Weekly Glance for July 11th

What's new in optometry, week by week.


Your Rundown

Can artificial intelligence help detect eye disease?  Google thinks so.

A collaboration between DeepMind, the artificial intelligence company owned by Google, and Moorfields Eye Hospital in London will analyze OCT and fundus images of 1 million patients to create an algorithm to identify the early signs of diabetic retinopathy and wet macular degeneration.  The hope is that AI can earlier detect these conditions and with greater accuracy.  Which might not be a bad thing because apparently we get it wrong 10-20% of the time.


New AMD drug on the horizon

The current options for intravitreal injections to treat wet AMD are all anti-VEGF drugs.
Quick Anti-VEGF drug review:
Avastin - FDA approved for colorectal cancer in 2004 but used off-label for wet AMD, cost $50
Lucentis - FDA approved for wet AMD in 2006, cost $2000
Eylea - FDA approved for wet AMD in 2011, injected every 2 months, cost $1800

We know VEGF stimulates abnormal blood vessel growth in the retina and macula but not all patients respond to anti-VEGF drugs.  So a new sheriff is coming to town.  And that sheriffs name?  Fovista.
Fovista, delivered via intravitreal injection, is targeting the platelet-derived growth factor (PDGF).  "PDGF stabilizes the maturing blood vessels and shields the inner/endothelial cells, keeping them alive despite anti-VEGF treatment."  Because both VEGF and PDGF play a role in the formation of new blood vessel growth, the theory is that anti-VEGF and anti-PDGF combined therapy will be more effective at treating wet AMD than just anti-VEGF therapy alone.
Fovista is currently in Phase 3 clinical trials.
And while we're on it, you may be hearing the name Durasert a bit more.  Using a sustained release insert method of delivery, the insert delivers a repurposed cancer drug, TKI, which blocks both VEGF and PDGF.  This, however, has only been tested in animal models thus far.


New eye test can help diagnose the presence of TBI

Patients with traumatic brain injury are often only diagnosed when moderate to severe head injury occurs leaving many mild cases of TBI undetected.  A new screening tool aims at solving that problem and getting these cases diagnosed as quickly as possible.  The study, funded by the Department of Defense, tested 2000 military personnel that had suffered a mild TBI in the past 72 hours.  The findings:
---reduced NPC (near point of convergence)
---pupil dilation and constriction velocity were reduced
---reduced dilation recovery time
---decreased saccadic eye function
Knowing this information, the goal is to design an easily reproducible test that could measure these things and get the patient treatment quicker.

What Your Patient Might Ask You

Can I lose an eye from a dental procedure?

The gist:  A woman went in for a routine procedure, wasn't given safety glasses to wear, and the dentist dropped the needle used to inject a local anesthetic into her eye by accident.  The needle wasn't the main issue but because the mouth is a cesspool of bacteria, an eye infection resulted.  After various surgeries/antibiotics, they ended up having to remove her eye.  So even if those glasses leave weird marks on your face, you should still wear them.

Did you hear about that mysterious eye condition affecting astronauts?

VIIP = visual impairment intracranial pressure syndrome.
This is the coined term for the mysterious condition that affects the eyesight of 80% of astronauts after a long duration in space.  Although not completely understood, the condition is similar to idiopathic intracranial hypertension (IIH).  Astronauts present with choroidal folds and occasionally disc edema though the reason why is unclear.  The theory is there is increased intracranial pressure but confirming that theory is difficult because doing a lumbar puncture in space is, quite frankly, rocket science and not exactly ideal.  Unlike the symptoms of headache, nausea and dizziness that come with IIH, the only symptoms astronauts reported were blurry vision. In some cases, the vision dropped to 20/100 which makes for an exciting space walk. 

Social Media Roundup

The week in numbers.

3.3 seconds.  The length of time you can make eye contact with someone before it starts getting weird.

107.  The age of the oldest corneal transplant donor.

120.  The number of prosthetic eyes that can be 3-D printed in one hour.
Consider yourself informed. 
Share this email with a fellow eye nerd and you will have one less crazy patient this week. 
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