| January 10,
2001
PENN RESEARCHERS TO STUDY TREATMENT
OPTIONS FOR " EYE ATTACKS"
Goal is to minimize collateral damage and prevent
involvement of second eye.
The terms "heart attack"
and "brain attack" have become commonplace, but now
neuro-ophthalmologists are waging war on the all too
common, underreported, and untreated condition referred
to as "eye attacks." These attacks, known medically
as Ischematic Optic Neuropathy ("ION"), result from
a sudden lack of blood flow to the eye. Eye attacks,
which are usually painless, can develop quite rapidly--sometimes
overnight, often with catastrophic consequences to the
vision of the individual, such as a sudden and permanent
loss of peripheral or central vision in one eye. The
resulting visual impairment and the degree of severity
usually varies from patient to patient but can include
loss of the bottom half of one's vision and difficulty
with light and darkness.
University of Pennsylvania Medical Center researchers
are working to help educate the public about this condition,
which is the most common cause of acute optical nerve
disease in adults over 50 years of age. While the frequency
of the condition is estimated to occur in only a couple
of people per thousand, per year, the catastrophic results
are unquestioned. Studies indicate that irreversible
damage can occur as quickly as within the first 90 seconds
of the attack. "Prompt acknowledgement and treatment
of the problem are essential if there is any chance
of minimizing present and future damage", says neuro-ophthalmologist
and researcher Nicholas J. Volpe MD, Associate Professor
of Ophthalmology & Neurology at the University of Pennsylvania's
Scheie Eye Institute. However, a new multi-center clinical
trial, funded by the pharmaceutical company Allergan,
is about to commence at approximately 50 research sites
across the country, including the Scheie Eye Institute.
The goal of the study is to determine whether neuro-protection--
i.e., delivering a proprietary and investigational topical
agent to help a damaged nerve-- is viable. Specifically,
Allergan is testing eye drops that will hopefully minimize
collateral losses to the eye by saving some of the optic
nerve fibers.
Contributing to the sense of urgency in promoting public
awareness is the fact that most sufferers do not come
forward and report the condition-- believing it, instead,
to be a problem with their glasses or just a temporary,
passing phase. This failure in reporting is critical,
as researchers have been hampered by limited access
to affected persons in a timely manner. Early reporting
is essential as evidence now suggests that measures
designed to limit further damage are most likely to
succeed if intervention occurs within the first several
hours. In addition, evidence exists that an attack in
the other eye occurs up to 15 % of the time, over the
following five years. Currently, a daily dose of aspirin
is the only treatment offered, having a potential prophylactic
effect on the second eye.
Eye attacks, which are not a new occurrence, have been
treated over the years by using steroids and surgical
intervention--neither with much success. A visual problem
that typically occurs later in life as part of the aging
process, "ION" is also suspected to occur with increased
frequency in patients with diabetes and hypertension,
in addition to occurring frequently in people with small,
crowded optic nerves.
At this time, little can be done for the damaged eye,
therefore successful prevention of second eye involvement
is another goal of new research studies. A secondary
and independent research study is also being performed
by Volpe in conjunction with Carolyn Glazer, MD and
Juan Grunwald MD, a retinal blood flow expert, also
with Penn's Scheie Eye Institute. This study will attempt
to focus on the characteristics and nature of the blood
flow patterns in a patient's healthy eye, once he or
she has suffered an eye attack. By examining the characteristics
of the optic nerve in the healthy eye, the researchers
hope to develop treatment strategies that can be used
to protect the second eye.
Editor's Note: Dr. Volpe has no have financial interest
in Allergan.
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