6 replies to this topic

[kevin]

this post originally by Lazarus Long: I liked the other article you had too about the replacement of the eye's aqueous fluid with a sterile synthetic that alters the refraction index and the lens stiffness. You might want to include it here too. -- thnx for the suggestion LL

As having reached the age of increasing arm length and slower refocussing, this bit of news was welcome.

from NewScientist.com

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Gel put springiness back into old lenses

8/6/2003 -- A NEAT fix for ageing eyes could be tested in humans next year. The treatment, which involves replacing the contents of the lens in the eye with a soft polymer gel, could allow millions of people to throw away their reading glasses.

"At first, we see it being used as an improvement to current cataract surgery," says Arthur Ho at the University of New South Wales, a key member of the Australian government's multinational Vision Cooperative Research Centre (Vision CRC) that is working on the technique. "But once it is shown to be safe and effective, we think that more and more younger people who are starting to need reading glasses will adopt it as well."



The eye's lens focuses by changing shape. When muscles in the eye relax, the lens is pulled flat to focus on distant objects. When they contract, the lens returns to a fatter shape, bringing closer objects into focus. But as we age, our lenses harden, preventing them reforming into their fatter shape: the lenses of 40-year-old people have only a quarter of their capacity to change shape, or "accommodate", as they did at birth. After the age of 45, most people need reading glasses, or bifocal glasses.


In the late 1980s, Jean-Marie Parel at the University of Miami showed that replacing the contents of an ageing rhesus monkey's lens with silicone oil could restore its ability to focus. But silicone oil gradually leaks from the lens capsule. Since then, researchers have been working to develop a polymer that has both the same refractive index as the human crystalline lens and also the right biomechanical properties.


After evaluating more than 30 different polymer formulations created at another Australian research institute, CSIRO Molecular Science in Melbourne, Ho thinks his group has cracked it. Vision CRC is staying tight-lipped about the new formulation while it is being patented. All the team will say is that it is a siloxane-based material, which is cured with UV or visible light after injection to turn it from a liquid to a gel.


Tests on rabbit and monkey eyeballs show the latest formulation has the same average refractive index as a healthy lens and could provide up to 9.5 dioptres of accommodation, enough to allow reading at a distance of only 10 centimetres. So far, the group has conducted tests on only a few human eyes and found the treatment provided between around 6 to 8.5 dioptres of accommodation- more than enough to permit easy reading.


Implanting the gel would be very similar to current cataract surgery, except that the lens is not replaced. Instead, after making a small incision in the cornea, a doctor would cut a tiny hole in the lens capsule and suck out the contents. The gel, which has the consistency of thick oil, is pumped in and a burst of UV or visible light transforms it into a jelly. "This could be a quick, 15-minute procedure," says Ho.


The gel-injection surgery has been perfected on rabbits by a team led by Parel in Miami. But adult rabbit eye lenses do not accommodate, so the next step is to assess the technique in live rhesus monkeys, which have similar eyes to humans. This work should begin by the end of this year, Ho says, "and in the best-case scenario, we should begin human trials by the end of next year."


Hugh Taylor, director of the Centre for Eye Research Australia in Melbourne, is enthusiastic. "This technique has enormous potential," he says. "It will totally change ophthalmic surgery, if we can get it right." New Scientist issue 9 August 2003.


Source: New Scientist
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Edited by kevin, 19 November 2003 - 05:01 PM.

[kevin]

Link: http://home.business...955&newsLang=en
Date: 11-17-03
Author: Dr. Jean-Marie Parel
Source: University of Miami's Bascom Palmer Eye Institute
Title: New Procedure on Track to Revolutionize Cataract Surgery; Technology Would Also End Middle Aged Eyes' Need for Reading Glasses
Comment: Things are coming along nicely in this area.

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New Procedure on Track to Revolutionize Cataract Surgery; Technology Would Also End Middle Aged Eyes' Need for Reading Glasses
ANAHEIM, Calif.--(BUSINESS WIRE)--Nov. 17, 2003--A revolutionary procedure that would make aging eyes "young again," by replacing the contents of the eye's lens with a soft polymer, promises to fundamentally change the way cataract surgery is performed -- and to allow middle-aged patients to enjoy life without reading glasses.

The University of Miami's Bascom Palmer Eye Institute today announced it is developing the new treatment which, when proven safe and effective, should enable cataract patients to see clearly -- and to rapidly focus near and far. Bascom Palmer biophysicist and biomedical engineer Dr. Jean-Marie Parel reported the findings yesterday at the American Academy of Ophthalmology's annual meeting in Anaheim. He leads the Bascom Palmer team responsible for developing both the surgical procedure and instrumentation for the technique.

"We expect aging patients will feel they are '16 again,' regaining teenage vision," said Dr. Parel. "This procedure goes beyond the relief from clouding provided by traditional cataract procedures, restoring the ability to quickly shift focus at varying distances. After surgery, patients would be able to focus on a computer screen, look down to read a credit card, and look up again to see a face across the room."

Initially, researchers expect the technology will be used in cataract surgery -- typically performed on elderly patients, and the most common surgical procedure worldwide. It offers further applications to restore middle-aged patients' ability to rapidly shift focus at varying distances, while ensuring they do not develop cataracts as they age.

Dr. Parel, research associate professor at Bascom Palmer Eye Institute, and his team are collaborating with an international scientific initiative, in which scientists at the Australian government's multinational Vision Cooperative Research Centre are developing a polymer gel formulation that would chemically reproduce the characteristics of a young adult's lens.

Dr. Parel said that in cataract surgery, physicians would no longer substitute an intraocular lens implant for the patient's own lens contents. Instead, the patient's lens capsule would be retained, its contents removed and replaced with the polymer. UV or visible light would transform the liquid to a gel after injection, restoring the lens' pliability to "accommodate," or adjust shape in focusing.

"Here, in Australia, Finland, and India, top research talent is working to perfect and prove that accommodation can be regained in this way," said Dr. Carmen Puliafito, chairman of the Department of Ophthalmology at the University of Miami School of Medicine and the director of Bascom Palmer Eye Institute. "With so many Baby Boomers and elderly adults affected by loss of the eye's ability to easily change focus, the advance would be most significant."

Dr. Parel's team is the first to restore over 9 dioptres of accommodation -- enough to comfortably read small print -- in a post-mortem human eye. The next steps will be to prove safety and effectiveness and seek Food and Drug Administration approval, followed by testing in humans perhaps as soon as 2005, Dr. Parel said.

One of the world's premier centers for ophthalmic research, education and eye care, Bascom Palmer Eye Institute annually treats over 200,000 patients and performs over 10,000 surgeries. The Institute has served as the Department of Ophthalmology for the University of Miami School of Medicine since its founding in 1962. For information: Cynthia Birch at 305/326-6190 or cbirch@med.miami.edu or visit http://www.bascompalmer.org.

Digital photo of Dr. Parel is available upon request.

Contacts

Bascom Palmer Eye Institute, Miami
Cynthia Birch, 305/326-6190
cbirch@med.miami.edu
or
Smith & Knibbs
Linda Lewis, 954/428-4477
llewis@smith-knibbs.com

[kevin]

Link: http://www.eurekaler...o-mes111803.php
Date: 11-18-03
Author: Media Relations media@aao.org 415-561-8534
Source: American Academy of Ophthalmology
Title: Medical experts say cataract and refractive surgeries merging

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Medical experts say cataract and refractive surgeries merging
ANAHEIM, CALIF. -- Leading cataract and refractive surgeons discussed the merging of cataract and refractive surgeries through use of intraocular lenses (IOLs) at the Annual Meeting of the American Academy of Ophthalmology, the Eye M.D. Association.

In his opening remarks, moderator Walter Stark, MD, professor of ophthalmology at Johns Hopkins Hospital, said that because cataracts are the major cause of blindness worldwide, he expects there will be more lens exchanges.

Morcher Implant Devices

Samuel Masket, MD, clinical professor of ophthalmology, UCLA Jules Stein Eye Institute, said, "Morcher implant devices, aniridic rings that allow surgeons to reduce the size of the patient's pupil for eyes with iris defects, are crucial in reducing glare." Although an FDA compassionate device exemption is necessary in the United States, Masket is hopeful these viable and valuable devices will become more widely available for patients who have defective irises from birth defects or trauma.

Super Vision with Refractive Clear Lensectomy

Jack T. Holladay, MD, clinical professor of ophthalmology, Baylor College of Medicine, emphasized the importance of assessing contrast sensitivity and spherical aberrations and explained the use of the Tecnis Z 9000 IOL, which allows light to focus perfectly on the retina, thus restoring contrast sensitivity and nighttime vision.

Implantable Miniature Telescope

Douglas Koch, MD, professor and chair of ophthalmology, Baylor College of Medicine, said, "The IMT provides a 60 percent field of vision as opposed to only 20 percent with an external telescope for patients who have lost vision from macular degeneration." The IMT is currently in Phase I clinical trials. So far, 77 percent of patients achieved an improvement in central vision of two eye-chart lines, and 62 percent achieved an improvement of three lines.

Multifocal IOLs for Presbyopia

"Unlike glasses or contact lenses, the multifocal IOL provides two focal ranges at the same time," said Roger Steinert, MD, associate professor of ophthalmology, Harvard Medical School. "The downside is that contrast sensitivity is somewhat compromised." In studies of the AMO Array multifocal lens, patients attained near visual acuity of 20/40, increased depth of focus, and 81 percent reduced their dependence on glasses. "The advantage of the multifocal lens," he said, "Is that it should work for everyone, whereas only two-thirds of patients are able to adjust to monovision, in which one eye is corrected for near vision and the other for distance."

Accommodating IOLs for Cataract Surgery and Refractive Lensectomy

Richard L. Lindstrom, MD, adjunct professor emeritus, University of Minnesota, discussed Eyeonics' CrystaLens, which was just approved by the FDA last Friday. Clinical trials found that 98.4 percent of patients achieved 20/40 or better visual acuity. "The important thing about this type of lens is that it restores the full range of vision, but my main concern is that this is the first truly effective technology that won't be covered by Medicare. It will not be available to those who need it most -- low-income elderly patients."

Refractive Lens Exchange

I. Howard Fine, MD, clinical professor of ophthalmology, Casey Eye Institute, Oregon Health and Science University said refractive lens exchange with IOLs will be the dominant refractive procedure because it's a "win-win-win" solution "It addresses all components of patients' refractive errors, including presbyopia." Dr. Fine said. "It reduces the number of patient problems for surgeons, and it even benefits the government because there will be "a dramatic decrease in the expense of cataract surgery."

The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons--Eye M.D.s--with more than 27,000 members worldwide. For more information about eye health care, visit the Academy's partner Web site, the Medem Network, at http://www.medem.com/eyemd. To find an Eye M.D. in your area, visit the Academy's Web site at http://www.aao.org.


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[LifeMirage]

NAC - Is It The Cure For Cataract?
By Robert Mason Ph.D.

In the East and particularly in Russia over the last several years, they have been researching a special analogue of the di-peptide carnosine. This particular form is known as n-acetylcarnosine or NAC and it has been proven to be highly efficacious in the treatment of cataract and may also present a case for the prevention of the same. This article is about the case for NAC and the problems associated with senile-cataract.

Cataract is the leading cause of blindness and accounts for about 42% of all such cases worldwide, and this is in-spite of the availability of effective surgical treatment. Today we have the appalling situation where more than 17 million people around the world are blind because of cataract and 28,000 new cases are reported everyday. In developing countries, there is simply not a sufficient number of surgeons to perform cataract operations.

Cataract surgery is the most commonly performed surgical procedure in people over 65-years of age, and 43% of all visits to ophthalmologists by Medicare patients in the US are directly associated with cataract.

Meanwhile, approximately 25% of the population over 65 (and about 50% over 80) have a serious loss of vision due to cataract. Since this is the population that is most susceptible to lens opacification and as this section of the population is expected to increase dramatically, the numbers of individuals with cataract is set to explode!

For example, the World Health Organization anticipates that within the next 25-years, that 20% of the population will be 65 or older. Furthermore, the single largest growing section of the population are those over 85 and their actual numbers are expected to quadruple in about the same period. Such a rapidly burgeoning older population can only increase the numbers of individuals suffering from cataract.

Of course, there is also the economic impact. Currently 1.35 million cataract operations are performed annually in the United States alone and Medicare estimates the annual cost at $3.5 billion! There's no doubt about it, cataract is a major disease.

It is also becoming apparent that it will not be possible to eliminate the overall problems (including blindness), caused by cataract with the current procedures. With so many people presenting the afflictions of maturity onset cataract, it appears not to be possible to train in-time, the necessary numbers of surgeons required. In-fact, as-it-stands, it looks likely that the total number of people with serious eye-disorders because of cataract, will increase dramatically worldwide.

Surgical complications

There is another aspect to the problem that is rarely discussed. While cataract surgery is generally recognised as being one of the safest operations, there is a significant complication rate. For example, in the United States 30% to 50% of all patients having cataract extraction, develop opacification of the posterior lens capsule within two years and require further lazer treatment.

Since the number of cataract operations is so large, even a small percentage of complications represents a significant number of people. Of the patients having cataract surgery, 0.8% have retinal detachments, 0.6% to 1.3% are hospitalized for corneal edema (or require corneal transplantation), and 0.1% present endophthalmitis.

Thus, aside from secondary cataract, about 2% of the 1.35 million (or approximately 27,000 individuals), just in the US each year, develop serious complications as a result of cataract surgery.

It is therefore difficult to support the argument that cataract research is unimportant with statistics such as those cited above. The large and growing number of people blind with cataract and the significant complication rate, should be sufficient reason to increase cataract research.

The considerable discomfort experienced by patients as their vision diminishes, and the complete loss of accommodation resulting in the removal of the lens should also be recognised. Besides the possible complications, an artificial lens just does not have the overall optical qualities of a natural lens.

A medical solution is required that will maintain the transparency of the lens. Even if the development of cataract can be delayed by 10-years, the overall benefits would be highly significant.

The development of NAC

Innovative Vision Products (IVP) is a US based corporation, operating in Russia (utilizing Russian researchers and scientists), who have over the last several-years developed and tested a unique new form of carnosine. This form of carnosine is known as n-acetylcarnosine or abbreviated to NAC.

NAC presents the first major leap forward in the treatment and possible prevention of senile cataract.

As a bio-engineering company, IVP have developed a proprietary method of producing extremely high purity NAC, that has proven itself to be a suitable ophthalmic drug for the non-surgical treatment of age-related cataracts. Yet it also displays high efficacy and physiological tolerance.

NAC has a highly statistical and very significant clinical success rate for patients within 3-12 months of treatment. Not surprisingly, IVP has been quick to ensure that its NAC has worldwide patents, including its use for cataract. It is also interesting to note that NAC eye-drops are patented for use in open-angle glaucoma, but as yet, the research for that disorder remains unpublished. [Ed.- We are keen to report on NAC's benefit for glaucoma as soon as it becomes available, especially as this is an eye-disorder that is extremely difficult to treat].

Human trials

Carnosine eye-drops were used in a clinical trial to treat 96 patients aged 60 and above. All the patients had senile cataract in various degrees of maturity. The duration of the disease in these patients ranged between 2 and 21 years.

Firstly, the researchers stopped the patients use of all other anti-cataract drugs. Then the patients instilled 1 or 2 drops into each eye 3 or 4 times a day, for a period of 3 to 6 months.

The level of eyesight improvement and the change of lens transparency was considered as an evaluation index. The results showed that there was a pronounced effect on primary senile cataract, the effective rate was 100% (i.e. all patients experienced an improvement). For the more mature senile cataract (i.e. those who had had the cataract the longest time, in some cases more than 20-years) the effective rate was still an extremely impressive 80%.

These are remarkable results considering that the best that could normally be expected would be a slight improvement, a halt to the progression and under normal (i.e. non-treated) circumstances a continual worsening of the disease.

Importantly, it was also noted that there were no side effects noted in any of the cases.

Another Russian study was designed to document and quantify the changes in lens clarity over a 6 to 24 month period for 49 volunteers. Their average age was 65 and all suffered from senile cataract of a minimal to advanced opacification.

The patients received either a 1% solution of NAC eye-drops or a placebo, as 2-drops twice a day into each eye. The patients were then evaluated at 2 and 6 month periods. The tests consisted of ophthalmoscopy (glare test), stereocinematagraphic (slit-image) and retro-illumination (photography). A computerized digital analysis then displayed the light scattering and absorbing effects of the centers of each lens.

At 6-months, 88.9% of all eyes treated with NAC had an improvement of glare sensitivity (lowest individual score was a 27% improvement, right the way up to a 100% improvement). 41.5% of all eyes treated with NAC had a significant improvement of the transmissivity of the lens, but perhaps most importantly 90% of the eyes treated with NAC showed an improvement in visual acuity. Meanwhile, in the placebo group there was little change in eye quality at 6-months and a gradual deterioration at 12 to 24 months.

Importantly, this study also showed that at 24-months the NAC treated group, (who already had significant improvement to the quality of their eyesight), sustained these results with continued use of the NAC eye-drops.

Once again, no significant side effects were noted in any cases throughout the 2-year period.

Another interesting study also evaluated patients between the ages of 48 and 60, who had various degrees of eyesight impairment, but who did not have the symptoms of cataract. After a course of treatment ranging from 2 to 6 months the conclusion was, that the eye-drops alleviated eye-tiredness and continued to improve eyesight (i.e. there was more clear vision). The subjects reported that the treatment "brightened" and "relaxed" their eyes. This is an important indicator that the eye-drops have a value both for preventative purposes, as well as medical applications.

At this time, it is now believed that carnosine eye-drop treatment has been applied to over one thousand patients with senile cataract in China and Russia, (those countries are home to the principal researchers behind the work). Clear evidence is emerging that NAC eye-drops are a safe, effective treatment and potential preventative against cataract.

NAC method of action

Cataract is a glycosylation problem. This reaction occurs when proteins became cross-linked (and hence impaired). The result of this reaction leads to the discoloration of the eye-lens to yellow and brown, and hence the impairment of vision. But, carnosine is known to compete on the molecule for the glycating agent and protect cellular structures against aldehydes. Therefore, carnosine can slow and help to prevent proteins from becoming cross-linked, (and in this case from becoming cataract).

NAC has been shown to be highly resistant to carnosinase, (the natural enzyme that breaks down L-carnosine into histamine etc.). An experiment on rabbits showed that NAC eye drops allow themselves to be broken down into L-carnosine once inside the eye's aqueous humor, (a process that occurs within 15 to 30 minutes after application of the eye-drops).

L-carnosine is an excellent anti-oxidant and is particularly effective against potent free-radicals, especially the Superoxide and the Hydroxyl. It is therefore presumed, that the anti-oxidant role of L-carnosine (within the aqueous humor) is a major factor, in slowing and preventing the appearance of cataract.

However, when L-carnosine eye-drops were used there was no presence of L-carnosine in the aqueous humor (even after 30-minutes). This may be because L-carnosine is broken down early into histamine etc., before it reaches the aqueous humor. So, NAC may act as a "carrier" for L-carnosine delivering it to where it is needed, [Ed.-see the next section of this article for further comparisons of NAC to L-carnosine].

The powerful anti-oxidant abilities of carnosine within the eye, and the prevention of cross-linking, helps to explain why NAC is effective at preventing and slowing cataract, perhaps even halting it. But it doesn't explain why NAC has been shown to reverse cataract. But we may already know the answer.

For example, it is known that when carnosine is delivered in high doses, that it can reverse protein-aldehyde cross-linking, (this reaction is normally very difficult to reverse). Under these circumstances, carnosine has been shown to have a "rejuvenating" effect on cultured cells.

Cataract develops when anti-oxidant defense is exhausted, leading to the cross-linking of the lens crystallins, (producing a clouded lens, and hence impaired eyesight). We can assume that the regular use of a 1% NAC eye-drop (as used in the clinical trials), delivers "a high-dose of carnosine capable of reversing the lens cross-linking," and hence the reduction and eradication of cataract.

So in conclusion, NAC eye-drops appear to act as a universal anti-oxidant, both in the lipid phase of the cellular lens membranes, and in the aqueous environment. NAC eye-drops reduce and protect the crystalline lens from oxidative stress-induced, cross-linking damage.

NAC compared to L-carnosine

We may logically ask the question; why have NAC eye-drops been shown to have this action upon cataract, and yet L-carnosine (which is its sister di-peptide) appears to have little benefit? Dr. Mark Babizhayev, one of the principal Russian researchers behind the clinical trials with NAC eye-drops gave us this reply to that very same question:

"I believe that the application of L-carnosine for the treatment of human cataracts is misleading. This is because L-carnosine readily becomes a substrate for the activity of natural peptidases (i.e. carnosinase) in the aqueous humor. So much so, that there is no sign of L-carnosine in the aqueous humor within 15 minutes after instillation. Furthermore, I consider that L-carnosine eye-drops may even be harmful for eyes because it gradually releases histamine, which, located as it would be in the presence of the eye-lens is a very toxic agent. However, NAC eye-drops are resistant to hydrolysis with natural carnosinase. Therefore, NAC is the only currently known agent which reverses and prevents human cataracts."

In conjunction with Dr. Hipkiss and Dr. Kyriazis information, we can conclude that while some of the benefits of oral L-carnosine may derive after carnosinase breaks down into histamine- [Ed.- see Dr. Kyriazis interview article in this issue for further details], that in the case of eye-drops, L-carnosine must be avoided.

It is also interesting to note that a study by Dr. Boldyrev et al, also concluded that the oral use of NAC was far less likely to be broken down by carnosinase than L-carnosine [Ed.- see Dr. Kyriazis interview in this issue for further details].

Buyer beware!

Dr. Mark Babizhayev also makes it quite clear that "ordinary" NAC will not be of much use in the treatment of senile-cataract. This is because there are many synthesized "carnosines" and their biological and medicinal activity strongly varies and depends on the mode of their obtention. [Ed.- see Dr. Babizhayev interview in this issue for further details].

For example, if carnosine is extracted from meat muscle substances, the biological and anti-oxidant activity is very low. This is presumably due to the contamination of the "pure" carnosine substance by heavy metal salts and proteins and other related impurities. It is very difficult to purify carnosine chromatographically, as the compound chelates divalent metal ions very heavily and the biological and anti-oxidant activities can not be regenerated during the purification procedures.

In conclusion, there were many forms of carnosine which were abandoned in the Russian studies because of their lack of anti-cataract and anti-oxidant ability in the human eye.

However, IVP (in conjunction with their Japanese partner and manufacturer), have developed a synthesized pure NAC which has biological activity and has been well controlled and proven in human lens studies. This is the same type that has been used in the clinical trials.

IVP hold the proprietary knowledge to the correct and efficient production of high-purity NAC. If the label doesn't state it is formulated by Innovative Vision Products (IVP), then the source of the raw material is NOT the one that the clinical trials were conducted with. "Unknown" sources of carnosine eye-drops should be avoided as the material could be ineffective, and possibly even dangerous to the human eye.

Cataract is a widespread age-related affliction and NAC eye-drops appear to be a highly efficacious and safe treatment for cataract. As such, I suspect that this supplement is going to become one of the most important new discoveries, and will have a major impact on the way that cataract is controlled.

References

1. Boldyrev AA, Dupin AM, Bunin Aya, Babizhayev MA, Severin SE "The antioxidative properties of carnosine, a natural histidine containing di-peptide." Biochem. Inrern., 1987, 15/6, 1105-1113.
2. Babizhayev MA et al "N-Acetylcarnosine, a natural histidine-containing di-peptide, as a potent ophthalmic drug in treatment of human cataracts." Peptides (USA) 2001, 22(6): 979-994.
3. Babizhayev MA, Yermakova VN, Deyev Al, Seguin M-C "Imidazole-containing peptiomimetic NACA as a potent drug for the medicinal treatment of age-related cataract in humans." J. Anti-Aging Medicine 2000, 2, 43-62.
4. Babizhayev MA, Yermakova VN, Semiletov yu A, Deyev Al "The natural histidine-containing di-peptide N-acetylcarnosine as an antioxidant for ophthalmic use." Biochemistry (Moscow), 2000, 65, 588-598.
5. Babizhayev MA, Yermakova VN, Sakina NL, Evstigneeva RP, Rozhkova EA, Zheltukhina GA "N-Acetycarnosine is a prodrug of L-carnosine in ophthalmic application as antioxidant." Clin. Chim. Acta., 1996, 254, 1-21.
6. Babizhayev MA, Bozzo Costa E "Composizioni farmaceutiche contenenti N-acetilcarnosina per il trattamento della cataratta." A61K gruppo 37/00 cap 20122 MI 15.10.1993. Italian patent.
7. Babizhayev MA, Bozzo Costa E "Pharmaceutical compositions containing N-Acetylcarnosine for the treatment of cataract." European Patent PCT/EP 94/03340 10.10.1994 Ref. SCB 238 PCT.
8. Babizhayev MA, Seguin M-C, Gueyene J, Evstigneeva RP, Ageyeva EA, Zheltukhina GA "L-carnosine and carcinine act as natural antioxidants with hydroxyl-radical-scavenging and lipid peroxidase activities." Biochem J. 304, 509-516.
9. Babizhayev MA, "Antioxidant activity of L-carnosine, a natural histidine-containing di-peptide in crystalline lens." Biochem. Biophys. Acta., 1989, 1004, 363-371.
10. Babizhayev MA, Deyev Al "Lens opacity induced by lipid peroxidation products as a model of cataract associated with retinal disease." Biochim. Biophys. Acta., 1989, 1004, 124-133.
11. Babizhayev MA, Deyev Al "Free radical oxidation of lipid and thiol groups in genesis of cataract." Biophysics (biofizika), 1986, 31, 119-125, Pergamon Journals Ltd.
12. Kantha S, Wada S, Tanaka H, Takeushi M, Watabe S, Ochi H (1966), Biochem. Biophys. Res. Commun. 223, 278-292.
13. Babizhayev MA, Deyev Al, Linberg LF "Lipid peroxidation as a possible cause of cataract." Mech. Ageing Dev. 1988, 44, 69-89.
14. Boldyrev AA, "Problems and perspectives in studying the biological role of carnosine" International Center for Biotechnology, Department of Biochemistry, Lomonosov, Moscow State University.
15. Hipkiss A, (1998) Int. J. Biochem. Mol. Biol., 30, 863-868.
16. Boldyrev AA, Dupin A, Bunin A, Babizhayev MA, Severin SE (1987), Biochem. Int., 15, 1107-1113.
17. Wang AM, Ma C, Xie H, F Shen "Medical application of carnosine" Department of Biochemistry and Neurobiology, Harbin Medical University, China.
18. World Health Organisation, Ageing and Health, Website: http://www.who.int/ageing/scope.htm


Source: http://www.antiaging-systmems.com

[kevin]

Link: http://www.eurekaler...c-mst031904.php

Public release date: 22-Mar-2004

Contact: Ramune Carothers
ramune_carothers@cox.net
949-218-0944

Mount Sinai Press Office
212-241-9200
NewsMedia@mssm.edu

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Mount Sinai to offer NearVision CK
CK is the only FDA-approved vision procedure for presbyopia(

NEW YORK CITY – March 22, 2004) – Today Mount Sinai Medical Center becomes one of the first medical centers in the country to offer NearVision CK (Conductive Keratoplasty) to treat presbyopia, addressing the primary vision concern of every adult over the age of 40.

This announcement comes on the heels of the FDA's approval of CK as the first procedure to improve near vision in patients with presbyopia. Affecting approximately 90 million Americans, presbyopia is a progressive condition that causes near vision to fade with age.

NearVision CK is indicated for the temporary improvement of near vision in emmetropic presbyopes (those who require only reading glasses) and hyperopic presbyopes (those who require reading and distance glasses). Generally, CK is performed on one eye to restore near vision without compromising the patient's binocular distance vision.

The FDA approved NearVision CK for use in presbyopes after reviewing clinical trial data from the 12-month follow-up data point. Mount Sinai participated in the clinical trials, in which 98 percent of patients could see J5 (magazine- and newspaper-size print) in the eye that was treated with CK and 87 percent could see 20/20 in the distance and read J3 (phone book-sized print; significantly smaller than newsprint).

No serious, sight-threatening or unanticipated safety events were reported, giving CK one of the highest safety profiles among refractive procedures. CK uses leading-edge radiofrequency energy, instead of a laser or scalpel, to restore near vision without cutting or removing corneal tissue.

In a three-minute procedure using topical (eye drop) anesthesia, CK uses a probe thinner than a strand of human hair to apply radio waves in a circular pattern on the outer cornea, shrinking small areas of tissue. This circular pattern creates a constrictive band (like the tightening of a belt), increasing the overall curvature of the cornea to improve the patient's near vision.

"The telltale symptom of aging for the baby boomer population is the need for reading glasses to perform everyday tasks, such as checking their watch for the time," said Penny Asbell, M.D., Director of the Cornea Service and Refractive Surgery Center at The Mount Sinai Hospital and a principal investigator of the Mount Sinai clinical trials for CK. "CK offers a safe, effective and minimally invasive procedure that helps people over 40 to overcome the aging of their eyes."


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Mount Sinai Department of Ophthalmology
Led by Chairman Steven M. Podos, M.D., Mount Sinai's Department of Ophthalmology is a complete interdisciplinary center for the visual sciences that is considered one of the most influential vision care centers in the world. The department boasts a comprehensive program of patient care that exposes patients to the latest therapies in eye care, a cutting-edge team of investigators who carry out both clinical trials and laboratory research, and a robust educational program that spans both undergraduate- and graduate-level courses at The Mount Sinai School of Medicine and at affiliated institutions in the New York metropolitan area, as well as an acclaimed residency training program.

The department comprises a full-time faculty of over 23 clinicians and senior research scientists, and a voluntary faculty of over 100 ophthalmologists located throughout the greater New York area.

[kevin]

Link: http://www.nytimes.c...ml?pagewanted=1

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To Read the Menu, Baby Boomers Turn to Eye Treatments

By MILT FREUDENHEIM
Published: April 11, 2004

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A patient undergoes a procedure that uses radio waves, not lasers,to correct a common near-vision problem.

A few months ago, George Miller, 55, a computer sales manager in Lexington, S.C., had reading glasses scattered all over the house. Worse, he found it was impossible to read a menu at night in a dimly lighted restaurant or the many car magazines that came to his house. "It really bothered me a lot because I love to read," Mr. Miller said.

So, when he heard about a new experimental eye surgery on the local television news, he researched it on the Internet and called his ophthalmologist.

"I'm a little vain," Mr. Miller conceded. Though the new procedure, which uses radio waves to correct near-vision problems, had not yet been approved by the Food and Drug Administration for his problem, he had it done last winter.

"It was a no-brainer," said Mr. Miller, who no longer needs reading glasses. "I can't imagine why anyone who could afford it would not do it."

Biology and vanity are collaborating to make vision correction techniques a boom market, as some 78 million aging Americans seem intent on seeing well but looking good. Granny glasses? Grandpa's bifocals? Not for them. Offer them the option of paying $1,500 for a three-minute remedy and the eyeglasses are gone.

"The baby boomers are kind of a picky bunch," said David Harmon, president of MarketScope, an eye care market research company in Baldwin, Mo., near St. Louis. "They want to be fixed."

Last month, the F.D.A. approved the latest surgical procedure, called conductive keratoplasty, to correct a common near-vision problem for people whose eyesight is otherwise excellent, in a minimally invasive way.

Unlike Lasik, the popular laser surgery, conductive keratoplasty procedures do not involve using lasers to change the shape of the eye. Instead, a tiny instrument applies radio waves in a circular pattern on the outer cornea, shrinking small areas of collagen, a fibrous protein found in connective tissue, bone and cartilage. The treatment increases the cornea's curvature, improving near vision.

In the last few years, about three million people, as many as 5 percent of Americans with vision problems, have opted for Lasik surgery to correct nearsightedness, farsightedness and astigmatism. In Lasik, the surgeon cuts and pulls a flap in the cornea and then uses a laser to reshape the underlying tissue at a cost of up to $1,600 an eye. Neither Lasik nor conductive keratoplasty is covered by most insurance plans.

The latest procedure is only one of an array of new vision therapies, recently introduced or in late stages of development. They include improvements that make laser surgery machines more accurate and eliminate the knife blade typically used to prepare the eye, as well as a dozen new types of lens implants.

One new artificial lens mimics a healthy 20-year-old's ability to see at both near and far distances. Others eliminate harmful high-spectrum blue light, reducing the need for sunglasses.

William Link, a California scientist and entrepreneur who helped start several eye care companies, estimates that established companies like Alcon Laboratories, Bausch & Lomb and VISX have spent a total of $750 million in the last five years developing products for the baby boomers. In addition, Mr. Link says, he and other venture capitalists have contributed more than $140 million to companies like Refractec, the start-up based in Irvine, Calif., that developed conductive keratoplasty.

The company teaches eye surgeons to do the procedure and sells them the machines for about $58,000, compared with about $325,000 for laser machines.

Conductive keratoplasty was approved by the F.D.A. for hyperopia, a less common vision problem, two years ago. After 30,000 cases, an agency panel of 12 experts unanimously recommended it for near-vision problems, and it received approval March 16.

Conductive keratoplasty is usually performed on one eye only. The other eye provides most of the distance vision, and the mind coordinates the visual information as it does for people who naturally have one farsighted eye and one nearsighted eye. Even so, if the patient's prescription requires treatment in both eyes, it can be done on the same day.

Ophthalmologists say the corrective effects may weaken after five years or so, but the procedure is too new for them to be sure. An F.D.A. panel said patients should be warned that the treatment "may affect depth perception," which could be a driving hazard. The panel also recommended to the full agency that there be information in the label about a relatively few patients who ended up with astigmatism after the procedure.

Dr. Penny A. Asbell, an ophthalmologist at the Mount Sinai School of Medicine in New York, recalled that a patient who works with younger colleagues in the music industry also wanted the procedure even before it was approved.

"He didn't want to be the only one at the table putting on reading glasses to read a contract," Dr. Asbell said. "Everybody else there is hip-hop, or whatever they do," she said.

Ophthalmologists say they find that many middle-aged patients are conservative about trying risky eye operations. An estimated 1 in 10 Lasik patients needed a repeat treatment until the technology was improved. The F.D.A. warns on its Web site that the procedure is not for everyone.

Last year, Alcon, which says it has 30 percent of the market for eye surgery in the United States, received approval in the European Community for a new intraocular lens implant for cataract patients that enhances close-up and distance viewing. The procedure has not yet been priced in the United States, the company said. These new lenses may cost as much as $600 each.

Although the company expects F.D.A. approval in 2005 for United States cataract patients, who are typically in their late 60's and 70's, the new multifocal lenses will probably attract some younger patients willing to pay for the implants. The new lens will also protect against blue light, eliminating dependence on sunglasses after the operation. "Also, they won't need a cataract operation later on," Bill Barton, an Alcon vice president, said.

Mr. Barton said tests with cells in the laboratory suggested that blue light might be a "causative factor" in macular degeneration, the leading cause of blindness in older Americans.

Alcon is also testing a prescription drug that is intended to stop or prevent changes in the eye that lead to macular degeneration. Bausch & Lomb is doing early stage research on a continuous drug delivery system at the back of the eye implant to combat the disease.

Despite all of the advances, millions of Americans will hold fast to their eyeglasses. After all, it might not have been as funny to watch Jack Nicholson and Diane Keaton using their vision problems (along with Viagra jokes) to illustrate advancing age in the comedy movie "Something's Gotta Give."

Still, for people who are over 40 and start having trouble reading, the message from the eye industry is clear: there are more options than ever.

Mr. Link, a managing director of Versant Ventures, a venture capitalist firm in Menlo Park, Calif., turns 58 today. He had the conductive keratoplasty procedure last year and was rewarded as a fly fisherman. "Now I can tie the flies on my line without reading glasses," he said.

[kevin]

Link: http://www.eurekaler...--saa041204.php

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Public release date: 12-Apr-2004
Contact: Wallace Ravven
wravven@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco

Statins and aspirin may protect against severe vision loss in elderly
Cholesterol-busting statins, the largest-selling prescription drugs in the U.S., may protect older people from blindness, a new study shows. Aspirin also appears to provide significant protection, according to the research.

Scientists at UCSF assessed the use of statins and aspirin among more than 300 elderly patients with age-related macular degeneration, or AMD, a common condition among people over 70. About one in eight cases of AMD deteriorates into what is called wet AMD, the leading cause of irreversible severe vision loss in older people.

The scientists found that those patients already taking statins were half as likely as those without statins to develop the more severe wet AMD, caused by the growth of new blood vessels underneath the retina. Those already on aspirin were about 40 percent less likely to develop this new blood vessel growth, technically called choroidal neovascularization (CNV).

The research is reported in the April issue of the American Journal of Ophthalmology.

"Standard treatments for wet AMD often result in stabilization of vision loss, rather than improved vision, so it's important to identify treatments that may prevent the disease," said Jacque L. Duncan, MD, assistant professor of ophthalmology at UCSF and senior author of the study.

Of the few earlier studies of the possible relationship between statins and either early or late AMD, three supported an association and one did not. All these studies involved relatively small numbers of people with wet AMD, Duncan said.

"This study is probably the strongest support we can get for the benefits of statins and aspirin against AMD," Duncan said. "A randomized controlled trial is unlikely to occur, because it would withhold statins and aspirin from the control group, and these drugs have been shown to save lives."

Some patients were on statins alone, some on aspirin alone, and some on both, Duncan noted. A statistical analysis found that both statin use and aspirin use were independently associated with reduced risk of CNV.

Earlier studies had suggested that statins' ability to lower cholesterol levels in the blood may account for their protective effect against macular degeneration, since some evidence suggests that fat deposits in eye membranes may lead to AMD. But Duncan and her colleagues found no association between cholesterol levels after statin treatment and wet AMD.

The most likely, but still unproven, explanation involves the anti-inflammatory properties of both statins and aspirin, Duncan said. Tissue studies of patients with CNV reveal chronic inflammatory cells and other evidence of inflammation. Statins inhibit production of proteins involved in inflammation and reduce the role of immune cells in inflammation. They also are antioxidants, which have been shown to reduce risk of CNV in AMD patients.

"There are lots of good reasons to be on statins and aspirin," Duncan concludes. "This study suggests yet another potential benefit. Although we are not sure of the mechanism, these drugs appear likely to have a protective effect against the leading cause of irreversible severe vision loss in older people."

The study also supported earlier findings that development of the harmful CNV is significantly more common among smokers.


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Lead author of the study is Hilary L. Wilson, MD, first-year resident in ophthalmology at Loma Linda University and former medical student at UCSF. Co-authors of the paper and collaborators in the research are Daniel M. Schwartz, MD, associate professor of ophthalmology at UCSF; Charles E. McCulloch, PhD, professor of epidemiology and biostatistics at UCSF; and Hilarey R. F. Bhatt, MD, assistant professor of medicine at the UCSF-affiliated Veteran Affairs Medical Center.

The research is supported by the National Eye Institute, by Research to Prevent Blindness, and grants from That Man May See, Inc. and The Foundation Fighting Blindness.