I have just written and placed online, a major study on the use of stem cells in ophthalmology.

It is a comprehensive look at the different types of stem cells, the eye diseases they may be able treat, and the companies involved in developing commercial stell cell-based treatments and therapies.

Briefly, stem cells are like blank slates that can develop or “differentiate” into specialized cells that carry out a specific function, such as in the skin, muscle, liver, or in the eye. Stem cells have application for diseases in the front of the eye, the middle of the eye, and the back of the eye.

In the front of the eye, scarred and degenerative corneas represent one prime area of research for the use of stem cells. Because of a lack of donated human cornea bank corneas for transplantation, especially in populous nations such as India and China (and the third World countries), the use of stem cells to regenerate damaged corneal tissues could become lifesavers in those countries where blindness due to damaged corneas is prevalent.

There are only a few research programs using stem cells for the middle areas of the eye, specifically in treating glaucoma. NeoStem has said that they are working with Schepens Research Institute in using the company’s VSELs (very small embryonic-like stem cells) in the treatment of glaucoma (and AMD), and Stemedica claims to be working with the Fyodorov Eye Institute in Moscow on a glaucoma program. I know of no programs targeting the lens.

Most of the research efforts appear to be focused on the back of the eye, specifically retinal tissue and diseases. Areas of interest that I have identified include regeneration of retinal epithelial (RPE) cells for the treatment of both dry and wet forms of age-related macular degeneration (AMD); replacement of damaged photoreceptors; the growth of artificial retinas, again for treating AMD; and direct treatments for diseases such as retinitus pigmentosa (RP), retinopathy of prematurity (ROP), diabetic retinopathy (DR), Stargardts disease (Stargardt Macular Dystrophy) (SMD), and retinal veinr occlusions (RVO).

The study also includes detailed information about the six companies that I’ve identified as active in this field, and includes a brief history of the use of stem cells in ophthalmology:

• Advanced Cell Technology Incorporated
• International Stem Cell Corporation
• NeoStem Incorporated
• Pfizer Regenerative Medicine
• Pfizer Ophthalmics
• StemCells Incorporated
• Stemedica

Here is the link to the full study.

I am a 38 year old African American Female, and currently under the care of a retina specialist in St. Louis, Missouri. I was involved in an automobile accident on 5/13/2009 which caused me to lose my sight in my left eye. I was the driver and on impact I was struck in my left eye by the sun visor. After having surgery to remove the blood, I was told by my retina specialist that my optic nerve was badly damaged and due to this damage unfortunately I won’t regain my sight. After several follow up visits it was mentioned that with technology advancing there is talk of “stem cell” treatment for optic nerve damage. I would love to see again out of my left eye and was hoping with today’s technology that would be possible. Please advise on any help that could be available to me. Thank you.

I recently wrote an extensive article about Illuvien and the future of ophthalmic drug delivery systems.

Illuvien is a new hope in the treatment of diabetic macular edema (DME). Illuvien delivers fluocinolone acetonide (FA), a corticosteroid, to the retina for up to three years, thus forgoing the need for multiple drug injections and/or laser treatments to alleviate the symptoms.

Well, Alimera, the company behind Illuvien, received good news yesterday in the form of notification from the FDA that its NDA (new drug application) for Iluvien had been accepted for filing and granted Priority Review status. FDA Priority Review status is granted to therapies that offer major advances in treatment or provide a treatment where no adequate therapy exists. This status accelerates the standard review time from 10 months to six months.

With priority review, Alimera could receive a response from the FDA in the fourth quarter regarding its NDA for Iluvien, which was submitted at the end of June 2010.

This is exciting news for patients, and will provide an alternative to laser, frequent injections and off-label treatments currently available for DME.

Here is a link to the full article.

My Father has been diagnosed for the second time with anterior ischemic optic neuropathy (AION). The first time was 9 years ago and he lost 95% of his vision in that eye. He was not put on any pills and there was no follow up or therapy. This time even with his history they disregarded his concerns until 8 days into the problem. He is now on prednisone for a month. He is again, about 95% blind in that eye, now as well. Is there any hope that since he is on prednisone that his condition will improve somewhat? Is there anything else that can be done? We are at a loss as to what to do. He has been told nothing will change, and in fact has not been seen by the doctor since he was put on the pills 10 days ago.

I am a 53 year female and just over a week ago I under went cataract surgery on my right eye.  I have developed extremely bad headaches behind my eye and reaching out to my temple.  It doesn’t seem to go away with normal pain medicine.  Could this be caused from some problem with the new lens?  Will this in course go away as the eye heals and gets used to the focus and light?  These don’t seem to be normal headaches – more like migraines although I have never had those before.

One of our contributors, Dr. David Richardson, of San Gabriel Valley Eye Associates, has published an audio CD that answers questions commonly asked by patients undergoing cataract surgery. Among topics covered are how to choose an eye surgeon and information on advanced introcular lenses.

The audio format is an excellent choice for patients with a significant cataract that make it difficult to read books on the subject.

Dr. Richardson was trained at Harvard Medical School, is Board Certified, holds an active license in the State of California, and has performed thousands of cataract surgeries. He has been named as a “Super Doctor” by his peers (Los Angeles Magazine 2010) as well as a “Top Doc” (Pasadena Magazine 2008 & 2009).

Click the link below to purchase the CD on Amazon.

Cataract Surgery Essentials or What All Patients Should Know About Cataract Surgery: A Patient’s Guide to Modern Eye Surgery including How to Choose an Eye Surgeon & Advanced Intraocular Lenses

One our contributors, Dr. David Richardson of San Gabriel Valley Eye Associates, recently wrote up a review of the NuLens® IOL from Israel on his blog entitled “NuLens IOL is No Optical Illusion.”

Dr. Richardson states that the NuLens IOL promises to allow cataract surgery patients to achieve a return to the same vision they enjoyed as teenagers. Dr. Richardson explains that unlike existing IOL’s on the market such as Crystalens, NuLens is made of a flexible silicon gel that uses the eye’s own muscles to push against the lens. Because the NuLens® is a truly flexible lens, it has the ability to produce a wider focusing capacity compared to other rigid and flat intraocular lens, and offers the prospect of better contrast, fewer aberrations and ghost images, and a better range of vision from intermediate (for activities such as cell phone dialing) to near focus (for activities such as reading the phone book) without negatively affecting distant vision (as with driving or watching TV).

Read Dr. Richardson’s full review.

I am scheduled for cataract surgery later this week.  My doctor prescribed and gave instructions for me to use Acuvail (drops) twice daily and Zymar 4 times daily, for three days before surgery and afterward.  When I picked up the prescriptions, he had changed the Acuvail to Nevanac 3 times daily. What is the difference between Acuvail and Nevanac, and why might he have changed the prescription?  I believe both are NSAIDs.

InSite Vision Incorporated, a company developing ophthalmic therapeutics, today announced the initiation of a Phase 1/2 clinical trial of ISV-303, a topical anti-inflammatory product intended to reduce the pain and inflammation associated with ocular surgery. ISV-303 combines a low dose of the non-steroidal anti-inflammatory (NSAID) bromfenac with InSite Vision’s proprietary DuraSite(R) technology. The randomized, placebo-controlled Phase 1/2 clinical trial is designed to evaluate the safety, efficacy and pharmacokinetics of ISV-303.

InSite’s DuraSite sustained delivery technology is a patented synthetic polymer-based formulation designed to extend the residence time of a drug relative to conventional topical therapies. It enables topical delivery of a solution, gel or suspension and can be customized for delivering a wide variety of potential drug candidates. The DuraSite platform is currently leveraged in two commercial products for the treatment of bacterial eye infections, AzaSite(R) (azithromycin ophthalmic solution) 1% and Besivance(TM) (besifloxacin ophthalmic suspension) 0.6%.

ISV-303 is intended to extend the duration of drug residence on the eye’s surface to facilitate better penetration and thus reduce dosing, while potentially improving the efficacy profile. ISV-303 combines a low concentration of bromfenac (Xibrom(TM), marketed by ISTA Pharmaceuticals) with DuraSite, InSite Vision’s proven bioadhesive polymer technology. In preclinical studies, ISV-303 demonstrated a superior delivery and ocular distribution profile when compared to the commercially available bromfenac eye drop.

Read the full press release on InSite Vision’s website.

Administering chemotherapy by cannulating the ophthalmic artery in patients with retinoblastoma was very effective in resolving these tumors in children and prevented enucleation in 27/28 cases. No complications! The procedure was safely repeated up to six times. The cannulation was performed under fluoroscopic control, and this method avoids all the side effects of chemo.