with strategic partner organizations throughout the Atlanta community including the city of Atlanta and mapping out future opportunities to provide resources that advance Atlanta’s comprehensive sustainability efforts and economic competitiveness. Burnes earned a bachelor’s degree in environmental studies from Warren Wilson College in North Carolina with an emphasis on environmental policy. She is a native of North Georgia and currently resides in East Atlanta with her husband and two children. She has been active in both community and environmental advocacy for several years having served on the boards of the Green Meeting Industry Council, SouthStar Community Development Corp., and Generation Green, a program of the Georgia Conservancy.
- Grizzard Communications Group announced that they have hired Karen E. Gleason as group vice president and senior strategist. Gleason will be responsible for leadership on national accounts and developing strategies for multichannel fundraising for a variety of clients. Gleason has more than 18 years of nonprofit health-care and agency experience and graduated from Furman University with a Bachelor of Arts. She serves on the Direct Marketing Association Advisory Council Nonprofit Board and sat on the Nonprofit Alliance Board from 2005 to 2010.
Saturday, May 21, 2011
Addenbrooke’s and Rosie staff pass on knowledge to their overseas counterparts
Doctors and nurses from Addenbrooke’s and the Rosie hospitals are offering their valuable skills to hospitals in the developing world.
Since Addenbrooke’s Abroad was set up in 2006, the charity has financially supported more than 100 hospital staff to undertake their jobs in 25 ‘resource poor’ countries as well as carrying out training with their overseas counterparts.
Addenbrooke’s Abroad - which is part of Addenbrooke’s Charitable Trust (ACT) - has also provided 60 bursaries to trainee doctors so they can undertake part of their training in a developing country.
Staff at the internationally renowned Cambridge hospitals – both medical and administrative - are asked to inform the Addenbrooke’s Abroad office on the biomedical campus of any related overseas voluntary work.
And the office has seen personnel travel to a myriad of countries offering their lifesaving or life-enhancing skills at the same time as increasing their own knowledge.
Those who struggle to pay their own travel costs can apply to Addenbrooke’s Abroad for a grant to help them to carry out their job overseas during periods of paid or unpaid leave.
Project director of Addenbrooke’s Abroad Evelyn Brealey said: “Addenbrooke’s recognises we rely hugely on staff from overseas to deliver our services and it is important that we give something back.
“There is also that personal satisfaction in giving something back.”
Mrs Brealey said it often enhances the skills of medical professionals to work in resource poor countries.
She said: “There is often an awful lot you can do without necessarily having lots of tests and equipment.”
While Addenbrooke’s staff have volunteered to help out in numerous countries, Addenbrooke’s Abroad has established links with hospitals and clinics in Botswana as well as the National Maternity Hospital in El Salvador in Central America.
Many members of staff from Addenbrooke’s and the Rosie have travelled to the African and Central American hospitals and have played host to their medical teams during visits to Cambridge.
And it is not just medical staff who have benefited from the exchanges.
Mrs Brealey said: “The leadership and management of the healthcare sector in Botswana is weak and Addenbrooke’s has done a huge amount of development in leadership and management.”
The link with the Princess Marina Hospital in Gaborone, the capital of Botswana, began as part of an ophthalmology programme to address diabetic retinopathy, the country’s second biggest cause of blindness.
Ophthalmic nurse at Addenbrooke’s Debbie Jankowski helped to launch a screening programme at the hospital and has travelled to Botswana twice to offer her skills and wisdom.
Ms Jankowski has also taught the African nurses how to recognise and treat the signs of early glaucoma.
She said: “Giving ophthalmic presentations and talks in Botswana boosted my confidence as a nurse and I feel that it has helped me progress considerably here in the UK.”
Medical photographer Catherine Martin, 41, travelled to Botswana in October to work on the diabetic retinopathy screening programme at the Princess Marina Hospital.
Miss Martin trained ophthalmic nurses at the African hospital to use a retinal camera to look at the back of the eye.
Should the early signs of diabetic retinopathy be detected, a patient can then undergo laser treatment to prevent blindness and Miss Martin said they were keen to offer this on the same day.
This is because Botswana’s population is spread over a vast rural area and therefore will often not make a second journey to hospital for treatment.
She said: “There is a big stigma in the country that if you go into the hospital you will not leave.
“The nurses I was training were very willing to learn and the experience made me realise how lucky we are in this country to have the facilities and the transport links so we can get to hospital quickly.”
Mrs Brealey stressed that no NHS resources are committed to Addenbrooke’s Abroad and many charitable events are held to raise funds.
Dr Mary Archer, the chairman of Cambridge University Hospitals NHS Foundation Trust, is hosting a fundraising evening of Latin American music at her Grantchester home on July 10 to celebrate Addenbrooke’s Abroad’s link with El Salvador.
It follows an African evening last year marking the charity’s link with Botswana.
Mrs Brealey said: “There is a lot of interest in Cambridge in international development issues.
“It is fantastic for people to see how their local hospital can contribute to international development while at the same time seeing their own hospital benefit.”
Surgeon faces suspension after tax evasion
SINGAPORE: Renowned eye surgeon Currie Chiang, who pleaded guilty on Thursday to tax evasion, faces a possible suspension from medical practice, her lawyers told the court.
Dr Chiang, who is liable to a jail term of at least six months, will face difficulties as a single mother to support her daughter, who is also a medical student, and her elderly mother, the court heard.
Dr Chiang was charged in September last year with three counts of tax evasion.
One charge was withdrawn on Thursday, with the courts proceeding on two counts.
For the years of assessment 2006 and 2007, she did not declare incomes totalling close to S$30,000. She faces a penalty of nearly S$118,000 -- close to four times the undeclared amount.
Her lawyers told the court that she was an illustrious medical practitioner.
Before setting up her own private practice The International Eye Clinic in 1993, 55-year-old Dr Chiang served in the Department of Ophthalmology in Singapore General Hospital, and was a consultant for the now-defunct Toa Payoh Hospital.
She "flew the Singapore flag proudly", having studied and practiced ophthalmology - a medical field involving the treatment and surgery of the eyes - in London, Manchester and Edinburgh, her lawyers said.
Besides working with prominent eye specialists in the United Kingdom and the United States, she was also known for her pro-bono work, providing eye treatment to villagers in Nepal and Batam.
Her peers at the Singapore General Hospital described her as "gentle and kind" as well as being an "excellent" ophthalmologist, the court heard.
But the prosecution said that tax evasion is a very serious offence and is not in line with public interest.
Dr Chiang's sentencing has been set for May 13.
Dr Chiang, who is liable to a jail term of at least six months, will face difficulties as a single mother to support her daughter, who is also a medical student, and her elderly mother, the court heard.
Dr Chiang was charged in September last year with three counts of tax evasion.
One charge was withdrawn on Thursday, with the courts proceeding on two counts.
For the years of assessment 2006 and 2007, she did not declare incomes totalling close to S$30,000. She faces a penalty of nearly S$118,000 -- close to four times the undeclared amount.
Her lawyers told the court that she was an illustrious medical practitioner.
Before setting up her own private practice The International Eye Clinic in 1993, 55-year-old Dr Chiang served in the Department of Ophthalmology in Singapore General Hospital, and was a consultant for the now-defunct Toa Payoh Hospital.
She "flew the Singapore flag proudly", having studied and practiced ophthalmology - a medical field involving the treatment and surgery of the eyes - in London, Manchester and Edinburgh, her lawyers said.
Besides working with prominent eye specialists in the United Kingdom and the United States, she was also known for her pro-bono work, providing eye treatment to villagers in Nepal and Batam.
Her peers at the Singapore General Hospital described her as "gentle and kind" as well as being an "excellent" ophthalmologist, the court heard.
But the prosecution said that tax evasion is a very serious offence and is not in line with public interest.
Dr Chiang's sentencing has been set for May 13.
Single Bioptic Telescope For Low Vision Driving May Not Obscure Road View Of Second Eye
A study by scientists at Schepens Eye Research Institute shows that a bioptic telescope on one lens of a pair of glasses used to magnify traffic signs and lights may not prevent the wider view of the road with the second eye. The study results, which will be published in the May 2011 Archives of Ophthalmology, are the first evidence that--under more realistic viewing conditions than in earlier studies--the second eye can detect objects in the area obscured by the magnification effect of the telescope (called the ring scotoma).
"These study results are significant because they should ease official and public concerns about the safety of bioptic telescope use for driving with visual impairments," says Dr. Eli Peli, the principal investigator of the study, who is a low vision expert, a senior Schepens scientist, and a professor of Ophthalmology at Harvard Medical School.
In previous studies, participants wearing the bioptic telescope were asked to view a blank (plain) background and focus on a simple fixation point—a cross— while detecting random visual targets presented to them, a task that requires little attention and concentration.
"Our current study required subjects to view more complex, textured backgrounds and focus on and read letters, which are more akin to visual situations encountered in real life and on the road," says Peli.
Bioptics, developed more than 100 years ago, are small telescopes that are attached above the center of one spectacle lens. A slight downward tilt of the head and upward shift of the eyes can bring a distant road sign or traffic light into view for people with vision impairments. When looking through the telescope, a blind area (scotoma) is created due to the magnification of the telescope. The blind area is in the shape of a ring surrounding what is seen through the telescope (hence the name "ring scotoma"). For instance, a person viewing a traffic light with the telescope will see the light, but will not be able to see the surrounding intersection, with the same eye. Although bioptics were introduced as driving aids 50 years ago and are approved for driving in 39 states, safety has remained a concern, in particular the effect of the ring scotoma on detection of traffic hazards. In some states this concern resulted in restricting the telescope to one eye only, leaving the other to monitor the area of the ring scotoma during telescope use.
In the Archives of Ophthalmology study, Amy Doherty, the first author, and the research team, conducted a series of tests evaluating the ability of the second (fellow) eye to detect targets in the area of the ring scotoma on both simple and complex backgrounds, with and without the bioptic telescope on one lens.
They began by fitting 14 subjects with bioptic glasses and used a novel display system that allowed them to present visual stimuli to each eye separately while both eyes were watching the screen. The team then "mapped" or determined the dimensions and position of the blind area (ring scotoma) in each subject's telescopic eye by presenting visual stimuli only to that eye.
Next, each subject underwent four viewing conditions while wearing the telescope in front of one eye, and the same four conditions without the telescope. In all cases, both eyes were open, while a visual stimulus or target (a small checkerboard square), presented to the second eye only, appeared randomly in different parts of the ring scotoma area. The subjects pressed a button whenever they saw the target.
The four conditions were: passively viewing a cross on a gray background, passively viewing a cross on a more complex textured background, actively reading letters on a gray background, and actively reading letters on the textured background. The textured background seen magnified in the telescopic eye resulted in a rivalry (competition) effect between the images from the two eyes that could result in the brain ignoring (suppressing) the image from the second eye. Any suppression of the second eye when looking through a bioptic telescope could potentially result in a traffic hazard not being noticed.
In all cases no significant difference was found between what the second eye saw when the first eye was using the telescope and when it wasn't using the telescope. With the bioptics, the second eye was able to detect the target 86 percent of the time, while without the bioptics, it detected the target 87 percent of the time. As expected, more targets were detected on a gray background than on a textured background and while focused on a simple cross than while reading letters.
"These results suggest that the bioptic driver may not be blind to traffic when looking through the telescope, because the second eye can detect targets in the area obscured by the telescope," says Doherty.
While the study results are encouraging, Peli and Doherty agree that it is still essential to test the use of bioptics in even more realistic circumstances.
"Our next testing conditions will be with video segments that closely mimic the visual scene and attention required during actual driving situations," says Doherty, who adds that over time, the research team also hopes to gather data from driving simulators and even actual on-the-road monitoring.
"These study results are significant because they should ease official and public concerns about the safety of bioptic telescope use for driving with visual impairments," says Dr. Eli Peli, the principal investigator of the study, who is a low vision expert, a senior Schepens scientist, and a professor of Ophthalmology at Harvard Medical School.
In previous studies, participants wearing the bioptic telescope were asked to view a blank (plain) background and focus on a simple fixation point—a cross— while detecting random visual targets presented to them, a task that requires little attention and concentration.
"Our current study required subjects to view more complex, textured backgrounds and focus on and read letters, which are more akin to visual situations encountered in real life and on the road," says Peli.
Bioptics, developed more than 100 years ago, are small telescopes that are attached above the center of one spectacle lens. A slight downward tilt of the head and upward shift of the eyes can bring a distant road sign or traffic light into view for people with vision impairments. When looking through the telescope, a blind area (scotoma) is created due to the magnification of the telescope. The blind area is in the shape of a ring surrounding what is seen through the telescope (hence the name "ring scotoma"). For instance, a person viewing a traffic light with the telescope will see the light, but will not be able to see the surrounding intersection, with the same eye. Although bioptics were introduced as driving aids 50 years ago and are approved for driving in 39 states, safety has remained a concern, in particular the effect of the ring scotoma on detection of traffic hazards. In some states this concern resulted in restricting the telescope to one eye only, leaving the other to monitor the area of the ring scotoma during telescope use.
In the Archives of Ophthalmology study, Amy Doherty, the first author, and the research team, conducted a series of tests evaluating the ability of the second (fellow) eye to detect targets in the area of the ring scotoma on both simple and complex backgrounds, with and without the bioptic telescope on one lens.
They began by fitting 14 subjects with bioptic glasses and used a novel display system that allowed them to present visual stimuli to each eye separately while both eyes were watching the screen. The team then "mapped" or determined the dimensions and position of the blind area (ring scotoma) in each subject's telescopic eye by presenting visual stimuli only to that eye.
Next, each subject underwent four viewing conditions while wearing the telescope in front of one eye, and the same four conditions without the telescope. In all cases, both eyes were open, while a visual stimulus or target (a small checkerboard square), presented to the second eye only, appeared randomly in different parts of the ring scotoma area. The subjects pressed a button whenever they saw the target.
The four conditions were: passively viewing a cross on a gray background, passively viewing a cross on a more complex textured background, actively reading letters on a gray background, and actively reading letters on the textured background. The textured background seen magnified in the telescopic eye resulted in a rivalry (competition) effect between the images from the two eyes that could result in the brain ignoring (suppressing) the image from the second eye. Any suppression of the second eye when looking through a bioptic telescope could potentially result in a traffic hazard not being noticed.
In all cases no significant difference was found between what the second eye saw when the first eye was using the telescope and when it wasn't using the telescope. With the bioptics, the second eye was able to detect the target 86 percent of the time, while without the bioptics, it detected the target 87 percent of the time. As expected, more targets were detected on a gray background than on a textured background and while focused on a simple cross than while reading letters.
"These results suggest that the bioptic driver may not be blind to traffic when looking through the telescope, because the second eye can detect targets in the area obscured by the telescope," says Doherty.
While the study results are encouraging, Peli and Doherty agree that it is still essential to test the use of bioptics in even more realistic circumstances.
"Our next testing conditions will be with video segments that closely mimic the visual scene and attention required during actual driving situations," says Doherty, who adds that over time, the research team also hopes to gather data from driving simulators and even actual on-the-road monitoring.
REIT to Spend $36.8M on Bedford, Texarkana Healthcare Facilities
American Realty Capital Healthcare Trust reported Thursday that it anticipates acquiring a free-standing, fee simple rehabilitation hospital in Bedford, TX and a free-standing fee simple ambulatory surgery center in Texarkana, TX for a total of $36.8 million.
Bedford, TX Rehab Hospital
The rehabilitation hospital in Bedford, TX is leased to Reliant Healthcare Partners, LLC, an operating joint venture between Nautic Partners, LLC and a physician group. Nautic and the physician group own 74% and 26% of Reliant Healthcare Partners, respectively.
The property contains 65,141 square feet of gross leasable area and 60 beds. The property is a clinical inpatient facility that provides nurse and therapy staff, ancillary services and supplies to treat patients who require intensive rehabilitative care generally after receiving treatment or service at an acute care hospital. The property is approximately one mile from Harris Methodist HEB Hospital, five miles from North Hills Hospital, and seven miles from Baylor Regional Medical Center at Grapevine.
The purchase price of the property is $32.3 million at a capitalization rate of 10.20%. American Realty Capital Healthcare Trust intends to fund sixty percent of the purchase price. The remainder will come from a first mortgage loan from a lender yet to be identified. Bedford Hospital Partners, L.P, which developed the property, will provide $3.5 million in personal guarantees for up to seven years from the lease commencement date which amount is reduced in multiple increments if Reliant Healthcare Partners achieves certain pre-prescribed performance metrics.
Reliant Healthcare Partners fully leases the asset via a lease with a twenty year term that commenced upon completion of the construction of the hospital and expires on October 23, 2030. The trade is expected to occur in September 2011. The lease contains 2.0% fixed annual rental escalations during the primary term and two renewal options of ten years each at market rates. The lease is triple net.
The total annual rent for the initial lease term will be approximately $2.7 million increasing on October 24, 2011.
Nautic, a private equity firm with over $2.5 billion of capital under management, purchased Reliant Hospital Partners in March 2011 and subsequently formed the joint venture with the physicians group. Nautic currently has four active investments in healthcare-related companies and has exited from eleven various healthcare related companies throughout its history. Nautic targets equity investments of $25 to $75 million.
Texarkana Surgery Center
American Realty Capital Healthcare Trust anticipates acquiring one free-standing fee simple ambulatory surgery center in Texarkana, Texas.
The tenant of the property will be Texarkana Surgery Center, L.P., an operating joint venture between Symbion, Inc. ("Symbion") and a 23-member physician group. The physician group and Symbion own 42% and 58% of Texarkana Surgery, respectively.
The property contains 17,500 rentable square feet which includes four operating rooms, a pre-op holding area, a recovery room, an x-ray room and a minor procedure room. The property was completed as a build-to-suit facility for the physicians in 1995 that later formed Texarkana Surgery with Symbion in 2000.
The purchase price of the property is $4.5 million at a capitalization rate of 9.42 percent. American Realty Capital Healthcare Trust intends to fund one hundred percent of the purchase price.
The property is 100% leased to Texarkana Surgery via a 10 year lease that expires on April 30, 2021. American Realty Capital Healthcare Trust estimate that it will close on the acquisition in June 2011. The lease contains 2.0% fixed annual rental escalations during the primary term.
This lease is double net. The landlord, American Realty Capital Healthcare Trust, is responsible for maintaining the roof and structure of the building and Texarkana Surgery is required to pay substantially all other operating expenses, in addition to base rent. The total annual rent for the initial lease term will be approximately $393,000.
Approximately 50 doctors practice at the Texarkana Surgery facility within various specialties with no procedure type representing more than 20% of the revenues. Primary services include ophthalmology and ear, nose and throat.
Symbion, located in Nashville, Tennessee, is an operator of short-stay surgical facilities. The company was founded in 1999 to acquire, develop and operate short-stay surgical facilities in partnership with physicians, hospitals and health systems.
Bedford, TX Rehab Hospital
The rehabilitation hospital in Bedford, TX is leased to Reliant Healthcare Partners, LLC, an operating joint venture between Nautic Partners, LLC and a physician group. Nautic and the physician group own 74% and 26% of Reliant Healthcare Partners, respectively.
The property contains 65,141 square feet of gross leasable area and 60 beds. The property is a clinical inpatient facility that provides nurse and therapy staff, ancillary services and supplies to treat patients who require intensive rehabilitative care generally after receiving treatment or service at an acute care hospital. The property is approximately one mile from Harris Methodist HEB Hospital, five miles from North Hills Hospital, and seven miles from Baylor Regional Medical Center at Grapevine.
The purchase price of the property is $32.3 million at a capitalization rate of 10.20%. American Realty Capital Healthcare Trust intends to fund sixty percent of the purchase price. The remainder will come from a first mortgage loan from a lender yet to be identified. Bedford Hospital Partners, L.P, which developed the property, will provide $3.5 million in personal guarantees for up to seven years from the lease commencement date which amount is reduced in multiple increments if Reliant Healthcare Partners achieves certain pre-prescribed performance metrics.
Reliant Healthcare Partners fully leases the asset via a lease with a twenty year term that commenced upon completion of the construction of the hospital and expires on October 23, 2030. The trade is expected to occur in September 2011. The lease contains 2.0% fixed annual rental escalations during the primary term and two renewal options of ten years each at market rates. The lease is triple net.
The total annual rent for the initial lease term will be approximately $2.7 million increasing on October 24, 2011.
Nautic, a private equity firm with over $2.5 billion of capital under management, purchased Reliant Hospital Partners in March 2011 and subsequently formed the joint venture with the physicians group. Nautic currently has four active investments in healthcare-related companies and has exited from eleven various healthcare related companies throughout its history. Nautic targets equity investments of $25 to $75 million.
Texarkana Surgery Center
American Realty Capital Healthcare Trust anticipates acquiring one free-standing fee simple ambulatory surgery center in Texarkana, Texas.
The tenant of the property will be Texarkana Surgery Center, L.P., an operating joint venture between Symbion, Inc. ("Symbion") and a 23-member physician group. The physician group and Symbion own 42% and 58% of Texarkana Surgery, respectively.
The property contains 17,500 rentable square feet which includes four operating rooms, a pre-op holding area, a recovery room, an x-ray room and a minor procedure room. The property was completed as a build-to-suit facility for the physicians in 1995 that later formed Texarkana Surgery with Symbion in 2000.
The purchase price of the property is $4.5 million at a capitalization rate of 9.42 percent. American Realty Capital Healthcare Trust intends to fund one hundred percent of the purchase price.
The property is 100% leased to Texarkana Surgery via a 10 year lease that expires on April 30, 2021. American Realty Capital Healthcare Trust estimate that it will close on the acquisition in June 2011. The lease contains 2.0% fixed annual rental escalations during the primary term.
This lease is double net. The landlord, American Realty Capital Healthcare Trust, is responsible for maintaining the roof and structure of the building and Texarkana Surgery is required to pay substantially all other operating expenses, in addition to base rent. The total annual rent for the initial lease term will be approximately $393,000.
Approximately 50 doctors practice at the Texarkana Surgery facility within various specialties with no procedure type representing more than 20% of the revenues. Primary services include ophthalmology and ear, nose and throat.
Symbion, located in Nashville, Tennessee, is an operator of short-stay surgical facilities. The company was founded in 1999 to acquire, develop and operate short-stay surgical facilities in partnership with physicians, hospitals and health systems.
Nice: IRIS Pharma and OPIA Technologies announce Licence Agreement
OPIA Technologies developp innovative medical devices for ophthalmology in animal studies
Iris Pharma, a world leader CRO specialized in ophthalmology, and OPIA Technologies, a company developping innovative medical devices for ophthalmology, announced they have entered into a long-term licence agreement for the development of EYEPRIM®,OPIA's main device platform, in animal studies.As part of the agreement, Iris Pharma will obtain the exclusive licence for the use of EYEPRIM® device to perform ocular surface biopsies of the living eye in its preclinical research activities.
"Gaining access to intellectual property and innovative medical device benefit our customers, and Iris Pharma sees significant value from this license agreement," said Dr. Pierre-Paul Elena, Founder and CEO, Iris Pharma.
"Using this new device into our preclinical models will improve them greatly. We will be able for example to assess many other endpoints and will obtain for sure outstanding results. Furthermore, by setting up such a device in animal we will give the veterinarians access to a very helpful tool for better diagnosis."
OPIA's patented sampling device is a reliable and efficient tool to perform conjunctival impressions. The conjunctival impression technique allows the most superficial layer of the conjunctival epithelial cells (both goblet and non-goblet cells) to be collected from the conjunctival mucosa in a quasi-painless and non-invasive way, for the purpose of analyses and diagnosis. EYEPRIM® device should become a diagnostic test template in the near future.
"Through this agreement, we are providing Iris Pharma access to our patented technology which they can use in their continued development of high level and expert preclinical services," said Pierre Roy, President, OPIA Technologies. "The outcome of such an agreement is very promising, thus, the initial results of our collaboration will be presented at the Association for Research in Vision and Ophthalmology (ARVO) 2011 Annual Meeting in May on a poster on the evaluation of membranes material for impression cytology."
More information: www.iris-pharma.com
Iranian Health Minister Urges Expansion of Medical Cooperation with Russia
She visited children and adults wards in Moscow ophthalmology center as well as installations for manufacturing ophthalmology equipment next to the center.
The center has 1,500 employees, 360 ophthalmologists and more than five million patients refer to the center annually.
Vahid Dastjerdi also visited gynecology center and talked with Iranian students there.
At the end of her visit, the minister expressed hope that the two countries can cooperate in exchanging medical experiences as well as doing joint projects.
She arrived in Moscow on Tuesday to attend the First Global Ministerial Conference on Healthy Lifestyles and Non-communicable Disease Control.
The two-day conference was held by the United Nations Health Center in Moscow on 28-29 April 2011.
The Iranian minister delivered a speech at the conference and brief participants about Iran's scientific, educational and treatment experiences.
She also held separate meetings with her foreign counterparts to discuss expansion of ties and mutual cooperation in areas of health and healthcare.
National Health Care Organizations Unite to Warn the Public About the Dangers of Indoor Tanning
In light of mounting scientific evidence showing that indoor tanning increases the risk for developing skin cancer, including melanoma, the deadliest form of skin cancer, a contingent of national health care organizations have joined together to highlight the dangers of indoor tanning. Physicians from these organizations are concerned about the impact of indoor tanning on the public's health, particularly young women. Joining together are the American Academy of Dermatology Association (AADA), American Academy of Pediatrics (AAP), American Academy of Ophthalmology (AAO), American Cancer Society Cancer Action Network (ACS CAN), American College of Physicians (ACP), American Congress of Obstetricians and Gynecologists (ACOG), American Medical Association (AMA), American Osteopathic Association (AOA), Melanoma Research Foundation (MRF), National Council on Skin Cancer Prevention (NCSCP) and The Skin Cancer Foundation (SCF).
The health care organizations held a congressional briefing to discuss the dangers of indoor tanning. Tanning beds are classified by the World Health Organization's (WHO) International Agency for Research on Cancer (IARC) as group 1 - carcinogenic to humans, the highest cancer risk category. The physicians' concerns stem from rising melanoma rates. In fact, melanoma, the deadliest form of skin cancer, is increasing faster in young women than in young men – and a major difference in behavior is that women are more likely to use indoor tanning beds. Nearly 70 percent of tanning salon patrons are Caucasian girls and women, primarily aged 16 to 29 years.
The AADA recently released results of a new survey that reviewed indoor tanning behavior in teen girls. While many teens and young adults – particularly females – acknowledge that indoor tanning is dangerous, they continue to tan indoors.
"In our recent survey, the majority (86 percent) of indoor tanners think using tanning beds can cause skin cancer, yet they still think that people look more attractive with a tan (87 percent)," said Ronald L. Moy, M.D., FAAD, president of the AADA. "It is imperative that we reach out to our young people and correct this misconception that a tan is a sign of good health while reinforcing the message that a tan is the body's response to damage from ultraviolet light."
"Using tanning beds increases one's risk for melanoma by 75 percent and melanoma is now the most common form of cancer for young adults 25-29 years old, and is the second most common form of cancer for adolescents and young adults 15-29 years old," said Cecil B. Wilson, M.D., president of the AMA.
"Pediatricians have been warning our young patients about the dangers of indoor tanning for years," said O. Marion Burton, M.D., FAAP, president of the AAP. "We are seeing rapidly increasing skin cancer rates, particularly for melanoma in young women, which adds further incentive to promote our message loud and clear: tanning beds are not safe for young people."
"Promoting women's health issues is central to our mission and we see the issue of indoor tanning as a growing problem, especially among young women," said Richard N. Waldman, M.D., president of the ACOG. "Most young women with melanoma are developing it on their torso, which may be the result of high-risk tanning behaviors such as indoor tanning."
Studies also have demonstrated that exposure to UV radiation during indoor tanning can lead to eye damage. "The AAO is committed to educating people that the eyes are at risk from UV exposure during indoor tanning," said Richard L. Abbott, M.D., president of AAO. "Tanning beds can produce UV levels up to 100 times what you would get from the sun, which can cause serious damage to the external and internal structures of the eye and eyelids."
As the number of diagnosed cases of skin cancer continues to increase – current estimates are that one in five Americans will develop skin cancer during his or her lifetime – prevention and early diagnosis of skin cancer remain important health messages for all health care organizations.
"Prevention is one of the most valuable tools that we have as physicians. We need to continue educating patients about the risks of indoor tanning and encouraging healthy decisions to help prevent skin cancer," said Virginia L. Hood, MBBS, MPH, FACP, president of ACP.
"Everyone needs to take preventive steps to protect themselves from unnecessary ultraviolet exposure, including avoiding indoor tanning beds. The regulation of indoor tanning devices needs to be updated to reflect what we know about their carcinogenic effects," said Christopher W. Hansen, president of ACS CAN.
"Approximately 75 percent of all skin cancer deaths are from melanoma," said Tim Turnham, Ph.D., executive director of the MRF. "In fact, one American dies from melanoma almost every hour and the Melanoma Research Foundation will continue to educate the public about the prevention, diagnosis and treatment of melanoma, and the need for a cure."
"The damage caused by UV radiation from tanning beds is cumulative and often irreversible, and the earlier people start to tan, the higher their risk of developing skin cancer in their lifetimes," said Perry Robins, M.D., president of SCF.
"The AOA encourages the public to make healthy lifestyle choices, especially when it comes to their skin," said Karen J. Nichols, DO, president of AOA. "And to be familiar enough with their skin to catch skin cancer early when it's most treatable."
"The five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 98 percent," said Sandra I. Read, M.D., FAAD, co-chair of the NCSCP. "Everyone should perform regular self-exams and if you notice a mole that is different from others, or that changes, itches, or bleeds, you should make an appointment to see your physician as soon as possible."
May is Melanoma/Skin Cancer Detection and Prevention Month®. Visit www.melanomamonday.org to find out how to perform a skin self-exam, download a body mole map or find free skin cancer screenings in your area.
About the American Academy of Dermatology Association:
The American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. A sister organization to the Academy, the American Academy of Dermatology Association is the resource for government affairs, health policy and practice information for dermatologists, and plays a major role in formulating policies that can enhance the quality of dermatologic care. With a membership of more than 17,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the Academy at (888) 462-DERM (3376) or www.aad.org.
About the American Academy of Pediatrics:
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults (www.aap.org). Follow the AAP on Twitter and Facebook.
About the American Academy of Ophthalmology:
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons—Eye M.D.s—with more than 29,000 members worldwide. Eye health care is provided by the three "O's" – opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.
About the American Cancer Society Cancer Action Network (ACS CAN):
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit www.acscan.org.
About the American College of Physicians:
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 130,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter and Facebook.
About the American Congress of Obstetricians and Gynecologists:
The American Congress of Obstetricians and Gynecologists (www.acog.org) is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 55,000 members, the American Congress of Obstetricians and Gynecologists strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care. Follow us on Twitter at www.twitter.com/acognews.
About the American Osteopathic Association:
The American Osteopathic Association (AOA) proudly represents its professional family of more than 70,000 osteopathic physicians (DOs); promotes public health; encourages scientific research; serves as the primary certifying body for DOs; is the accrediting agency for osteopathic medical schools; and has federal authority to accredit hospitals and other health care facilities. More information on DOs/osteopathic medicine can be found at www.osteopathic.org.
About Melanoma Research Foundation:
The Melanoma Research Foundation (MRF) is the largest independent, national organization devoted to melanoma in the United States. Committed to the support of medical research in finding effective treatments and eventually a cure for melanoma, the MRF also educates patients and physicians about prevention, diagnosis and the treatment of melanoma. The MRF is an active advocate for the melanoma community, helping to raise awareness of this disease and the need for a cure. The MRF's website is the premier source for melanoma information seekers. More information is available at http://www.melanoma.org/.
About the National Council on Skin Cancer Prevention:
The National Council on Skin Cancer Prevention is the united voice of 45 organizations, associations, and agencies dedicated to reducing skin cancer morbidity and mortality in the United States. The National Council members represent some of the nation's premier researchers, clinicians and advocates for melanoma and skin cancer prevention. To learn more about the National Council, visit: www.skincancerprevention.org.
About The Skin Cancer Foundation:
The Skin Cancer Foundation is the only global organization solely devoted to the prevention, early detection and treatment of skin cancer. The mission of the Foundation is to decrease the incidence of skin cancer through public and professional education and research. For more information, visit www.SkinCancer.org.
SOURCE American Academy of Dermatology
The health care organizations held a congressional briefing to discuss the dangers of indoor tanning. Tanning beds are classified by the World Health Organization's (WHO) International Agency for Research on Cancer (IARC) as group 1 - carcinogenic to humans, the highest cancer risk category. The physicians' concerns stem from rising melanoma rates. In fact, melanoma, the deadliest form of skin cancer, is increasing faster in young women than in young men – and a major difference in behavior is that women are more likely to use indoor tanning beds. Nearly 70 percent of tanning salon patrons are Caucasian girls and women, primarily aged 16 to 29 years.
The AADA recently released results of a new survey that reviewed indoor tanning behavior in teen girls. While many teens and young adults – particularly females – acknowledge that indoor tanning is dangerous, they continue to tan indoors.
"In our recent survey, the majority (86 percent) of indoor tanners think using tanning beds can cause skin cancer, yet they still think that people look more attractive with a tan (87 percent)," said Ronald L. Moy, M.D., FAAD, president of the AADA. "It is imperative that we reach out to our young people and correct this misconception that a tan is a sign of good health while reinforcing the message that a tan is the body's response to damage from ultraviolet light."
"Using tanning beds increases one's risk for melanoma by 75 percent and melanoma is now the most common form of cancer for young adults 25-29 years old, and is the second most common form of cancer for adolescents and young adults 15-29 years old," said Cecil B. Wilson, M.D., president of the AMA.
"Pediatricians have been warning our young patients about the dangers of indoor tanning for years," said O. Marion Burton, M.D., FAAP, president of the AAP. "We are seeing rapidly increasing skin cancer rates, particularly for melanoma in young women, which adds further incentive to promote our message loud and clear: tanning beds are not safe for young people."
"Promoting women's health issues is central to our mission and we see the issue of indoor tanning as a growing problem, especially among young women," said Richard N. Waldman, M.D., president of the ACOG. "Most young women with melanoma are developing it on their torso, which may be the result of high-risk tanning behaviors such as indoor tanning."
Studies also have demonstrated that exposure to UV radiation during indoor tanning can lead to eye damage. "The AAO is committed to educating people that the eyes are at risk from UV exposure during indoor tanning," said Richard L. Abbott, M.D., president of AAO. "Tanning beds can produce UV levels up to 100 times what you would get from the sun, which can cause serious damage to the external and internal structures of the eye and eyelids."
As the number of diagnosed cases of skin cancer continues to increase – current estimates are that one in five Americans will develop skin cancer during his or her lifetime – prevention and early diagnosis of skin cancer remain important health messages for all health care organizations.
"Prevention is one of the most valuable tools that we have as physicians. We need to continue educating patients about the risks of indoor tanning and encouraging healthy decisions to help prevent skin cancer," said Virginia L. Hood, MBBS, MPH, FACP, president of ACP.
"Everyone needs to take preventive steps to protect themselves from unnecessary ultraviolet exposure, including avoiding indoor tanning beds. The regulation of indoor tanning devices needs to be updated to reflect what we know about their carcinogenic effects," said Christopher W. Hansen, president of ACS CAN.
"Approximately 75 percent of all skin cancer deaths are from melanoma," said Tim Turnham, Ph.D., executive director of the MRF. "In fact, one American dies from melanoma almost every hour and the Melanoma Research Foundation will continue to educate the public about the prevention, diagnosis and treatment of melanoma, and the need for a cure."
"The damage caused by UV radiation from tanning beds is cumulative and often irreversible, and the earlier people start to tan, the higher their risk of developing skin cancer in their lifetimes," said Perry Robins, M.D., president of SCF.
"The AOA encourages the public to make healthy lifestyle choices, especially when it comes to their skin," said Karen J. Nichols, DO, president of AOA. "And to be familiar enough with their skin to catch skin cancer early when it's most treatable."
"The five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 98 percent," said Sandra I. Read, M.D., FAAD, co-chair of the NCSCP. "Everyone should perform regular self-exams and if you notice a mole that is different from others, or that changes, itches, or bleeds, you should make an appointment to see your physician as soon as possible."
May is Melanoma/Skin Cancer Detection and Prevention Month®. Visit www.melanomamonday.org to find out how to perform a skin self-exam, download a body mole map or find free skin cancer screenings in your area.
About the American Academy of Dermatology Association:
The American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. A sister organization to the Academy, the American Academy of Dermatology Association is the resource for government affairs, health policy and practice information for dermatologists, and plays a major role in formulating policies that can enhance the quality of dermatologic care. With a membership of more than 17,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical, and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin. For more information, contact the Academy at (888) 462-DERM (3376) or www.aad.org.
About the American Academy of Pediatrics:
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults (www.aap.org). Follow the AAP on Twitter and Facebook.
About the American Academy of Ophthalmology:
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons—Eye M.D.s—with more than 29,000 members worldwide. Eye health care is provided by the three "O's" – opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.
About the American Cancer Society Cancer Action Network (ACS CAN):
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit www.acscan.org.
About the American College of Physicians:
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 130,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter and Facebook.
About the American Congress of Obstetricians and Gynecologists:
The American Congress of Obstetricians and Gynecologists (www.acog.org) is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 55,000 members, the American Congress of Obstetricians and Gynecologists strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care. Follow us on Twitter at www.twitter.com/acognews.
About the American Osteopathic Association:
The American Osteopathic Association (AOA) proudly represents its professional family of more than 70,000 osteopathic physicians (DOs); promotes public health; encourages scientific research; serves as the primary certifying body for DOs; is the accrediting agency for osteopathic medical schools; and has federal authority to accredit hospitals and other health care facilities. More information on DOs/osteopathic medicine can be found at www.osteopathic.org.
About Melanoma Research Foundation:
The Melanoma Research Foundation (MRF) is the largest independent, national organization devoted to melanoma in the United States. Committed to the support of medical research in finding effective treatments and eventually a cure for melanoma, the MRF also educates patients and physicians about prevention, diagnosis and the treatment of melanoma. The MRF is an active advocate for the melanoma community, helping to raise awareness of this disease and the need for a cure. The MRF's website is the premier source for melanoma information seekers. More information is available at http://www.melanoma.org/.
About the National Council on Skin Cancer Prevention:
The National Council on Skin Cancer Prevention is the united voice of 45 organizations, associations, and agencies dedicated to reducing skin cancer morbidity and mortality in the United States. The National Council members represent some of the nation's premier researchers, clinicians and advocates for melanoma and skin cancer prevention. To learn more about the National Council, visit: www.skincancerprevention.org.
About The Skin Cancer Foundation:
The Skin Cancer Foundation is the only global organization solely devoted to the prevention, early detection and treatment of skin cancer. The mission of the Foundation is to decrease the incidence of skin cancer through public and professional education and research. For more information, visit www.SkinCancer.org.
SOURCE American Academy of Dermatology
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