Category Archives: Ophthalmology

CRISPR Tech for Eye Disease Moves Closer to Reality

A study published in the journal of the American Academy of Ophthalmology shows that a CRISPR-based treatment can restore retinal function in mice.

Researchers from Columbia University have developed a new technique for the powerful gene editing tool CRISPR to restore retinal function in mice afflicted by a degenerative retinal disease, retinitis pigmentosa. This is the first time researchers have successfully applied CRISPR technology to a type of inherited disease known as a dominant disorder. This same tool might work in hundreds of diseases, including Huntington’s disease, Marfan syndrome, and corneal dystrophies. Their study was published online today in Ophthalmology, the journal of the American Academy of Ophthalmology.

Stephen H. Tsang, M.D., Ph.D., and his colleagues sought to create a more agile CRISPR tool so it can treat more patients, regardless of their individual genetic profile. Dr. Tsang calls the technique genome surgery because it cuts out the bad gene and replaces it with a normal, functioning gene. Dr. Tsang said he expects human trials to begin in three years. “Genome surgery is coming,” Dr. Tsang said. “Ophthalmology will be the first to see genome surgery before the rest of medicine.”

Retinitis pigmentosa is a group of rare inherited genetic disorders caused by one of more than 70 genes. It involves the breakdown and loss of cells in the retina, the light sensitive tissue that lines the back of the eye. It typically strikes in childhood and progresses slowly, affecting peripheral vision and the ability to see at night. Most will lose much of their sight by early adulthood and become legally blind by age 40. There is no cure. It is estimated to affect roughly 1 in 4,000 people worldwide.

Since it was introduced in 2012, the gene editing technology known as CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) has revolutionized the speed and scope with which scientists can modify the DNA of living cells. Scientists have used it on a wide range of applications, from engineering plants (seedless tomatoes) to producing animals (extra lean piglets). But as incredible as genome surgery is, CRISPR has some flaws to overcome before it can live up to its hype of curing disease in humans by simply cutting out bad genes and sewing in good ones.

Typically, CRISPR researchers design a short sequence of code called guide RNA that matches the bit they want to replace. They attach the guide RNA to a protein called Cas9, and together they roam the cell’s nucleus until they find a matching piece of DNA. Cas9 unzips the DNA and pushes in the guide RNA. It then snips out the bad code and coaxes the cell to accept the good code, using the cell’s natural gene repair machinery.

Diseases like autosomal dominant retinitis pigmentosa present a special challenge to researchers. In autosomal dominant disorders, the person inherits only one copy of a mutated gene from their parents and one normal gene on a pair of autosomal chromosomes. So, the challenge for CRISPR-wielding scientists is to edit only the mutant copy without altering the healthy one. In contrast, people with autosomal recessive disorders inherit two copies of the mutant gene. When two copies of the gene are mutated, treatment involves a more straightforward, one-step approach of simply replacing the defective gene. Dr. Tsang and colleagues have come up with a better strategy to treat autosomal dominant disease. It allowed them to cut out the old gene and replace it with a good gene, without affecting its normal function.

Instead of using one guide RNA, Dr. Tsang designed two guide RNAs to treat autosomal dominant retinitis pigmentosa caused by variations in the rhodopsin gene. Rhodopsin is an important therapeutic target because mutations in it cause about 30 percent of autosomal dominant retinitis pigmentosa and 15 percent of all inherited retinal dystrophies.

This technique allowed for a larger deletion of genetic code that permanently destroyed the targeted gene. Dr. Tsang found that using two guide RNAs instead of one increased the chance of disrupting the bad gene from 30 percent to 90 percent. They combined this genome surgery tool with a gene replacement technique using an adeno-associated virus to carry a healthy version of the gene into the retina. Another advantage is that this technique can be used in non-dividing cells, which means that it could enable gene therapies that focus on nondividing adult cells, such as cells of the eye, brain, or heart. Up until now, CRISPR has been applied more efficiently in dividing cells than non-dividing cells.

Dr. Tsang used an objective vision test to evaluate the mice after treatment to show a significant improvement in retinal function. An electroretinogram is typically used to evaluate retinal health in humans. It tests the health of the retina much like an electrocardiogram (EKG) tests the health of the heart. Previous CRISPR studies for retinal diseases have relied on a less objective measure that involves evaluating how often the mouse turns its head in the direction of a light source. Dr. Tsang used electroretinography to show that retinal degeneration slowed in treated eyes compared with untreated eyes.

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Millennials Face a New Threat: Blue Light from Tech Devices

A “Jacob Moses MD Memorial Lecture” offers a new perspective on Blue light and innovative technology to prevent disease while enhancing visual performance.

Millennials and technology users all face the dangers of over-exposure to blue light waves from devices

Melanin and Ocular Lens Pigment are natural defenses to filter Blue light in skin and eyes. Innovative external lenses using these derivatized compounds complement the human body to reduce glare, improve sleep, balance circadian rhythm to maintain overall health, and may prevent blindness.

Dr. Michael Tolentino MD delivered the prestigious “Jacob Moses MD Memorial Lectureship” to an audience of over 40 eye doctors in Columbus Ohio regarding the impact of naturally occurring and artificially generated sources of High Energy Visible (Blue) light on the primary optical tract and retinal-hypothalamic tract. “Blue light threatens our eyes, our vision, and circadian rhythm,” explained Dr. Tolentino. He detailed preventative measures to protect our visual and physiological systems using cost-effective external lenses to enhance natural defenses.

The human body produces Melanin and Ocular Lens Pigment, which were paradigms for Blue light protection, and patented by Dr. James Gallas of Photoprotective Technologies as derivatives that filter light in proportion to the Blue light wavelengths ability to cause damage.

“The combination of Melanin and Ocular Lens Pigment (OLPTM) provide more effective filtration of Blue light than anything I am aware of and I recommend using the lenses to reduce issues involving glare and damage to the retina and macula from prolonged or intense Blue light exposure. Further, the MPF lens promotes balanced Melatonin production, critical to proper physiological function to help mitigate chronic diseases including cardiovascular issues, depression, diabetes, obesity, and cancer,” explained Dr. Tolentino.

About Dr. Michael Tolentino: He is Associate Professor of Clinical Ophthalmology at the University of Central Florida and co-founder of the Tolentino Eye Research Foundation (www.tolentinoeye.org) is recognized globally as a medical authority, whose qualifications include education or faculty at Brown University, Harvard University, University of Massachusetts and University of Pennsylvania. He co- invented the concept of intravitreal anti-Vascular Endothelial Growth Factor (VEGF) injections, in particular, the drug Avastin. He is credited for determining that VEGF is sufficient and necessary for the development of diseases such as diabetic retinopathy and wet macular degeneration. He also co-invented Bevasiranib a siRNA against VEGF. As a clinical trialist, he has helped more than half a dozen drugs or treatments for the eye obtain FDA approval.  He is currently developing novel topical, nutritional, and preventative alternatives to prevent blindness.

TrueBlue Vision holds the exclusive production of lenses and products for both natural (outdoor) and artificial (indoor) blue light filtration. After an extensive review of product performance, TrueBlue was recently chosen by “IRIS The Visual Group” Canada’s largest network of Eyecare Professionals. To learn more about preventative strategies and novel therapies for retinal diseases such as macular degeneration and diabetic retinopathy, please visit http://www.tolentinoeye.org.  To learn more about the Blue Light Threat and TrueBlue lenses, please visit http://www.truebluevision.com

Source: TrueBlue Vision, Displayed with permission from PRNewswire for Journalists

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Ophthalmology Devices Global Market Forecast (to 2021)

Ophthalmology is a segment of medical science associated with study of anatomy, physiology, diseases of human eye, and developing various therapeutic methods to treat eye diseases.

SUMMARY:  Some of the major eye diseases are either age-related or caused due to chronic disorders. They include various degenerative eye diseases like macular degeneration, cataract, ocular hypertension (glaucoma), and refractive errors among others. Revolution in the field of medical science has led to the rapid development of ophthalmology devices that are invented to effectively treat ocular defects and disorders.

Ophth Devices REPORTOphthalmology devices market is segmented on the basis of products type as diagnostic devices, surgical devices and vision care. Based on the applications the ophthalmology devices market is segmented into cataract, glaucoma, age-related macular degeneration, diabetes retinopathy and others (refractive errors, amblyopia, and strabismus). End-users are segmented into hospitals, academic and research laboratories, and others (private eye clinic and vision care outlets).

The global ophthalmology devices market is expected to grow at a CAGR of around 5.8% from 2015 to 2021. Increasing incidence of degenerative diseases of eyes, increasing baby boomer population, increase in R&D activities in ophthalmology key players and extensive use of high-end technologies involving use of software and computer aided devices and platforms in ophthalmology drives the market of ophthalmology devices market. Lack of ophthalmologists, economic slowdown and saturation of the market in developed countries are the factors hampering the market growth.  (Access the full report: http://www.reportlinker.com/p03086455-summary/view-report.html)

Lifestyle changes owing to increase in ocular cancer, diabetes and macular degeneration patients, early diagnosis and treatment of diseases, advancement of technology with its wide application areas shows that ophthalmology devices market has vast opportunities in the coming years.

North America accounts for the highest market share followed by Europe. Steep rise in aging population, increase in minimally invasive surgeries and favorable government policies makes U.S. the leader of ophthalmology devices market. However, Asian countries especially India and China’s are the fast growing regions with its growing demand for ophthalmology devices and increasing research investments.

Major players in ophthalmology devices market include: Abbott Medical Optics, Inc. (USA), Alcon Laboratories, Inc. (USA), Bausch & Lomb, Inc. (USA), Carl Zeiss (Germany), Essilor International SA (USA), Haag-Streit Holding AG (Switzerland), Hoya Corporation (Japan), Nidek Co. Ltd (Japan), STAAR Surgicals (USA), Topcon Corporation (Japan).

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