Volume 14, Number 3
Monday, January 20, 2014


In this issue: (click heading to view article)
######### Link Between Sleeping Position and Asymmetric Visual Field Loss in OAG Patients

######### Use of SD-OCT to Differentiate Long-Standing CRAO and NAION

######### Treating Severe Infectious Keratitis with Riboflavin/UVA Photochemical Therapy
######### Ginkgo Biloba's Effect on Visual Field and Contrast Sensitivity in Chinese Patients with NTG
######### Briefly


Link Between Sleeping Position and Asymmetric Visual Field Loss in OAG Patients

This retrospective, cross-sectional study investigated the relationship between preferred sleeping position and asymmetric visual field (VF) loss in open-angle glaucoma (OAG) patients.

A total of 692 patients with bilateral normal-tension glaucoma (NTG) or high-tension glaucoma were consecutively enrolled, and administered a questionnaire to determine the preferred sleeping position was administered to each patient. Asymmetric VF loss was defined as a difference in mean deviation between the two eyes of at least 2 dB. According to these values, the better eye and worse eye were defined. Among the patients with asymmetric VF loss, the numbers preferring the worse-eye-dependent lateral decubitus position and the better-eye-dependent lateral decubitus position were compared.

It was reported that, among the enrolled patients, (60.6%) with NTG and 121 (66.5%) with high-tension glaucoma had asymmetric VF between the two eyes. Among the 309 NTG patients, 100 (32.4%) preferred the lateral decubitus position. Of these, 66 (66.0%) preferred the worse-eye-dependent lateral decubitus position (p=0.001). Among the 121 high-tension glaucoma patients, 32 (26.4%) preferred the lateral decubitus position, and of these, 23 (71.9%) preferred the worse-eye-dependent lateral decubitus position (p=0.013).

These results suggest that the sleep position habitually preferred by glaucoma patients may be associated with greater VF loss

SOURCE: Kim KN, Jeoung JW, Park KH, et al. Relationship between preferred sleeping position and asymmetric visual-field loss in open-angle glaucoma patients. Am J Ophthalmol. 2013; Dec 16. [Epub ahead of print]. DOI: 10.1016/j.ajo.2013.12.016.

Use of SD-OCT to Differentiate Long-Standing CRAO and NAION

Researchers reported on the efficacy of macular and optic nerve spectral-domain optical coherence tomography (SD-OCT) in differentiating between long-standing central retinal artery occlusion (CRAO) and nonarteritic anterior ischemic optic neuropathy (NAION).

They compared SD-OCT scans of the macula and optic nerve in 24 patients with unilateral optic atrophy secondary to CRAO (12 patients) and NAION (12 patients) both qualitatively and quantitatively for differentiating features.

In patients with long-standing CRAO, the researchers noted a significantly greater (p<0.001) thinning of the macula relative to the fellow uninvolved eye (–59.7 ± 31.8 µm) compared to patients with long-standing NAION (–19.9 ± 8.4 µm), even though both conditions caused a similar (p=0.726) degree of peripapillary retinal nerve fiber layer loss (–42.4 ± 18.5 µm and –44.1 ± 12.4 µm, respectively).

They determined that SD-OCT macular scans can be used as an adjunctive tool for differentiating between long-standing CRAO and NAION.

SOURCE: Dotan G, Goldenberg D, Kesler A, et al. The use of spectral-domain optical coherence tomography for differentiating long-standing central retinal artery occlusion and nonarteritic anterior ischemic optic neuropathy. OSLI Retina. 2014;45(1):38–44.


Treating Severe Infectious Keratitis with Riboflavin/UVA Photochemical Therapy

To describe the antibacterial activity of treatment with riboflavin and ultraviolet A light (UVA) in cases of severe infectious keratitis, investigators performed a retrospective analysis of an interventional case series in which six eyes of six patients with severe infectious keratitis, all of whom were refractory to multidrug conventional therapy, were treated with riboflavin/UVA.

The procedure was conducted according to the standardized protocol of corneal collagen crosslinking (CXL) for keratoconus and best spectacle-corrected visual acuity and clinical outcomes were evaluated before and during the follow-up period.

The investigators reported that five of the six patients showed rapid reduction in symptoms and decreased infiltrate size after riboflavin/UVA photochemical therapy. Signs of infection and inflammation mostly resolved within one to two weeks after the treatment. Despite this therapy, one patient continued to deteriorate, and penetrating keratoplasty was performed.

To conclude, the adjunctive use of riboflavin/UVA photochemical therapy has a positive effect on refractory infectious keratitis. The treatment seems to be safe and effective and should be considered as part of the first-line therapy in severe cases of infectious keratitis.

SOURCE: Skaat A, Zadok D, Goldich Y. Riboflavin/UVA photochemical therapy for severe infectious keratitis. Eur J Ophthalmol. 2014; 24(1):21–28.

Ginkgo Biloba's Effect on Visual Field and Contrast Sensitivity in Chinese Patients with NTG

The authors of the following prospective, randomized, placebo-controlled crossover study evaluated the effect of ginkgo biloba extract on visual field defect and contrast sensitivity in a Chinese cohort with normal-tension glaucoma (NTG).

Patients newly diagnosed with NTG, either in a tertiary glaucoma clinic (n=5) or in a cohort undergoing routine general physical examinations in a primary care clinic (n=30), underwent two four-week phases of treatment, separated by a washout period of eight weeks. Randomization determined whether ginkgo biloba extract (40 mg, three times per day) or placebo (identical-appearing tablets) was received first. Primary outcomes were change in contrast sensitivity and mean deviation on 24-2 SITA standard visual field testing, while secondary outcomes included IOP and self-reported adverse events.

According to the authors, 35 patients with mean age 63.7 (6.5) years were randomized to the ginkgo biloba extract-placebo (n=18) or the placebo-ginkgo biloba extract (n=17) sequence. And 28 patients (80.0%, 14 in each group) who completed testing did not differ at baseline in age, sex, visual field mean deviation, contrast sensitivity, intraocular pressure or blood pressure. Changes in visual field and contrast sensitivity did not differ by treatment received or sequence (p>0.2 for all). Power to have detected a difference in mean defect as large as previously reported was 80%.

In contrast to some previous reports, ginkgo biloba extract treatment had no effect on mean defect or contrast sensitivity in this group of NTG patients.

SOURCE: Guo X, Kong X, Huang R, e al. Effect of ginkgo biloba on visual field and contrast sensitivity in Chinese patients with normal tension glaucoma: a randomized, crossover clinical trial. Invest Ophthalmol Vis Sci. 2014;55(1):110–116.

  • SAUFLON INTRODUCES FAMILY OF SILICONE HYDROGEL DAILY DISPOSABLE CONTACT LENSES. Sauflon is entering the U.S. contact lens market with its clarity 1 day silicone hydrogel daily disposable contact lenses. As the first and only family of sphere, toric and multifocal silicone hydrogel daily disposable contact lenses, the company says clarity 1 day is able to satisfy the broad range of practitioner and patient needs. And Sauflon's AquaGen technology produces high-quality silicone hydrogel lenses that provide exceptional comfort and affordable convenience for wearers. To learn more about the company and register for updates, visit www.sauflonusa.com or call (800) 682-3240.
  • SEQUENOM GRANTS NICOX PROMOTION AND MARKETING RIGHTS TO RETNAGENE AMD TEST IN NORTH AMERICA. Nicox Inc. and Sequenom Laboratories have entered into an exclusive agreement where Nicox has been granted the North American promotional rights to the Sequeonom Laboratories RetnaGene AMD laboratory-developed test for the evaluation of a patient's risk of AMD disease progression within two, five and 10 years. Nicox expects to begin promoting the RetnaGene AMD test in the United States in the first half of 2014. Read more about the terms of the agreement here.
  • PREVENT BLINDNESS AMERICA UNDERGOES NAME CHANGE. The eye health and safety organization Prevent Blindness America has changed its operating name to Prevent Blindness. The group says it is using the new name as a launching pad to refocus efforts around a number of key areas including awareness of diabetic eye disease with the growing diabetic epidemic, women's eye health, children's vision, improving the quality of life for those living with low vision, and an increased role in public health research related to vision. For further details, see the press release.

  • LEADING VENTURE CAPITALIST AND SINGER-SONGWRITER TO BE HONORED AT GLAUCOMA RESEARCH FOUNDATON GALA At its Annual Gala on February 6, 2014 at San Francisco's historic Palace Hotel, the Glaucoma Research Foundation will recognize leading venture capitalist William J. Link, PhD, for his outstanding achievements and dedication to the development of new treatments for glaucoma by presenting him with its Catalyst Award. Additionally, Grammy Award-winning singer-songwriter Judy Collins will receive The Visionary Award in recognition of her long time social activism and efforts to promote glaucoma awareness. She will perform a private concert for attendees. Highlights of the Annual Gala include the Award presentations, a live auction to raise funds in support of glaucoma research, a reception and dinner. For additional information, visit www.glaucoma.org.

  • COBURN TECHNOLOGIES TO BE AN EXCLUSIVE DISTRIBUTOR OF NEW HUVITZ EQUIPMENT, ANNOUNCES CONSTRUCTION OF NEW EXPRESS LOGISTICS CENTER. Coburn Technologies recently announced their new exclusive distributorship of diagnostic products manufactured by Huvitz Co. Ltd. (e.g., auto ref-keratometers, digital refractors, auto lensmeters, slit lamps) to the United States ophthalmic market. These new products will be manufactured and distributed through a new strategic partnership with Huvits Co. Ltd. Coburn has been working with Huvitz since 2011 to develop and distribute the popular Excelon and Exxpert series of edgers and other in-house finishing equipment, which has now grown to include exclusive development and distribution of their digital refraction and diagnostic equipment in the United States. A full list of diagnostic products manufactured by Huvitz and available through Coburn Technologies can be found online at www.coburntechnologies.com.

    In other news, Coburn is constructing its new Express Logistics Center at its world headquarters in South Windsor, Conn. According to the company, the new facility will consolidate all of Coburn's worldwide shipping efforts and will take the place of the current distribution warehouse operated out of Louisville, Ky. As a result, many customers should experience faster delivery times, improved on-time deliveries and, in some cases, lower overall freight costs. Complete worldwide shipping efforts will be coordinated through the new facility beginning in February 2014.

  • OCUSOFT CONTINUES EXPANSION OF NEW COSMETIC LINE. OCuSOFT announced its continued expansion into the skin care field with the launch of Zoria Recovery Bruise and Scar Cream, which is specifically formulated to promote healing and minimize the unsightly postop effects of eyelid/facial surgical procedures or bruising from injections. According to OCuSOFT, the patent-pending formula contains a unique blend of ingredients that support the skin’s natural healing process. Zoria Recovery Bruise and Scar Cream will only be promoted through physician specialties at a discounted price to encourage direct dispensing to patients.



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