USC: "Screen time" possible culprit for increased childhood myopia rates
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The largest study of childhood eye diseases ever undertaken in the U.S. found the incidence of childhood myopia among American children has more than doubled over the last 50 years, according to the University of Southern California (USC) Eye Institute at Keck Medicine, which conducted the study in conjunction with the National Institutes of Health. The Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) evaluated more than 9,000 children in the L.A. area from 2003 through 2011. Findings are similar to research conducted in adults and children in Asia, where 90% or more of the population has been diagnosed with myopia, the university said in a news release.
The possible culprit? Too much "screen time" and not enough sunlight, according to Rohit Varma, MD, director of the USC Eye Institute. He said the "rapid proliferation of myopia in a matter of a few decades among Asians" suggests the use of mobile devices and close-up work on a daily basis coupled with improper lighting or sunlight "may be the real culprit behind these dramatic increases."
The USC study found that the incidence of childhood myopia in the U.S. is greatest in African-American children, followed by Asian-American children, Hispanic/Latino, and Non-Hispanic white children. Future research may include reexamining the MEPEDS cohort to evaluate how widespread use of screens and other environmental or behavioral factors may be affecting the progression of childhood myopia and other eye diseases over time.
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EGP-437 phase 3 study enrolls first patient
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A confirmatory phase 3 clinical trial of EGP-437 for the treatment of non-infectious anterior uveitis has enrolled its first patient, developer EyeGate Pharmaceuticals (Waltham, Mass.) said; data is expected in early 2017.
The study is a double-masked, randomized, positive-controlled trial being conducted at up to 60 clinical sites in the United States, the company said. The trial intends to enroll up to 250 subjects and is designed to evaluate the safety and efficacy of iontophoretically delivered EGP-437, a novel formulation of dexamethasone phosphate ophthalmic solution, through the EyeGate II Delivery System, in patients with unilateral or bilateral non-infectious anterior segment uveitis. Subjects will receive 3 treatments of either EGP-437 iontophoresis treatment or a placebo iontophoresis treatment. Patients in the EGP-437 arm will receive placebo eye drops, while patients receiving placebo iontophoresis treatment will be given prednisolone acetate (1%) drops. Eye drops for both arms will be administered for up to 28 days and up to 8 drops per day. The primary efficacy endpoint is the proportion of subjects with an anterior chamber cell count of zero at day 14.
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Green leafy vegetables may lower glaucoma risk
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A greater intake of dietary nitrate and green leafy vegetables was associated with a 20-30% lower risk of primary open-angle glaucoma (POAG), according to researchers at Brigham and Women's Hospital and Harvard Medical School, Boston. The researchers followed up with participants biennially in the prospective cohorts of the Nurses' Health Study (63,893 women; 1984-2012) and the Health Professionals Follow-up Study (41,094 men; 1986-2012). Eligible participants were 40 years or older, were free of POAG, and reported eye examinations. Information on diet was updated with questionnaires.
During follow-up, 1,483 incident cases of POAG were identified. Participants were divided into quintiles (1 of 5 groups) of dietary nitrate intake (quintile 5, approximately 240 mg/d; quintile 1, approximately 80 mg/d). Those with greater dietary nitrate/green leafy vegetable intake had a "particularly strong" association, 40-50% lower risk of POAG with early paracentral visual field loss.
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Isunakinra fails to meet primary endpoint
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A phase 3 study of EBI-005 (isunakinra) for severe allergic conjunctivitis failed to meet its primary endpoint, developer Eleven Biotherapeutics (Cambridge, Mass.) said in a press release. There were no statistically significant differences between the isunakinra-treated group and the vehicle control group on the primary endpoint of ocular itching or on any secondary endpoints. The company sees "no immediate path forward" to continue development of EBI-005.
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RESEARCH BRIEFS
- Both femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification cataract surgery (PCS) achieved similar safety and efficacy outcomes for performing cataract surgery, according to Y. Yu and colleagues. In their prospective, consecutive, non-randomized comparative cohort study, 124 eyes from 106 patients (70 in FLACS and 54 in PCS) were evaluated for macular central subfield thickness (CST), cube volume (CV), cube average thickness (CAT), endothelial cell density (ECD), central corneal thickness (CCT), and photon count value (PCV). CST, CV, and CAT increased postoperatively, and did not return to preoperative levels by 6 months. The values were similar between groups throughout the follow-up, and comparison of changes from baseline also showed no significant difference. Preoperative ECD showed significant difference, which decreased postoperatively and remained stable during follow-up, being lowest at 1 month. FLACS had greater endothelial cell loss than PCS, which was not significant. CCT in both groups increased, reaching maximum on day 1, and tended to decrease thereafter. No significant differences were found regarding postoperative values and the mean increase. In both groups, mean PCV increased from preoperatively to day 1, week 1, and month 1. Flare values in FLACS were lower than PCS, reaching statistical significance at 6 months (P=0.001). The study is published in Clinical and Experimental Ophthalmology.
- Reservable foils, particularly 0.15 mm diameter polydioxanone foil (PDS), generate the best results in orbital floor defects with a size of 250 to 300 mm2 over both the short and intermediate term, according to H. Holtmann and colleagues. They retrospectively evaluated surgical and ophthalmological data plus CT scans from a collective of 775 patients between 2005 and 2012 who had orbital floor fractures. There were 593 patients with full pre- and postoperative short-time data appropriate to inclusion criteria; of these 507 (85.5%) underwent primary surgical treatment. Smallest average defect size was found in cases with no indication for surgical treatment (81 mm2) and largest in cases indicating titanium mesh reconstruction (601.5 mm2). In 15 cases, exact fragment reposition was possible without insertion of alloplastic material. Four hundred forty-four patients had reduced diplopia pre- to postoperative, 16% to 6% (p<0.01), and ex- and exophthalmos <2% after surgery. In comparison to reconstruction with PDS foil, a higher percentage of patients reconstructed with titanium meshes (n=22) revealed no significant reduction of diplopia (45.5% to 31.8%; p=0.07). Half the patients reconstructed with titanium meshes indicated foreign body sensations and cold feeling in the long term. The study is published in Head and Face Medicine.
- The superior incision in 2.2 mm phacoemulsification cataract surgery caused a change in the corneal vertical coma in a negative direction, according to Seok Song, MD, and colleagues. Their study in the Journal of Cataract & Refractive Surgery divided 119 eyes into 3 groups according to the different axes of incision location: superior, temporal, and nasal. Preoperative and 1-month postoperative corneal coma, trefoil, and spherical aberrations were compared after patients underwent cataract surgery. The superior incision group showed significant changes in the vertical coma (amount of change: −0.119±0.153 μm; P<.001) and vertical trefoil (amount of change: 0.185±0.260 μm, P=.001). The nasal incision group showed a significant change in oblique trefoil (amount of change: 0.176±0.207 μm; P<.001). The temporal incision group did not show significant changes in higher order aberrations.
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EyeWorld Weekly Update is edited by Stacy Jablonski and Michelle Dalton.
EyeWorld Weekly Update (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery and the American Society of Ophthalmic Administrators, is published every Friday, distributed by email, and posted live on Friday.
Medical Editors: Eric D. Donnenfeld, MD, chief medical editor; Rosa Braga-Mele, MD, cataract editor; Clara C. Chan, MD, cornea editor; Reay H. Brown, MD, glaucoma editor; and Steven C. Schallhorn, MD, refractive editor.
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Opinions expressed in EyeWorld Weekly Update do not necessarily reflect those of ASCRS*ASOA. Mention of products or services does not constitute an endorsement by ASCRS*ASOA. |
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