EARLIER AGE OF ONSET OF MYOPIA THE GREATEST PREDICTOR OF HIGH MYOPIA

 According to this Chinese study, 

Patients who developed myopia before 12 years old had a higher risk of developing high myopia than those who developed myopia later.  Age of myopia onset may be the single best predictor for high myopia.  

RETINAL FINDING ASSOCIATED WITH HEART ATTACKS

 This study in The American Journal of Ophthalmology states that there is an association between retina ischemic perivascular lesions (RIPLs, "ripples") and myocardial infarction in patients with coronary artery disease.  

317 patients with coronary artery disease had OCT (optical coherence tomography) performed.  59.3% of the patients in that group who had a history of myocardial infarction demonstrated the presence of RIPLs on their OCT, while only 35% of those who did not have a myocardial infarction demonstrated RIPLs. 

RIPLs show focal areas of atrophy of the inner nuclear layer of the retina along with resultant expansion of the other nuclear area, causing a "ripple" appearance on cross-sectional OCT. . 

Prior studies have demonstrated an association of RIPLs with certain cardiovascular disease, including diabetes, hypertension, coronary artery disease, atrial fibrillation, and carotid artery stenosis. 

This study suggests that OCT screening in patients with coronary artery disease could determine if patients have a higher risk of myocardial infarction. They suggest that patients with RIPLs on OCT should be referred for cardiovascular consultation. 

POPULAR CLASS OF A DIABETIC DRUG DECREASES GLAUCOMA RISK

 In this study,  type 2 diabetic patients taking Glucagon-like Peptide-1 Receptor Agonist (GLP-1RAs) have an initial 19% reduced glaucoma risk, increasing to a 29% reduction after 3 years.   

Examples of GLP-1RAs include Exanatide (Byetta), Semaglutide (Ozempic), Liraglutide (Victoza, Saxenda), and Lixisenatide (Adlyxin).  

MYOPIA CONTROL SPECTACLES SHOW DECREASED EFFECTIVENESS IN PATIENTS WITH CONVERGENCE EXCESS

 

According to this study, "myopic subjects with convergence excess had faster elongation (resulting in faster progression of myopia) than normal myopic children in DIMS wearers (those who wore the myopic control spectacles). 

The article suggests that this occurs because convergence excess causes an accommodative lag that creates greater peripheral retinal defocus, thus counteracting the effect of the myopia control lenses.  

DEEP BREATHING AND GLAUCOMA

 According to this study: 

After 6 weeks of adding the 360 breathing technique (deep breathing six cycles per minute for 5 minutes, three times per day) to pharmacological glaucoma treatment, patients on average had a reduction of their intraocular pressure by roughly 2.5mmHg.  The study concludes:

"365 breathing technique can reduce IOP, serum cortisol and improve autonomic dysfunction in glaucoma patients."

ACETYLCHOLINESTERASE INHIBITORS AND MACULAR DEGENERATION

 According to this study: acetylcholinesterase inhibitors, commonly used in the treatment of Alzheimer's Disease, decreases the risk of macular degeneration by 6%.  

ASSOCIATION BETWEEN LOWER BIRTH WEIGHT AND VERTICAL CUP TO DISC RATIO

 This review of a German study indicated that children born with lower birthweight, regardless of term, have a higher rate of increased vertical cup to disc ratio as adults, and possibly lower retinal nerve reserve.   

Association Between Oral Hygiene and Macular Degeneration?

 This paper suggests a link between oral hygiene and macular degeneration. 

Alzheimer Therapy May Reduce AMD Risk

 This study suggests that the use of acetylcholinesterase inhibitors, used to improve the quality of life in Alzheimer's patients, may reduce the incidence of age-related macular degeneration in patients with Alzheimer’s by 6%.   Randomized clinical trials would be necessary to truly evaluate any cause-and-effect relationship. 

Consumption of Alcohol Can Increase Glaucoma Odds

 Alcohol has been shown to be a modifiable risk factor in a number of ocular diseases, and recent research suggests glaucoma may be one of them. Those with or at risk for glaucoma may benefit from reducing their alcohol consumption.

They found that the group of regular drinkers had a higher IOP than never/infrequent drinkers (+0.15mm Hg). The team also noted non-significant trends in the regular drinker group toward a thinner retinal nerve fiber layer (RNFL), thinner ganglion cell-inner plexiform layer and higher odds of glaucoma. Even those who self-identified as former drinkers had higher odds of developing glaucoma (odds ratio: 1.44).

If further studies can confirm that a causal relationship does exist, it may prove beneficial to advise glaucoma patients and those at increased risk to be cognizant of their alcohol intake and aware of its potential effects on disease development.

Original abstract content © Association for Research in Vision and Ophthalmology 2022.

https://www.reviewofoptometry.com/news/article/consumption-of-alcohol-could-increase-glaucoma-odds

Vitamin B Combo Provides Dry Eye Relief

 

Dry eye symptoms improved significantly following treatment with supplements and artificial tears, study finds.

A new study suggests oral vitamins B1 and mecobalamin, a form of B12, can help relieve symptoms of  dryness, pain and light sensitivity.

“These observations suggest that oral vitamin B1 and mecobalamin can help nourish and repair the corneal nerve layer to some extent, thereby alleviating burning and photophobia,” the study authors concluded in their paper. Of note, oral vitamin B1 and mecobalamin were more effective in men than women, particularly for dryness and photophobia, they wrote.

Ren X, Chou Y, Jiang X, et al. Effects of oral vitamin B1 and mecobalamin on dry eye disease. J Ophthalmol. 2020;2020:9539674. reported in Review of Optometry

Eye Drop for the Treatment of Presbyopia

 Allergan announced that it has submitted a new drug application to the FDA for investigational AGN-190584 (pilocarpine 1.25%) ophthalmic solution for the treatment of presbyopia. The FDA is expected to act on the NDA by the end of 2021.

If approved, this is expected to be the first eye drop for the treatment of presbyopia by the FDA. The most common treatment emergent non-serious adverse events occurring at a frequency of ≥5% in AGN-190584 treated participants were headache and conjunctival hyperemia.

AGN-190584 is an investigational optimized formulation of pilocarpine, a cholinergic muscarinic receptor agonist, which activates the iris sphincter muscle and ciliary muscle. The proposed mechanism of action is through constricting the pupil to enhance the depth of focus. AGN-190584 also contracts the ciliary muscle, facilitating accommodation. 

High-dose Sex Steroids Improve Tear Parameters

 Upon examining the effects of exposure to high-dose sex steroid hormones, researchers recently observed impro­vement in tear function test results following the use of estradiol. They noted that the use of estradiol during menopause could improve dry eye symptoms in patients.

Reported in Review of Optometry