Stem Cell Research at Duke Med

The following is from Phil Rego & Lauren Tappen.

Early findings by Duke University ophthalmology researcher Dennis Rickman and others indicate that stem cells indeed restore damaged retinas.

“The cells migrate to the area of injury, and in many cases appear to integrate into the tissue and differentiate into those cells,” Rickman said.

But it will take a lot more research before those findings can yield therapy.

https://dukeeyecenter.duke.edu/news-events/researcher-uses-stem-cells-eye-disease

Osteoporosis Treatment and Macular Degeneration

Bisphosphonates, which are typically used to prevent osteoporosis, are some of the most prescribed drugs. They are known to increase the risk of inflammatory eye diseases such as scleritis, uveitis, and optic neuritis, and their pro-inflammatory properties may account for this increased risk as well as the flu-like symptoms that have been reported as adverse effects of their use.

The appearance of flu-like symptoms after use of the injected bisphosphonate zolendronic acid (Reclast/Novartis) has been attributed to the release of inflammatory mediators such as C-reactive protein. This common marker of systemic inflammation has been associated with coronary artery disease and implicated in the development of age-related macular degeneration (AMD), including its neovascular (wet) form.

For more info:

http://www.mdmag.com/medical-news/oral-bisphosphonate-use-poses-risk-of-wet-age-related-macular-degeneration

https://www.ncbi.nlm.nih.gov/pubmed/27163238

https://www.medscape.com/viewarticle/868998

Reading with Low Vision

“I now have five books lined up in  my Kindle library waiting for me to read.

It is so exciting to be able to read the books that I want, when I want to read them.

On my I-Pad with Kindle app.

As a low-vision reader I have had to settle for books that are available from the Library for the Blind and our local library.  This has been unsatisfactory as I could never find the books that I really wanted to read.  I had to settle for what was available or pay a reader to read the books to me that I really wanted.

Up to this point, my reading material and when I could read it has been restricted

It is a joy to sit down in a local Café and start reading the book that I have been longing to read and then have time to contemplate the words and ideas.

If you are a low vision reader, frustrated with the available reading material then I strongly suggest making the effort to get an I-Pad and download Kindle books.   I suggest asking a Low Vision Occupational Therapist to help you learn how to do this.

Lauren Tappan

Tips for Healthy Eyes

The following is by  https://home.bt.com

1. Eat a healthy diet – Vitamins A, C, E and minerals like copper and zinc are essential to eyesight. Current research shows that consuming yellow and green vegetables can help prevent age-related macular degeneration, a leading cause of blindness.

2. Sleep – It’s essential for eye health, sleep allows your eyes to fully rest, repair, and recover.

3. Stop smoking – It makes you more likely to get cataracts, damage to your optic nerve, and macular degeneration.

4. Wear sunglasses – Sunglasses will protect your eyes from the sun’s UV Rays, too much UV exposure boosts your chances of sun and macular degeneration.

5. Look away from the screen – Rest your eyes every 20 minutes. Look 20 feet away for 20 seconds and close your eyes for 20 seconds. Get up at least every 2 hours and take a 15-minute break.

6. Remove eye make-up every night – This prevents any make up from going into your eye and possibly scratching your cornea.

7. Exercise – it improves blood circulation, which, in turn, improves oxygen levels to the eyes and the removal of toxins.

8. Have regular eye exams – these become more important when you reach your 50s. You want to be certain that no problems are beginning to develop and certain medications can affect your vision and eye health, so it’s important to tell your doctor about all of your medications.

9. Avoid dry air – aim your car vents down at your feet rather than at your face, air conditioning takes the moisture out of your eyes which can lead to serious dryness.

Seeing AI App

There are several low-vision apps that have been created for the cellphone. I am continually impressed with the Seeing AI app. It has many features that I find extremely helpful. If you hold the cellphone over text, it will read it immediately. It is now able to read money and does face recognition. You can train it to point the cellphone at the individual in front of you and it will tell you the name, location, and distance between you and the person. The Seeing AI app can also read handwriting.

                I find this app to be an invaluable tool for someone with low vision. I highly recommend checking out this app.

Lauren Tappan

How to Avoid Macular Degeneration

February is Macular Degeneration Month

The following is by Bert Keller and Bill Simpson of the Charleston SC Post & Courier.

The key is recognizing the disease early. Risk factors help us to recognize persons at greater risk of AMD. As indicated by its name, age is a key risk factor. AMD occurs after age 60 and increases to affect almost 15 percent of those over 80.

Caucasians are more likely to develop AMD than any other race, and women are more likely to develop it than men, probably only because they tend to live longer. The risk of the disease also doubles if one or more first-degree relatives have it, especially if it develops at an early age.

Likewise, smoking doubles the risk of AMD. Ultraviolet light exposure increases risk by about 50 percent in persons who have the heaviest levels of exposure (think mountaineers and sailors). People with high blood pressure and other cardiovascular diseases are also at greater risk of AMD.

An eye-healthy diet is essentially a heart-healthy one with extra emphasis on dark green, leafy vegetables such as collards, kale and spinach. These contain high levels of good-for-the-eyes carotenoids (lutein and zeaxanthin).

At least two servings of fish a week are recommended and have been shown to decrease AMD risk by up to 45 percent. A diet high in fruits and nuts and with fewer refined carbohydrates, including white bread, white potatoes and sugary beverages, is also recommended.

Because we aging amateurs often fail to get all the vitamins and minerals we need via our dietary intake alone, a “mature” multivitamin and mineral supplement is probably a good investment. Talk to your eye doctor about whether a special eye-vitamin formula is indicated for you based on your exam and family history.

If you have elevated blood pressure and/or cholesterol, get those issues taken care of. But avoid beta-blockers such as atenolol or propranolol unless used after a heart attack, or vasodilators such as Apresoline and others. These are old treatments for high blood pressure and rarely used today. They also have been associated with increased risk for AMD.

Those who exercise regularly, walking at a moderate clip for at least 30 minutes a day, and maintain a healthy weight are up to 70 percent less likely to develop AMD.

Wear sunglasses with UV and HEV (high energy visible) ”blue” light protection when outdoors in daylight. If you use a smart phone, computer or flat screen television several hours a day, consider a blue light filter or blue-light filtering lens.

A tool that has some research support is the Amsler grid. It is available in several forms, black lines on white paper, white lines on black, in a small key fob-like gizmo that looks like an old View-Master eyepiece. You look at the grid one eye at a time to recognize a spot in your visual field that is fuzzy or isn’t there at all or lines in the grid that are not straight.

Spots or curved lines may indicate problems in the retina. Used every week, or even more frequently, the grid may pick up early changes in the retina that, with treatment, can avoid problems with AMD. The grid and instructions for its use are available at: allaboutvision.com/conditions/amsler-grid.htm.

Finally, to decrease your risk of AMD, get regular eye check-ups, at least annually for those over 60.

For more info:

http://www.minicassia.com/online_features/senior_living/article_d79bbcc1-82c4-5aea-89ff-3d635db9226b.html

https://www.prnewswire.com/news-releases/7-ways-to-protect-your-eyes-from-age-related-macular-degeneration-300594667.html

http://www.journal-spectator.com/online_features/senior_living/image_20ced437-22b4-5383-b85c-9a315c871f17.html

Adverse Stem Cell Effect

A patient taking part in a clinical trial of an induced pluripotent stem cell treatment for age-related macular degeneration has experienced an adverse effect, the Japan Times reports.

The patient, who is in his 70s, received a transplant of retinal cells derived from donor iPS cells to treat his age-related macular degeneration, the paper adds. The Japan News notes that the clinical trial, consisting of five patients, began in March.

After treatment, the patient’s retina became swollen, leading him to have surgery earlier this week in the hopes of relieving the swelling, as steroids and anti-vascular endothelial growth factors didn’t diminish his symptoms, the Japan Times says. The team removed his pre-retinal membrane and his symptoms improved, it adds

Masayo Takahashi, the Riken researcher who heads the team conducting the trial, said at a news conference earlier this week that “[w]e cannot deny the causal correlation with iPS cells.”

Takahashi first tested this technique in 2014 when an 80-year-old Japanese woman received retinal pigment epithelium cells that were developed from reprogrammed skin cells. The Japan Times says the new patient is the first to experience an adverse reaction to the treatment.

But University College London’s Mike Cheetham tells New Scientist that the swelling was probably due to the original surgery, not the iPS cells.

Diet Changes to Avoid Macular Degeneration

Certain diets in large population studies may have some effect in slowing the progression of age-related macular degeneration. Some studies suggest that eating green, leafy vegetables and other vegetables may slow the progression of AMD, while people who do not typically eat any such vegetables may experience faster progression of AMD. Some potentially beneficial vegetables include kale, spinach, turnips, collard greens and romaine lettuce. Other vegetables that may slow the progression of AMD include broccoli, spinach and Brussels sprouts.

— Dr. Francis DeCroos, Southeastern Retina Associates; member, Chattanooga-Hamilton County Medical Society

Avoiding Macular Degeneration

Macular degeneration is a common eye condition that typically manifests in people over age 50. It damages the macula of the eye, which is located near the center of the retina, and can lead to vision loss. The macula is the part of the eye that helps you see objects that are right in front of you. When this area is damaged, you may see spots or your vision may get blurry or dark. These changes might make it more difficult for you to drive or perform other everyday activities.

Macular degeneration can run in families, so if you have relatives with the condition, you may be at higher risk of developing it yourself. However, the good news is that modifiable risk factors also play an important role when it comes to developing macular degeneration. According to the National Eye Institute, you can reduce your risk by quitting smoking. Smoking cigarettes can double your risk of the condition. Also, try to maintain a healthy blood pressure, act to lower high cholesterol, and eat a healthy diet, one high in nutrients from green leafy vegetables and fish.

Not only are these recommendations beneficial when it comes to preventing macular degeneration, they are good, healthy practices for any individual. There is also evidence that certain nutritional supplements may slow the progression of macular degeneration in some instances. Discuss preventive strategies and early detection with your doctor if macular degeneration runs in your family. And getting a regular eye exam is a good idea, even for people without a family history of the condition.

For more info:

https://www.health.harvard.edu/diseases-and-conditions/can-i-avoid-macular-degeneration

Lions Club

The lions club in Durham has an ongoing support group for the blind. It is called “Vision Insight”. They meet the first Friday of every month at the Lions meeting-place 1850 Hillandale Rd in Durham. If interested contact Jim Turner at 919-872-3538.

Lauren Tappan