Practice pulse TIPS, TRENDS & NEWS YOU CAN USE

COULD OCULAR PULSE AMPLITUDE BECOME PART OF THE COMPREHENSIVE EYE EXAM?

Eye Test Appears to Identify Stroke Risk

■ Ocular pulse amplitude (OPA) via dynamic contour tonometry appears to detect carotid artery stenosis (CAS), which is a stroke risk factor, says June's Ophthalmology. So, the study's researchers say OPA may be used as a noninvasive and inexpensive screening parameter to detect CAS and possibly to reduce stroke incidence.

Study results showed patients with the lowest OPA scores also had the most blocked arteries. The researchers then employed ultrasound to corroborate that each subject had CAS and to determine blockage severity.

The study was comprised of 134 eyes of 67 patients (25 women, 42 men) with a mean age of 67 + 13 years (range 25 to 87) who were referred for a color duplex ultrasound of the extra- and intra- cranial cerebral arteries.

The researchers performed multivariate analysis (e.g. age, total cholesterol, low-density lipoprotein and trigylcerides) to compare the diagnostic value of OPA measurements with other non- or minimally invasive screening parameters.

Carl Zeiss Launches Web Vision Screening Tool
	Through visiting www.zeiss.com/C1256FBA003362DA/ContainerTitel/EyesightTest/$File/eyetest_en_US.html, patients can access the Zeiss Online Vision Screening, which helps to identify uncorrected vision problems (e.g. visual acuity, contrast and color perception). Also, it includes a link of Zeiss eyecare practices in the patient's area where they can seek a further vision assessment.

SYSTEM WOULD PROVIDE SIGHT FOR RETINAL DEGENERATIVE DISEASE PATIENTS

Stanford Scientists Developing Retinal Prosthesis

■ Stanford University School of Medicine Scientists are developing a retinal prosthesis to provide sight for those who have retinal degenerative diseases, such as age-related macular degeneration and retinitis pigmentosa, says a Stanford School of Medicine article.

Specifically, the prosthesis includes a pair of goggles armed with a miniature camera and a pocket PC designed to process the visual data stream. A liquid crystal microdisplay implanted in the goggles (akin to what's employed by video game goggles), would display the resulting images, the article explains. How so? The LCD would beam the images using laser pulses of near-infrared light to a photovoltaic silicon chip — one third as thin as a strand of hair — embedded underneath the retina. Electric currents from the chips' photodiodes would then trigger signals in the retina, which are delivered to the brain, enabling the aforementioned patients to regain vision, though not in color and far from normal.

“Since this photovoltaic retinal prosthesis device requires no wires, surgical implantation will be simpler than many current prosthetic retinas, which are driven by coils and often require complex surgery to be implanted,” explains Joseph J. Pizzimenti, O.D., F.A.A.O., associate professor of Optometry at Nova Southeastern University and a member of the Optometric Retina Society. “Therefore, safety and complications, such as fibrotic tissue, may be less of a concern. Of course, any new medical device will require rigorous testing to ensure safety and efficacy.”

STEMCELLS, INC. PROVIDES PURIFIED HUMAN NEURAL STEMS CELLS

Phase I/II Stem Cell Trial Initiated for Dry AMD

■ HuCNS-SC (purified human neural stem cells), from StemCells, Inc., will be undergoing a Phase I/II trial at the Retina Foundation of the Southwest's (RFSW) Anderson Vision Research Center in Dallas, Texas, to determine its safety and efficacy as a dry age-related macular degeneration (AMD) treatment, according to a company press release.

“… Our clinical strategy is to preserve visual function before it is lost,” says StemCells, Inc.'s vice president and head of the Central Nervous System program, Stephen Huhn, M.D., F.A.C.S., F.A.A.P. “Our published preclinical data provides a strong rationale for this approach in dry AMD, and we hope to replicate these results in this clinical trial … ”

The Phase I/II trial will be an open-label, dose-escalation study, which is expected to enroll 16 patients, the press release says. The HuCNS-SC cells will be given via a single injection into the space beneath the retina in the most affected eye. Patients' vision will then be determined using both conventional and advanced methods of ophthalmological assessment. These assessments will be performed at predetermined intervals through a one-year period to assess safety and signs of visual benefit. Patients will also be followed for an additional four years in a separate observational study. Patients interested in participating should call (214) 363 3911.

HIGHEST COURT UPHOLDS INDIVIDUAL MANDATE, CHANGES MEDICAID PORTION

Supreme Court Rules Healthcare Act Constitutional

■ As we go to press, the U.S. Supreme Court has narrowly ruled the 2010 Affordable Care Act (ACA) as Constitutional in a five to four decision.

“The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” wrote Chief Justice John Roberts in the Court's majority opinion. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”

Chief Justice Roberts added, however, that the Medicaid Expansion portion of the ACA violates the constitution by threatening existing Medicaid funding. The reason: Congress has no power to order the States to regulate according to its instructions. “Congress may offer the States grants and require the States to comply with accompanying conditions, but the States must have a genuine choice whether to accept the offer…” he wrote. The States are given no such choice in this case. They must either accept a basic change in the nature of Medicaid, or risk losing all Medicaid funding.”

The cure for this Constitutional violation is to prevent the Federal Government from charging such a sanction, “which does not require striking down other portions of the Affordable Care Act,” Chief Justice Roberts wrote.

The bottom line: Although the ACA is alive for now, the November elections will decide its ultimate fate.

Shortly after President Obama signed the ACA into law in March 2010, 26 states challenged its constitutionality, encouraging the Supreme Court to omit the individual mandate, and therefore, kill the law.