10.5 LCA repair

After 2 years, the preliminary results of LCA (Leber congenital amaurosis) gene therapy are in [Aug 12, 2009].

This study is still ongoing at U of FL and UPenn (and other universities). The participants are a woman and two men between the ages of 21 and 24. After 12 months, the safety is maintained. More important is this:

"The tiny portions of the patients’ retinas that received gene therapy [RPE65] experienced restored function up to 1,000-fold during the day and 63,000-fold at night."

In other words, the patients have developed a preferential retinal locus at the injected (treated) area. The visual acuity will depend on the photoreceptor density, among other issues. And the field size will necessarily be limited to the locus. Still, it is a giant leap forward.

Let's hope this study continues to be successful.

10.4 Blue-eyed rodent

Researchers at Univ of Rochester have discovered that Brilliant Blue G, a food dye, when injected IV can prevent secondary neuronal damages caused by an excess release of ATP into the spinal injury site.

The injection works only if it is done within 15 min after the injury and the skin turns blue for a while as a result.

The more interesting to us is the eyes now also appear blue (right). The pink hue of the paws, ears, nose, and the eyes (top left) is typical of the lack of pigmentation in this type of rats allowing the vascularity to show through.

Presumably then, a fair-skinned person, after consuming a large quantity of blue M&Ms, may develop dark blue eyes even if only briefly. The blue skin? We refer you to Star Trek (2009), Uhura's roomate (and Kirk's date) for more details.

10.3 Target: one million cases of cataracts

This is a news report on June 24, 2009:

来源：荆楚网　(楚天都市报 陈媛 田静欣 高翔 向清)

记者昨从湖北省卫生厅获悉，我省于近日启动“贫困白内障患者复明工程”，近万名患者可从中受益。　　
今年，我国启动“百万贫困白内障患者复明工程”，计划利用3年时间，为100万名贫困白内障患者实施复明手术，湖北省今年的任务是9475例，每位患者将享受800元的费用减免。全省三级医院和大部分具备条件的二级医院都将成为项目医院。
昨日，中南医院开始接受手术报名，凡我省农业户口以及城镇下岗职工、低保、残疾人士等都可持相关证明到该院登记手术。
该院眼科主任蔡小军介绍，我国约有盲人1240多万，因白内障致盲人数约为699万，这其中又有15%的患者属于贫困阶层，无钱做手术。

Partial translation: "Hubei Province will soon institute a program, Cataract Vision Restoration for the Poor, and about 1 million patients will benefit. This is a 3-year program and for the current year, 9,475 patients will enjoy a $800 (about USD 100) discount for the surgery... It is estimated that there are 12.4 million blind in China. Of them, 6.99 million are cataract cases and 15% cannot afford to pay for the surgery [hence this program]."

Certainly a step in the right direction.

10.2 Blurred vision

Lies all well disguised, masses all hypnotized
Terror's all you hear, war won't make it disappear
Leader's teach us, everything we shouldn't be
everyday people, this is no Democracy!

(a song in support of the Iranian people, try http://blurredvisionmusic.com or here)

10.1 Truth or Consequences

Drug companies in Taiwan probably have sold the most atropine eyedrops than anywhere in the universe. You might wonder what it is used for. It turns out that atropine drops and other cycloplegics are used to control the progression of school myopia.

There has been a long history of cycloplegics used for this purpose; however, it has never gained any popularity elsewhere. In fact, atropine in particular is prescribed, if at all, only for the treatment of amblyopia. As it does appear as efficacious as eye patching; although the treatment is short-term. In contrast, atropine treatment for myopia goes on for years.

Since so many myopic children in Taiwan are treated with cycloplegics and who do not wear optical corrections in school, teachers are running out of front-row seats for these children and start to question this practice.

Do the cycloplegics work? Yes, if one considers less myopia progression a success and a goal by itself. What about the ultimate purpose? Unclear. Because cycloplegics do not reverse myopia, which merely slow down the progression. So, by late teens or early 20s when the myopization process naturally stops, patients are still left with moderate to high myopia. The atropine treatment appears to have based on the assumptions that (1) all myopia cases can become degenerative myopes and that (2) high myopia equals ocular diseases developed later in life such as glaucoma and various retinal integrity issues. And by lowering the degree of myopia, these diseases can be avoided. Unfortunately, so far there is no hard evidence to support this proposal. Perhaps a certain segment of the myopic population can indeed benefit from cycloplegia; again, there is no evidence.

And the downside of long-term atropine treatment? Let's see, cycloplegia causes loss of accommodation and prolonged pupil dilation, allows large amounts of UV into the eye, and potentiates chronic narrow-angle glaucoma. Worse, it is not known how long the treatment can continue without irreversible paralysis of ciliary and iris muscles.

There is something amiss here.

9.15 Looking upward and forward

This is a fish named the barreleye (http://www.livescience.com/animals/090223-fish-head.html) from Indonesia. The two dots above the mouth are not the eyes, they actually are the nostrils. Where are the eyes? They are inside the see-through head looking upward. The two green caps are in fact lenses of the eyes. The tubular eyes can point forward as well when the barreleye has to find its way around. Why looking up? To see the silhouette/luminescence of an overhead jellyfish or a small fish, so that it can quickly attack.

Looking upward and forward - sounds like a very short lecture on life.

9.14 Galileo's eyes

(Galileo Galilei [1564-1642], circa 1630)

Well, it is only inevitable in this age of TV CSI shows: Scientists from both UK and Italy are now seeking the Vatican's approval to exhume Galileo's body, so that they can do some DNA analysis to figure out what had ailed Galileo's eyes.

This news has been widely reported, see for example, here and here. The scientists' interest is to explain why Galileo described Saturn as having "lateral ears" rather than rings around the planet. And the theory is that poor eyesight was behind the error.

Galileo's drawings of Saturn are shown on the left:

The one on top was sketched in 1610, and the bottom, 1616.

These "arms" were clarified by Dutch astronomer, Christiaan Huygens, in 1659, as a ring system. He was able to do so because of improved telescope optics. [Note: Huygens also discovered Saturn's moon, Titan, and for this reason, the probe exploring Titan is named after him. And a few years later, Jean-Dominique Cassini discovered 4 other major moons of Saturn: Iapetus, Rhea, Tethys, and Dione.]

So what was wrong with Galileo's eyes and vision? It was actually quite well-documented. According to this site, for example:

"Galileo’s sight began to deteriorate in the middle of 1636 when he was 68 years old, and by the end of June 1637 he had lost the use of his right eye while his left eye was affected by a constant discharge. He described seeing a 'luminous halo' around candle flames. To date there has been little speculation by modern optometrists or physicians about the possible causes of Galileo’s blindness. In July 1636 he wrote to his friend, an Italian lawyer living in France, Elia Diodati, 'I have been in bed for five weeks oppressed with weakness and other infirmities. Added to the (proh dolor!) the sight of my right eye - that eye whose labours (I have no hesitation in saying) have had such glorious results, is lost forever. That of the left, which was and is imperfect, is rendered null by a continual running’. He became totally blind early in December 1637, a few months after using the telescope to discover that the moon wobbles on its axis ('lunar libration') which was quite a remarkable observation to make with only one useful eye. At this point he wrote to Father Castelli noting that 'The noblest eye is darkened which nature ever made, an eye so privileged and so gifted with rare qualities that it may with truth be said to have seen more than the eyes of all those who are gone, and to have opened the eyes of all those who are to come'."

The keywords are shown in red. The symptom/sign suggests active keratitis [discharge] accompanied by corneal edema [halo]. And since both eyes eventually lost vision, it would imply a chronic retinal problem, perhaps posterior uveitis. The left eye was probably further complicated by band keratopathy in his last years. His 20X telescope was actually a low-vision device - at least by 1616, Galilio appeared to still have retained enough vision (at least 20/400) to allow somewhat accurate observation of Saturn's rings/arms.

What the proposed DNA analysis can prove? Probably not much. The project is expected to cost around £282,000, by the way.