CLINICAL CORNER – AUGUST 2010

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ADDITIONAL GENES ASSOCIATED WITH AMD. A large genetic study (supported by the National Eye Institute) of age-related macular degeneration (AMD) identified three new genes associated with this disease. The strongest AMD genetic association found was in a region on chromosome 22, near a gene called metalloproteinase inhibitor 3 (TIMP3). It also uncovered two genes associated with AMD risk in the high-density lipoprotein (HDL) cholesterol pathway: human hepatic lipase and cholesterol ester transfer protein.

REPLACING CLS ON TIME FOR BETTER VISION AND COMFORT. In a survey of 1,334 U.S. contact wearers sponsored by CIBA VISION, researchers at the Centre for Contact Lens Research at the University of Waterloo School of Optometry confirmed that patients wearing monthly replacement silicone hydrogel contact lenses were better than two-week silicone hydrogel wearers at complying with manufacturer recommended replacement schedules—71% versus 41%. As a result, this study showed patients who replaced their lenses according to the manufacturer recommendations experienced better comfort and vision at the end of day than non-compliant patients.

HEALTHY DIET AND NUCLEAR CATARACT IN WOMEN. The Department of Ophthalmology and Visual Sciences at the University of Wisconsin assessed the association between healthy diet scores and prevalence of nuclear cataract in women aged 50 to 79. Having a high Healthy Eating Index score was the strongest modifiable predictor of low prevalence of nuclear cataract among numerous risk factors. This data adds to the body of evidence suggesting that eating foods rich in vitamins and minerals may contribute to postponing this common type of cataract.

STEM-CELL THERAPY RESTORES BURN-DAMAGED CORNEAS. Researchers at Milan’s San Raffaele Scientific Institute and the Center for Regenerative Medicine Stefano Ferrari investigated the long-term clinical results of cell therapy in 112 patients with burn-related corneal destruction associated with limbal stem-cell deficiency, a highly disabling ocular disease. Researchers used autologous limbal stem cells cultivated on fibrin to treat patients. Permanent restoration of a transparent, renewing corneal epithelium was attained in 77% of eyes. Researchers concluded that cultures of limbal stem cells represent a source of cells for transplantation in the treatment of cornea destruction due to burns.

ORAL VISUAL CYCLE MODULATOR FOR DRY AMD. The ENVISION Clarity Trial is a Phase 2 clinical trial of Acucela’s ACU-4429, an oral treatment for dry AMD. ACU-4429 slows the eye’s visual cycle for processing light, thereby decreasing levels of toxic byproducts in the eye and potentially stopping the advance of dry AMD. Phase 2 builds upon pre-clinical findings from Phase 1 that demonstrated ACU-4429’s safety and tolerability. The Phase 2 trial involves three planned escalating dose levels of ACU-4429 and up to two additional dose levels in dry AMD patients. Patients receive either ACU-4429 or placebo once daily for three months. The trial is being conducted at multiple U.S. sites and is expected to be completed in 2011.

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