Bimatoprost Being Tested for Baldness
Researchers for Allergan have initiated a clinical trial that will examine the effects of three new formulations of bimatoprost on baldness. The researchers recruited a total of 28 men and women, aged 18 to 64 years, with moderate male-pattern and female-pattern baldness. The study should be completed by mid- to late February.

In 2008, the FDA approved Latisse (bimatoprost 0.03% ophthalmic solution) for the stimulation and enhancement of eyelash growth. (Latisse is a variation on Lumigan, Allergan’s bimatoprost drug for glaucoma.) Latisse is rubbed onto the base of the upper eyelashes with a specialized applicator brush. However, if this new treatment receives FDA approval, it would most likely be manufactured as a cream that would be rubbed directly onto the scalp, the researchers suggested.

“It’s actually really exciting,” Richard S. Mizuguchi, M.D., director of the Hair Restoration Surgery Center, Department of Dermatology at St. Luke’s-Roosevelt Hospital Center in New York, told the New York Daily News. “It’s been talked about forever, and there really haven’t been any new topical medications in a long time.”

However, the treatment could be rather expensive. “Latisse costs around $120 per bottle––and that’s for a tiny bottle,” says Dr. Mizuguchi. “For someone with a large bald spot on the scalp, you probably couldn’t afford it unless you are a millionaire.”

Safety and Pharmacokinetics Study of New Formulation of Bimatoprost in Patients With Alopecia. ClinicalTrials.gov. Available at: http://clinicaltrials.gov/ct2/show/NCT01189279 (accessed January 2011).

Allergan Launches New Anti-Allergy Drop
Allergan has launched Lastacaft (alcaftadine 0.25% ophthalmic solution) for the prevention of ocular itching due to allergic conjunctivitis.

Initially OK’d by the FDA in July 2010, Lastacaft is approved for once-daily dosing in patients aged two years or older.

The active ingredient alcaftadine is a new chemical entity with an affinity for H1, a histamine receptor in the early phase of allergic conjunctivitis.

In clinical studies, Lastacaft provided relief of ocular itching within three minutes in 97% of participants, and one drop was shown to prevent ocular itching through 16 hours in 87% of patients.

Lastacaft was expected to become available at the end of January.

Glaucoma Pathway Similar to That of Parkinson’s and Alzheimer’s
Researchers have identified a new and unexpected biological pathway that likely contributes to the development of glaucoma and resultant vision loss, according to a study in the

January 18 edition of the Proceedings of the National Academy of Sciences.

Previous studies have indicated that the optic nerve head plays a significant role in glaucoma development.

Likewise, the researchers in this study uncovered that, at a specific location within the optic nerve head, there is a unique class of cells called astrocytes that are partially responsible for the visual blinding associated with glaucoma.

Additionally, at this same anatomical site, the researchers found abnormal forms of a protein called gamma synuclein that are similar to abnormal forms of alpha synuclein––a related protein known for its key role in cell loss secondary to Parkinson’s disease.

This specific finding suggests that both glaucoma and Parkinson’s (as well as other protein aggregative neurodegenerative diseases, such as Alzheimer’s) share a similar biological process, according to the researchers.

“These compelling results put us on the cusp of discovering a treatment for glaucoma while also being invaluable for others whose research priority is in the area of neurodegenerative disease,” says senior author Nicholas Marsh-Armstrong, Ph.D., research scientist at the Kennedy Krieger Institute, in Baltimore, and assistant professor of neuroscience at the Johns Hopkins University School of Medicine.

“Our primary goal is to find interventions that halt, or at least slow, glaucoma progression. We believe that understanding the underlying mechanism of vision loss in glaucoma brings us much closer to that goal,” Dr. Marsh-Armstrong says.

Nguyen JV, Soto I, Kim KY, et al. Myelination transition zone astrocytes are constitutively phagocytic and have synuclein dependent reactivity in glaucoma. Proc Natl Acad Sci U S A. 2011 Jan 18;108(3):1176-81.

Cataract Scorecard Helps Predict Success
Although cataract removal is the most common surgery performed in the United States, there is no standard assessment tool to help doctors and health planners decide the best candidates for cataract removal or gauge the expected quality of life improvements post-surgery.

A Spanish research team, Investigacion en Resultados de Salud Y Servicios Sanitarios (IRYSS) Cataract Group, seeks to change that with the development of such a universal tool.

“This easy-to-use scoring tool can help physicians determine whether a patient is highly or moderately likely to benefit from surgery and provides a cut-off score below which patients are unlikely to benefit,” says lead investigator Silvia Vidal, M.D. “It can also help doctors set realistic expectations for vision gains and life improvements with their patients,”

The scoring tool, when testing early improvement after surgery, positively predicted 74% of visual acuity cases and 85% of visual function/quality of life cases.

The study group consisted of 5,512 patients on waiting lists for cataract surgery at 17 public health centers in 2004 and 2005. Data from 60% of the group was used to develop the scoring tool, while data for the remaining 40% was used to validate the accuracy of the tool’s predictions.

The scoring tool was designed using visual acuity, age and ocular co-morbidity, and measured with patients’ self-evaluation of their vision and whether/how it limits their daily activities.

The scores were validated by a second round of patient assessment about a month post-surgery.   

IRYSS said this tool was best used as a guide for people considering cataract surgery, rather than as criteria to exclude some patients from surgery.

Perea-Milla E, Vidal S, Briones E, et al. Investigación en Resultados de Salud y Servicios Sanitarios (IRYSS) Cataract Group. Development and validation of clinical scores for visual outcomes after cataract surgery. Ophthalmology. 2011 Jan;118(1):9-16.e1-3. Epub 2010 Aug 17.

Spectacle Shoppers Don’t ‘Add to Cart’
It’s no surprise that patients go online to shop before buying their glasses and contact lenses. But, do they in fact make their purchase online?

According to a VisionWatch study on the role of the Internet in Americans’ eyewear decisions and purchases, just 28% of people who shop online actually buy online.

The 2010 Vision Council VisionWatch Internet Influence Report was conducted in November 2010 and reflects responses of consumers who had purchased spectacles, sunglasses, contact lenses and/or readers within six months of the survey. Of the 9,293 participants, just 1.9% purchased readers online and 3.6% purchased non-prescription sunglasses online.

Contact lens purchases were much higher, however, with 15% of participants reporting purchasing contact lenses online.

These findings presents a good opportunity for eye care practitioners, says Gary Gerber, O.D., founder and senior consultant at PowerPractice.com.

“O.D.s must step up to the plate and ensure that the in-office buying experience is so memorable that patients won’t return to the Internet for their next purchase. Or, if they do go back to the Net, it will be via a portal that the doctor provides,” Dr. Gerber says.

‘Lab on a Chip’ Detects 90 Retinal Disease Genes
In genetic retinal disease patients, identifying the causative mutation is important to confirm the clinical diagnosis and inheritance pattern, and to predict the disease’s clinical course. It’s also important for genetic counseling and for future gene-targeted treatment. But, identifying and classifying gene mutations has proven challenging

Now, researchers in the Netherlands have a solution: a 300-kilobyte retinal resequencing chip that features a flexible, sensitive, high-throughput method for detecting known and new mutations.

The chip, in combination with a unique patient pooling strategy, resulted in direct sequencing of DNA from multiple patients for multiple genes, with very high detection rates (99%), high reproducibility (100%), and low false-positive rates (0%).

The chip detected known and new sequence changes in 90 retinal disease genes for one-tenth of the cost of conventional direct sequencing. The researchers intend to use it as a prescreening tool before making a formal DNA diagnosis.

Booij JC, Bakker A, Kulumbetova J, et al. Simultaneous mutation detection in 90 retinal disease genes in multiple patients using a custom-designed 300-kb retinal resequencing chip. Ophthalmology. 2011 Jan;118(1):160-167.e1-3.

Hearing Loss Linked With AMD Vision Loss
A recent study has linked the prevalence of age-related macular degeneration (AMD) with the incidence of age-related hearing.¹

Investigators in Turkey tested subjects 50 years or older. Fifty patients with AMD and 43 healthy subjects underwent ophthalmological and otolaryngological examinations. Statistical analyses were conducted for the poorer eye and ear. Age-related hearing loss and pure tone averages were compared between the macular degeneration group and the healthy control group.

The macular degeneration group reported 50% of mild, 20% of moderate and 6% of severe hearing loss. In comparison, the control group reported only 35% of mild, 5% of moderate and no severe hearing loss cases.

Researchers found that the median pure tone average was significantly poorer in the macular degeneration group (35dBHL) compared to the control group (23dBHL). A further breakdown of the macular degeneration group showed that hearing loss was significantly greater in the dry type (43dBHL) compared to the wet type (23dBHL) cases. There was a weak, but significant, correlation between each patient’s visual acuity and pure tone average results.

The researchers concluded that age-related hearing loss is more common in patients with AMD. Patients who present themselves with hearing difficulty should be referred to an otolaryngologist.

In the United States, 21 million adults are visually impaired and about 36 million have some degree of hearing loss.²

1. Bozkurt MK, Ozturk BT, Kerimoglu H, et al. Association of age-related macular degeneration with age-related hearing loss. J Laryngol Otol. 2010 Dec;1-5 [Epub ahead of print]
2. Klein R. Vision and Hearing. Progress Review. 2008 Oct 21. Presented at Healthy People 2010. Available at: www.healthypeople.gov/2010/Data/2010prog/focus28/default.htm

ABO to Modify Claims
The American Board of Optometry (ABO) has informed the American Optometric Society (AOS) that it intends to “delete all references on its website to any ‘explicit comparison to licensure.’”

The decision was in response to the AOS’s lawsuit now pending in U.S. Federal Court, which claims that statements by the ABO on its website about ABO Board Certification are false and misleading.

The AOS sought an order enjoining the ABO from continuing to suggest that ABO certification demonstrates competence in optometry beyond that required for licensure and that ABO certified doctors are more competent than other merely licensed optometrists.

The AOS has declined to end its lawsuit, saying that the ABO’s proposed change falls “woefully short” of the AOS’s expectations if the matter is going to settle.

The ABO declined to comment.