BIONIC EYE SEEKING FDA APPROVAL

This article and video in Wall Street Journal discusses bionic eye technology for use in patients that have lost significant vision from retinitis pigmentosa or macular degeneration.   This bionic eye, seeking FDA approval for use in the United States, enables certain blind individuals to perceive large objects in black and white.

OFFICIAL ABSTRACT OF ASPIRIN/AMD STUDY

JAMA Intern Med. 2013 Jan 21:1-7. doi: 10.1001/jamainternmed.2013.1583.

The Association of Aspirin Use With Age-Related Macular Degeneration.

Liew G, Mitchell P, Wong TY, Rochtchina E, Wang JJ.

Abstract

OBJECTIVE To determine whether regular aspirin use is associated with a higher risk for developing age-related macular degeneration (AMD) by using analyzed data from a 15-year prospective cohort. METHODS A prospective analysis was conducted of data from an Australian population-based cohort with 4 examinations during a 15-year period (1992-1994 to 2007-2009). Participants completed a detailed questionnaire at baseline assessing aspirin use, cardiovascular disease status, and AMD risk factors. Age-related macular degeneration was graded side-by-side from retinal photographs taken at each study visit to assess the incidence of neovascular (wet) AMD and geographic atrophy (dry AMD) according to the international AMD classification. RESULTS Of 2389 baseline participants with follow-up data available, 257 individuals (10.8%) were regular aspirin users and 63 of these (24.5%) developed neovascular AMD. Persons who were regular aspirin users were more likely to have incident neovascular AMD: the 15-year cumulative incidence was 9.3% in users and 3.7% in nonusers. After adjustment for age, sex, smoking, history of cardiovascular disease, systolic blood pressure, and body mass index, persons who were regular aspirin users had a higher risk of developing neovascular AMD (odds ratio [OR], 2.46; 95% CI, 1.25-4.83). The association showed a dose-response effect (multivariate-adjusted P = .01 for trend). Aspirin use was not associated with the incidence of geographic atrophy (multivariate-adjusted OR, 0.99; 95% CI, 0.59-1.65). CONCLUSION Regular aspirin use is associated with increased risk of incident neovascular AMD, independent of a history of cardiovascular disease and smoking.

APPLE CIDER VINEGAR

I have a patient I've been treating for glaucoma who told me about the health benefits of apple cider vinegar that she buys at the health food store.  She says it helps her vision and her circulation.  If it's true that apple cider vinegar improves circulation, then it might be beneficial in glaucoma and hypertensive retinopathy. But studies are lacking.  I found a good WebMD article that discusses the claims, what's proven, and some precautions regarding apple cider vinegar.

Women Who Experience Migraines With Aura May Face Higher Risk Of Heart Attack, Stroke

Healthday reports on a study with the following findings. 

Women who suffer from migraines with visual disturbances like flashing lights, called aura, may be at a higher risk for heart attack and stroke," according to a study scheduled to be presented at the American Academy of Neurology annual meeting.

After high blood pressure, migraine with aura was the strongest predictor for having a heart attack or stroke among these women. The risk was even more pronounced than that associated with diabetes, smoking, obesity and a family history of heart disease, the investigators noted."

"Dr Tobias Kurth, lead author, said it is not yet known if the migraine with aura causes the increased risk or if there is a common factor causing both the migraine and the heart and stroke." Kurth "said it might be that a problem with blood vessels lay behind both, that genetics were involved along with other factors."

A second study, also scheduled to be presented at the American Academy of Neurology meeting, "found that migraine sufferers – and especially those with aura – who use combined hormonal contraceptives are at elevated risk for thrombotic events."

"The risk appears to be highest with newer agents, such as drospirenone/ethinyl estradiol (YAZ, Bayer HealthCare)." 

ASPIRIN USE INCREASES RISK OF WET AMD. HOWEVER...

This report in Healthday describes the study that shows that aspirin use increases risk of wet macular degeneration.  Some excerpts from the study are below:

Long-term aspirin use may slightly raise the risk of developing age-related macular degeneration, a new study suggests.

The study found that the potential risk is small but statistically significant "and needs to be balanced with the significant morbidity and mortality of undertreated cardiovascular disease,"

Also, "the increased risk of age-related macular degeneration was only detected after 10 or 15 years, suggesting cumulative dosage of aspirin may be important," Wang said.

The report, published Jan. 21 in the online edition of the journal JAMA Internal Medicine, collected data on more than 2,300 people. Regular aspirin use was defined as once or more a week.

After 15 years, about 25 percent of the aspirin users developed what is called neovascular age-related macular degeneration. The cumulative rate was about 9 percent among aspirin users compared to less than 4 percent among non-aspirin users.
People taking aspirin for heart and stroke prevention benefits should not be alarmed, however, Wang said.

"Currently, there is insufficient evidence to recommend changing clinical practice, except perhaps in cases of patients with strong risk factors for age-related macular degeneration, such as existing age-related macular degeneration in one eye," she said.
For most patients, the cardiovascular benefits of regular low-dose aspirin use outweigh the potential risks, he said.

"Individuals prescribed aspirin for high-risk primary prevention or secondary cardiovascular prevention should not be concerned or discontinue this beneficial therapy," Fonarow said.
People who take aspirin regularly for pain might consider switching to another painkiller to avoid possible side effects, which also include bleeding, Kaul added.

"Heart attacks have a high risk of death, so the question is: Is it worth the possible increase in [risk for] age-related macular degeneration, compared to the risk of getting a heart attack?" said lead researcher Dr. Barbara Klein, of the University of Wisconsin School of Medicine and Public Health.

Klein said the data from her study does not suggest that people should stop taking aspirin for preventing heart attack.

More informationFor more information on aspirin and heart disease, visit the American Heart Association.

SOURCES: Jie Jin Wang, Ph.D., senior research fellow, Center for Vision Research, University of Sydney, Australia; Gregg Fonarow, M.D., spokesman, American Heart Association, and professor, cardiology, University of California, Los Angeles; Sanjay Kaul, M.D., director, Vascular Physiology and Thrombosis Research Laboratory, Cedars-Sinai Medical Center, Los Angeles; Jan. 21, 2013, JAMA Internal Medicine, online

TOPICAL ANTIBIOTIC USE CAN INDEED LEAD TO INCREASED RESISTANCE

We previously have believed that topical antibiotic use contributed very little to antibiotic resistance. This study reported in Medwire News suggests otherwise.

TOTALLY BLIND MICE GET SIGHT BACK

This article in the BBC reported on a study where they injected "precursor" cells into blind mice which will develop into the building blocks of a retina once inside the eye. Two weeks after the injections a retina had formed, according to the findings presented in the Proceedings of the National Academy of Sciences journal. Read more.