Week in review: Pinterest redesign, scleral mystery, stroke predictors

APR 27, 2018

By Anni Griswold

Comprehensive Ophthalmology, Cornea/External Disease, Neuro-Ophthalmology/Orbit, Retina/Vitreous

A weekly roundup of ophthalmic news from around the web.

Pinterest just rolled out a new app, designed with visually impaired people in mind. The company spent more than a year reworking its app based on feedback from people with eye conditions ranging from macular degeneration to complete blindness. The new app boasts user-friendly colors and fonts, special markings around buttons and menus, and—most importantly—compatibility with Voice Over and Talk Back. Co. Design

This isn’t another scleral tattoo mishap: When a 70-year-old man realized the whites of his eyes had taken on a blue hue, he turned to doctors for help. Eye exams revealed normal vision and no sign of disease. The culprit? An antibiotic called minocycline that he’d been taking for 15 years to treat inflammatory arthritis. His case appeared last week in the New England Journal of Medicine. LiveScience

Retinal imaging could potentially stave off stroke, according to new evidence that abnormalities in the retinal microvasculature — due to arteriovenous nicking, focal arteriolar narrowing, retinal micro-aneurysms or retinal hemorrhage—increase the risk of ischemic or lacunar stroke. The findings, presented last week at the American Academy of Neurology annual meeting, came from an analysis of 10,468 individuals who were enrolled in a large NIH-funded study. MedPage Today

A new vlog highlights the daily lives of legally blind people. The Low Vision Specialists of Maryland and Virginia launched the series to show how a local man with retinopathy and legal blindness navigates the workforce. PR Web

image.axd?id=c7143359-a78b-4f95-94d9-83c03df6b8f9&t=636604369556000000Skiers and snowboarders need a lesson in UV protection, warn vision scientists from the University of Liverpool. They asked participants to apply sunscreen to their faces, then used a UV-sensitive camera to snap before and after photos. Areas covered with sunscreen appeared black—and the delicate skin around the eyelids and the inner corner of the eye often remained unprotected. Researchers stress the importance of wearing UV protective eye gear on the slopes.  EurekAlert!
*Image credit: University of Liverpool


Novartis launches app for remote participation in clinical trials

APR 26, 2018

By Anni Griswold


Comprehensive Ophthalmology

A new smartphone app lets patients participate in ophthalmology trials without ever stepping foot in a clinic. Novartis’ FocalView app guides patients through self-assessments of visual function and disease activity, streaming large volumes of real-world data directly into researchers’ hands.

The app, created using Apple’s ResearchKit platform, aims to dissolve barriers to patient participation by easing the enrollment process, improving compliance and reducing the time and expense of clinical exams. Data capture in traditional ophthalmic clinical trials tends to be “inflexible and infrequent,” Novartis says, so adapting a trial’s design to fit the daily routine of patients could spur participation.

If proven effective, FocalView could help uncover key insights about disease manifestation or progression by providing researchers with real-time reports collected over a span of months or years.

“Optimizing digital technology in research and development, particularly in ophthalmic disease, could have a marked impact on the quality of the data we capture,” said Bertrand Bodson, chief digital officer at Novartis. “We believe apps like FocalView, which we’ve made freely available to the research community on an open-source platform, can help accelerate the development of treatments and bring them to the patients who need them most.”

Researchers will soon take the app for a test run in a prospective, non-interventional trial to determine how well it captures visual acuity and contrast sensitivity compared with traditional assessments in a clinical setting. During the study, scientists will rate the app’s ease of use, track enrollment numbers and report any challenges related to gathering documentation, such as informed consent, from participants.

FocalView is available for download from the App Store in the US and will be offered in additional markets in the future, Novartis says.


Omega-3s no better than placebo for treating dry eye


Patients with dry eye may not significantly benefit from supplementation with fish-derived omega-3 fatty acids, according to findings from a year-long randomized controlled trial.

The results, reported earlier this month in The New England Journal of Medicine, are the most reliable and generalizable evidence thus far on omega-3 supplementation for dry eye disease, and goes against what previous trials have shown. These new observations were surprising to many eye care providers that routinely prescribe omega-3s for this condition.

“This study is sure to stir up a lot of controversy,” commented Julie Schallhorn, MD, an assistant professor of clinical ophthalmology at the University of California, San Francisco.

Both Dr. Schallhorn and Sumitra S. Khandelwal, MD, an associate professor of ophthalmology at Baylor College of Medicine, point out that though the DREAM (Dry Eye Assessment and Management) study was rigorous and well executed, the results should be taken in context.

“It looked at one type of omega-3 formulation. Its placebo was olive oil, which could have its own anti-inflammatory properties,” explained Dr. Khandelwal. “In addition, it was a real-world study, which has pros and cons, one of which being that additional treatment was not controlled. All that being said, it is the first study of its kind and opens the door to discussion of management of dry eye.”

Conducted at 27 centers across the United States, the NEI-funded DREAM trial was a double-masked study that enrolled 535 individuals with moderate to severe dry eye disease. The treatment arm consisted of 349 patients who took 3000 mg of omega-3 (2000-mg eicosapentaenoic acid and 1000-mg docosahexaenoic acid) daily—the highest dose ever tested for treating dry eye disease. The 186 individuals who were randomly assigned the control arm took 5000 mg of olive oil. Unlike in most industry-sponsored trials, all participants were free to continue taking their previous dry eye medications.

After 1 year, both the active supplement and placebo groups reported significantly improved Ocular Surface Disease Index (OSDI) scores from baseline (13.9 vs. 12.5 points, respectively). However, the 1.4-point difference did not reach statistical significance (P=0.21). Other ocular surface parameters—including conjunctival staining, corneal staining, tear break-up time and Schirmer’s test scores—were also comparable between groups.

“I think this study really highlights how much we don’t understand about the complex interplay between patient-reported symptoms and clinical dry eye disease,” concluded Dr. Schallhorn. “Moving forward, it may make sense to start investigating psychometric factors in future dry eye trials to try to help us better understand the treatment of dry eye disease.”


ARVO 2018: World’s Largest Show and Tell for Innovations in Eye Research

In addition to funding sight-saving research, we at FFB work hard to tell the scientific world about it. That’s because knowledge sharing and collaboration are critical to accelerating the advancement of promising therapies. Progress in developing treatments and cures isn’t made in a vacuum.

The best opportunity for us to showcase FFB-funded research is at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO), which is being held April 29 – May 3 this year in Honolulu. More than 11,000 eye researchers from around the world — including five intrepid members from FFB’s science team — will gather to participate in what is essentially a massive “show and tell” of the latest scientific advancements.

This year at ARVO, FFB will have its own, impressive show and tell, highlighting nearly 100 posters and presentations on a variety of topics including:

  • MyRetinaTracker.org (our global patient registry),
  • FFB patient genetic testing program,
  • FFB ProgStar natural history study for Stargardt disease,
  • and dozens of FFB-funded research efforts for treatments and cures.

In addition, we’ll be hosting our 5th Retinal Innovation Summit, which convenes more than 200 researchers and industry leaders for 37 presentations on the latest developments in clinical trials and translational research for inherited retinal diseases. This pre-ARVO, one-day summit is co-hosted by Casey Eye Institute at Oregon Health & Science University, and sponsored by: Spark Therapeutics, AGTC, REGENXBIO and NightStar Therapeutics.

Other examples of FFB-related sessions at ARVO include:

How Foundations Can Enhance Clinical Trial Enrollment and Advance Patients as Partners

Saturday, April 28, 3:45-4:00 p.m. HST, Room 316A

Stephen Rose, PhD, FFB’s chief research officer will discuss how FFB has engaged patients to boost clinical trial enrollment, and opportunities to educate patients on how trials for specific treatments benefit the entire community of people with retinal diseases.

Proctor Award: From Observations in the Retina Clinic to Insights into Pathophysiology

Sunday, April 29, 10:45-11:30 a.m. HST, Ballrooms BC

Sam Jacobson, MD, PhD, and Artur Cideciyan, PhD, FFB-funded researchers at the Scheie Eye Institute, University of Pennsylvania, are world leaders in clinical research for inherited retinal diseases. Among their many groundbreaking efforts, they played a key role in advancing RPE65 gene therapy into and through human studies. In addition to receiving the prestigious Proctor Award, they will deliver what is sure to be an insightful lecture on clinical diagnosis and the new era of vision-saving therapeutics.

Optogenetics for Vision Restoration — Translation

Sunday, April 29, 3:37-3:54 p.m. HST, Room 314

Optogenetics is an innovative approach for restoring vision to people who are completely blind from diseases like retinitis pigmentosa, regardless of the gene causing their vision loss. Deniz Dalkara, PhD, at the Institut de la Vision in Paris, will present FFB-funded research to move this approach into a clinical trial sponsored by GenSight.

Genetic Testing Adds Research and Clinical Value to a Retinal Degeneration Registry

Wednesday, May 2, 12:45-1:00 p.m. HST, Room 316C (paper session 4472)

Kari Branham, genetic counselor at the University of Michigan’s Kellogg Eye Institute, will discuss how FFB’s genetic testing program and global patient registry (www.MyRetinaTracker.org) are boosting retinal-disease research and patient access to clinical trials and studies.

Stay tuned to Eye on the Cure for updates from Honolulu on some of the outstanding research underway to save and restore vision.

ALOHA for now!




Cataract surgery on Ebola survivors appears safe for patients and physicians

APR 20, 2018

By Kanaga Rajan


Cataract/Anterior Segment, Comprehensive Ophthalmology, Retina/Vitreous, Uveitis

Cataract surgery can be safely performed on Ebola survivors, according to a study from scientists at Emory University School of Medicine and their international colleagues.

The team systematically assessed the persistence of the Ebola virus in the ocular fluid of survivors and report vision outcomes after cataract surgery. Their study appeared in the April 2018 issue of EBioMedicine.

“These findings are truly exciting, as they improve our ability to impact vision care and quality of life for thousands of Ebola survivors at risk for eye disease,” says Steven Yeh, MD, the M. Louise Simpson Associate Professor of Ophthalmology, Uveitis and Vitreoretinal Surgery at Emory.

Dr. Yeh treated the first known case of ocular Ebola in 2015. His 43-year-old patient, Ian Crozier, MD, an Ebola virus survivor, presented with rapidly declining vision approximately 9 weeks after being declared Ebola-free. Upon further investigation, the clinicians discovered that it stemmed from a lingering Ebola infection in the eyes. The safety of invasive ophthalmic procedures for Ebola survivors and their physicians has been unclear ever since.

Trying to resolve this uncertainty, this cross-sectional study screened 137 Ebola survivors from Sierra Leone and enrolled 50 with visually significant cataracts. The team tested aqueous humor and conjunctival fluid, sampled at a median of 19 and 34 months after Ebola diagnosis, and found no evidence of Ebola RNA. Thirty-four of the patients consented for manual small-incision cataract surgery with IOL implantation at the Lowell and Ruth Gess Eye Hospital in Freetown, Sierra Leone.

Following surgery, all patients showed better vision. Median visual acuity improved from hand motions at baseline to 20/70 by the end of 1 month postop and further improved to 20/30 at 3 to 4 months.

Their step-wise protocol, which features high-level safety precautions for preventing virus exposure, was designed to protect eye care providers and offers a step towards safe and efficient Ebola treatment and prevention. However, the study was small and not designed to determine if the eye harbored Ebola RNA at earlier time points, limitations that the authors say require further investigation before eye care providers can be assured about the safety of invasive ocular procedures.


Multifocal IOLs susceptible to decentration in myopic eyes

APR 24, 2018

Cataract/Anterior Segment, Refractive Mgmt/Intervention

This prospective study examined the tilt and decentration of multifocal IOLs following implantation in myopic eyes.

Study design

The authors studied 28 myopic (axial length >24.5 D) and 56 emmetropic eyes that underwent phacoemulsification and Tecnis ZMB00 multifocal IOL (Abbott) implantation.

Outcomes included tilt and decentration of the IOLs, high-order aberrations and modulation transfer function (MTF), measured using an OPD-Scan III aberrometer. Subjective symptoms were assessed using a questionnaire.


At 1 year postop, UDVA, CDVA and UNVA did not differ between groups, nor did horizontal decentration or IOL tilt. Vertical decentration, however, was statistically worse in the myopic group. The myopic group also had worse aberration data, poorer MTF and more subjective symptoms than controls.

Axial length negatively correlated with vertical decentration.


The study only used the ZMBOO IOL, which is high add and sensitive to centration. Newer lenses, such as the extended-depth of focus IOLs and low add, may not have this issue. One confounding factor is that higher axial length patients have poorer vision—whether it be from the retina or another sources—and are prone to worse aberration, poorer MTF and subjective symptoms even without a multifocal IOL.

Clinical significance

In general, patients with myopia are satisfied after cataract surgery, especially those with high axial lengths. This study suggests opthalmologists should counsel patients with high axial lengths about the risk of decentration of the lens and worse aberration data. These patients may be better off with a monofocal IOL that is less sensitive to centration but keeps them slightly myopic. However, further studies looking at newer lenses may help to adjust practice patterns.


Week in review: Insta-fail, shoebox-sized scanner, President Samuelson

APR 20, 2018

By Anni Griswold

Cornea/External Disease, Glaucoma, Retina/Vitreous

A weekly roundup of ophthalmic news from around the web.

An Instagram model paid the ultimate price to change her eye color from hazel to light grey. Nadinne Bruna, 32, shelled out $3,000 to have silicone plates implanted in front of her iris, but the procedure ended up costing her much more: 80% of vision in her right eye and 50% in her left eye. Daily Mail

Glaucoma expert Thomas W. Samuelson, MD, took the reins this month as the 33rdpresident of the American Society of Cataract and Refractive Surgery (ASCRS). Samuelson is an attending surgeon and founding partner of Minnesota Eye Consultants, and an adjunct professor of ophthalmology at the University of Minnesota. Healio

Canadian engineer Marinko Sarunic says his shoebox-sized retinal scanner
(shown above) can capture high-resolution, 3-D, cross-sectional images of the tissue in a level of detail that rivals images from much larger scanners. Dr. Eduardo Navajas, a vitreoretinal specialist who tested the device for 8 months, says the scanner eliminates the need for—and the complications from—the injected dye used with fluorescein angiography, the current gold-standard imaging technique. EurekAlert!

A genetically modified cornea could help prevent graft rejection,
according to a report in the journal Human Gene Therapy. Researchers say a donor cornea engineered to express 2 genes that prevent new blood vessel formation can reduce the risk of tissue rejection in a high-risk rabbit model. The therapy is called OXB-202. EurekAlert!

An Indianapolis retirement community recently honored the work of a color-blind artist with late-stage AMD. Ralph Rancourt, 95, began drawing black and white portraits of pets, family members and 20th-century presidents around the time that he was declared legally blind in his left eye. Seven years later, he lost vision in his right eye (also from AMD) and had to pack up his pencils, but his art lives on. Current