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THE NATIONAL ALLIANCE FOR EYE AND VISION RESEARCH

E-ZINE Volume 2, Number 3 (September 2006)

Welcome to the fourth edition of the National Alliance for Eye and Vision Research's (NAEVR) E-Zine, a quarterly electronic publication that highlights breakthrough eye and vision research funded by the National Eye Institute (NEI) within the National Institutes of Health (NIH). The nation's investment in the NEI results in new treatments and therapies to not only stabilize vision loss but to restore it, or ultimately prevent the onset of eye disease. Vision impairment and eye disease currently cost the United States $68 billion annually in healthcare expenditures, reduced productivity and diminished quality of life.

In this edition:

 

DIABETIC EYE DISEASE EXPERT TO SPEAK AT CAPITOL HILL BRIEFING:
HOUSE MEMBERS APPLAUD NEI EFFORT TO FIND CURES

"Our team takes a new perspective on how diabetes impairs vision. We look at how diabetes targets the whole retina, not just its blood vessels."

- Thomas Gardner, M.D.

The Alliance for Eye and Vision Research (AEVR) is pleased to announce that on September 19, 2006, from 12 Noon – 1:15 pm in Rayburn B-339, NEI-funded physician-researcher Thomas Gardner, M.D., will speak. This briefing is presented by AEVR in conjunction with the American Diabetes Association (ADA) and the Juvenile Diabetes Research Foundation International (JDRF).

Dr. Gardner, who has dedicated his career to preventing vision loss in patients with diabetes, is the Jack and Nancy Turner Professor of Ophthalmology and Cellular & Molecular Physiology and Vice Chair of Ophthalmology Research at the Pennsylvania State University Milton S. Hershey Medical Center. The author of more than 90 journal articles and abstracts on diabetic eye disease and cellular biology, he has just released an article in the journal Diabetes where he presents a new perspective for solving the growing problem of blindness in diabetes. Treatment for diabetic eye disease usually tries to stop blood vessels of the retina from leaking. "Our team is looking at how diabetes targets the whole retina, not just the blood vessels," says Dr. Gardner. "This should allow us to develop strategies that will help people with diabetes retain their vision." The NIH estimates that approximately 20.8 million people in the US have diabetes—about 7 percent of the population—and about 40 to 45 percent have diabetic retinopathy, which is the leading cause of vision loss in working-age adults.

In recent report language for the Fiscal Year 2007 Labor, Health and Human Services, and Education funding bill, the House Appropriations Committee applauded the NEI “…for the collaborative efforts of the Diabetic Retinopathy Clinical Research Network to test innovative treatment for diabetic eye disease.” (See House Report 109-515.) The Diabetic Retinopathy Clinical Research Network, or DRCR.net, was established by the NEI in partnership with JDRF in September 2002 to run major clinical trials testing new drugs and therapeutics for reversing or preventing diabetes. Penn State’s Hershey Medical Center is one of the approximately 155 clinical research centers participating in DRCR.net.

Dr. Gardner has a personal as well as a professional perspective about eye disease research. In addition to having two brothers with diabetes, he has had a personal brush with a vision-threatening disorder.

AEVR Briefing

"Diabetic Retinopathy Research: New Approaches in
Detection, Treatment and Prevention"

Tuesday, September 19, 2006
12 Noon – 1:15 pm
House Rayburn B-339
Please RSVP to Dina Beaumont (202-530-4672 or dina_Beaumont@yr.com)

ABOUT BLOOD VESSELS, WE NOW KNOW WHY THE CORNEA LACKS THEM: ANSWERS FROM CANCER STUDIES AND HOPE FOR NEW TREATMENTS

The cornea—the transparent outer covering of the eye’s black pupil and colorful iris —is one of the only blood vessel-free parts of the body. Without its clarity, which comes from being “avascular,” eyesight would be impaired.

NEI-funded researchers from Harvard Medical School reported this summer, in an article published in the Proceedings of the National Academy of Sciences, just why blood vessels steer clear of the cornea. The discovery derived from years of research originating with scientists studying the blood supply of tumors. The new corneal findings are expected to have implications for treatment of a variety of vision disorders and more.

The key to the transparency of the corneal is a protein called vascular endothelial growth factor receptor-3 (better known as VEGFR-3), which the researchers found in large quantities in the top layer of cells of the cornea. VEGFR-3, it turns out, prevents blood vessel formation by blocking other proteins called vascular endothelial growth factors (VEGF) that trigger blood vessel growth, or angiogenesis.

Cancer researchers have known for many years that tumors develop rich blood supplies. This angiogenesis, they found, is regulated by VEGF released from cells looking for oxygen and other nutrients (which are derived from blood). The VEGF binds to nearby blood vessels and stimulates them to expand their reach. The idea of blocking VEGF surfaced about 30 years ago but it only became a reality in 2004 with the approval of a drug therapy for treating colon cancer. Subsequently, the Food and Drug Administration (FDA) has approved the first generation of anti-VEGF ophthalmic drugs for the treatment of age-related macular degeneration (AMD). In AMD, abnormal blood vessels grow under the retina where they leak blood and fluid, which can lead to severe vision loss. These anti-VEGF drugs are currently in clinical trials for treatment of diabetic retinopathy.

Over the years, the NIH has invested significantly in angiogenesis research. The NEI alone has spent nearly $95 million and has sponsored more than 300 research studies investigating neovascularization in the eye.

MAJOR RESEARCH ADVANCES IN AGE-RELATED MACULAR DEGENERATION (AMD): AMD Awareness Week Held September 19-23

As the vision community works to enhance awareness of age-related macular degeneration (AMD) the week of September 19-23, important discoveries have been made regarding this leading cause of blindness in the United States:

  • Gene researchers discovered two genes where variations within the genes can lead to AMD. In fact, it is felt that the gene variants explain nearly three out of every four cases of AMD. The genes are involved in regulation of the immune system. They are named complement factor H (CFH) and complement factor B (CFB).


  • On August 1, 2006, the NEI committed $14.5 million to an international, interdisciplinary effort to convert the genetic discoveries in AMD into diagnostics and treatments. The effort is being led by Gregory Hageman, Ph.D., at the University of Iowa Carver School of Medicine. Dr. Hageman, who is one of the researchers who discovered the connection between CFH and AMD, spoke about his work at a September 2005 Capitol Hill briefing.


  • Researchers at Harvard Medical School report findings concerning the increased genetic susceptibility to AMD caused by cigarette smoking and high body mass index (BMI). These two lifestyle factors alter genetic susceptibility to AMD associated with the CFH gene. Cigarette smoking in people with the homozygous risk genotype (with two versions of the AMD-associated variant in their CFH gene) had a tenfold higher risk for AMD than nonsmokers with no genetic risk genotype. Having the risk genotype plus higher BMI increased risk of AMD almost sixfold.

    The research was led by Joanna M. Seddon, M.D., director of the epidemiology unit at Harvard’s Massachusetts Eye and Ear Infirmary. Dr. Seddon reminds people that genetic risk for AMD can be modified by controlling weight and not smoking.


  • Researchers showed that vision loss from AMD is sometimes associated with reduced cognitive function. It is not clear whether the vision loss is associated with the same neurodegenerative process that leads to cognitive decline or whether vision loss leads to cognitive decline related to fewer interactions and less activity. The findings are reported by the NEI-funded Age-Related Eye Disease Study (AREDS) Research Group. Assessments were conducted on nearly 3000 AREDS participants.

NIH EXPANDS ITS INVENTORY OF FACTS SHEETS: EYE CONDITIONS DOMINATE

The NIH Web site now includes a section dedicated to Research Results for the Public. The site contains fact sheets about "how NIH is pursuing its goal to make important medical discoveries that improve health and save lives." The inventory of fact sheets has just been expanded with three more from NEI: diabetic retinopathy, amblyopia, and age-related macular degeneration. Eye diseases are represented more than any other disease category on the site.

The fact sheets explain the history of research for each disease, the current status with regard to disease prevention and treatment and how discoveries are poised to yield even greater advances. For more information, see http://www.nih.gov/about/researchresultsforthepublic/