Category: Procedures

USC Roski Eye Institute Researchers Report First Results in Stem Cell-Based Clinical Trial for Dry Age-Related Macular Degeneration

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Researchers, clinicians, scientists from the USC Roski Eye Institute and collaborators report encouraging results of a first-in-kind stem-cell based implant in a featured article in Science Translational Medicine entitled, “A Bioengineered Retinal Pigment Epithelial Monolayer for Advanced, Dry Age-Related Macular Degeneration.”

The novel minimally invasive stem cell-based therapy for dry age-related macular degeneration (AMD) was developed by a team at USC Roski Eye Institute, led by Mark S. Humayun MD, PhD, and David R. Hinton, MD, which was funded by the California Institute for Regenerative Medicine. The implant consists of stem cell-derived retinal pigment epithelium cells (RPE) on an ultrathin synthetic substrate. The implanted scaffold of RPE are localized and can function to support and replenish light sensing cells of the eye, which would help restore and prevent vision loss in patients with AMD.

“This is the first human trial of this novel stem cell–based implant, which is designed to replace a single-cell layer that degenerates in patients with dry age-related macular degeneration,” says lead author and surgeon for the study Amir H. Kashani, MD, PhD, assistant professor of clinical ophthalmology at the Keck School of Medicine of USC. “This implant has the potential to stop the progression of the disease or even improve patients’ vision. Proving its safety in humans is the first step in accomplishing that goal.”

Photo courtesy of Britney O. Pennington, PhD
Photo courtesy of Britney O. Pennington, PhD

The first results of the phase I/IIa clinical trial conducted at the USC Roski Eye Institute has been reported on four patients which were followed up to one year to assess safety. It was determined that the implant is safe and integrates well with the patient’s retinal tissue. One patient had improvement in visual acuity by up to 17 letters and two patients had gains in visual function, which was measured by how well they could use the area of the retina treated by the implant. None of the patients showed evidence of progression in vision loss.

Dry AMD can have a profound affect on the quality of life of an individual. In time as the disease progresses, patients will be unable to recognize faces, read or even drive. It is projected that over 3 million will be diagnosed with dry AMD by 2020.

“Our study shows that this unique stem cell–based retinal implant thus far is well-tolerated, and preliminary results suggest it may help people with advanced dry age-related macular degeneration,” says coauthor and lead inventor of the implant Mark S. Humayun, MD, PhD, director of the USC Institute for Biomedical Therapeutics, co-director of the USC Roski Eye Institute, affiliate principal investigator with the Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research at USC and University Professor of Ophthalmology at the Keck School.

Stem Cell AMD blog final
 

Other USC researchers include Biju B. Thomas, PhD; Debbie Mitra, PhD; and Danhong Zhu, MD, PhD.

Collaborating institutions for the study include Regenerative Patch Technologies LLC, which also contributed to the funding of the study, as well as Camtek LLC, the California Institute of Technology, Retina Vitreous Associates Medical Group, California Retina Consultants, Atlantis Eyecare, City of Hope, University of California, Santa Barbara and Denney Research Center. Additional sources of funding for the study include Lori Mars and David Fields Gift, Estate of Beatrice Apple, William K. Bowes Foundation, Vermont Community Foundation, Breaux Foundation, Wilcox Family Foundation and Research to Prevent Blindness.

For more information about the study, visit https://clinicaltrials.gov/ct2/show/NCT02590692?term=nct02590692&rank=1. To participate in the study, please call (323) 442-6335.

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Disclosures: Regenerative Patch Technologies LLC was founded by Mark Humayun, MD, PhD, and David R. Hinton, MD, from Keck Medicine of USC and Dennis O. Clegg, PhD, from the University of California, Santa Barbara. The technology to produce the stem cell–based retinal implant is exclusively licensed to Regenerative Patch Technologies LLC from the University of Southern California, the California Institute of Technology and the University of California, Santa Barbara. Humayun and Hinton have an equity interest in and are consultants for Regenerative Patch Technologies LLC.

Model Risks Losing Eye after Tattooing it Purple

A model in Ottawa, Canada made the decision to tattoo her eye purple, as it was her favorite color. Very quickly she realized something was wrong when the purple ink began to leak from the white part of her eye. Experiencing excruciating pain, her eye began to swell and become infected.

In recent years, the procedure of scleral staining or episcleral tattooing has become an emerging trend. The sclera is the white outer layer of the eye. It is significantly more porous and thinner than skin. As a consequence, these dyes and inks can easily diffuse through the sclera and reach the fragile visual processing structures inside the eye. According to a report in 2015, episcleral tattooing can result in headaches or photophobia (light sensitivity) to more severe complications like infection, hemorrhage or even direct penetration into the eyeball.

Photo: Catt Gallinger
Photo: Catt Gallinger

“Eye tattooing is not recommended as it is very dangerous and can cause serious complications. Once inside the eye, these chemicals will wreak havoc because of their innate toxicity and will most certainly lead to devastating visual loss,” says Charles W. Flowers, Jr. MD, Associate Professor of Clinical Ophthalmology at the USC Roski Eye Institute.

The ophthalmologist who treated model Catt Gallinger, observed a scleral tear from the large needle used to stain her eye as well as a severe infection. Gallinger received grafts and has permanent vision loss from this procedure.

Having posted multiple times on Facebook, Gallinger has brought greater awareness to the dangers of undergoing episcleral tattooing.
 
 

Schedule an Appointment at USC Roski Eye Institute Today

The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected, please complete our online contact form or call 323-442-6335 today!

To learn more about the health services at the USC Roski Eye Institute or to support the Institute with a tax-deductible gift, please contact Rebecca Melville, executive director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.

By: Debbie Mitra, PhD
 

References:

https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-015-0095-y

https://www.washingtonpost.com/news/to-your-health/wp/2017/12/02/a-model-tattooed-her-eyeball-purple-she-now-could-lose-her-eye/?utm_term=.862cdc8f7131

USC Roski Eye Institute Helps Blind Patient Regain Sight with Two Retinal Implants

Terry Byland and his wife Sue, just before his surgery to implant an Argus II prosthetic device in his left eye.When USC Roski Eye Institute patient Terry Byland fully lost his sight to retinitis pigmentosa at age 45, he never could have imagined what his future had in store. Byland recently became the first person in the world to have to retinal prostheses implanted – one in each eye – restoring some sight and much-needed independence.

“I just can’t get over what I can see, and all the things I’ve seen so far,” Byland said.

The 66-year-old Riverside resident began his journey toward regaining his sight when he participated in a clinical trial for the original retinal prostheses, the Argus I, between 2004 and 2010. The 16-electrode artificial retina was implanted in his right eye on June 23, 2004.

Participating in the initial trial gave Byland new purpose after struggling with not only retiring early and giving up the job he loved, but also losing out on getting to watch his children grow up.

“Terry is a true pioneer,” said Mark Humayun, M.D., Ph.D., co-inventor of the device, who holds joint appointments at the Keck School of Medicine of USC and the USC Viterbi School of Engineering. “His work with the first-generation implant helped our team develop the FDA-approved Argus II. For him to enjoy the benefit of this smaller, better device is gratifying.”

On June 22, 2015, Byland received the new 60-electrode Argus II implant by Lisa Olmos de Koo, M.D. at the USC Roski Eye Institute. The Argus II is equipped with software that can be updated as new image processing technology becomes available, allowing Byland to have new features introduced to continually improve his sight.

Combining Medicine and Engineering

The Argus II is revolutionary in that it helps patients identify large letters as well as locate objects using a small video camera, which is mounted to a pair of eyeglasses. The video processing unit then transforms the images picked up by the camera into electronic signals that are wirelessly transmitted to the implant. The prosthesis stimulates visual neurons that send the signals through the optic nerve to the brain, which are interpreted as a visual image.

“The prosthesis allows more independence. And the more independent you are, the happier you are,” said Byland.

The Argus II is the groundbreaking success of a close collaboration between USC Roski Eye Institute, Keck School of Medicine of USC, and USC Viterbi School of Engineering. The device is designed to help patients who have suffered blindness as a result of an inherited retinal degenerative disease called retinitis pigmentosa.

Contact an Innovative Ophthalmology Team

The Argus II is available to qualifying patients at the Keck Medical Center of USC. It is important to receive a thorough eye exam from a professional optometrist or ophthalmologist to catch vision problems and get effective treatment. Please do not wait to make an appointment with a skilled ophthalmologist at USC Roski Eye Institute for a comprehensive eye exam using the most state-of-the-art technology available.

Help support our research and innovation by making a tax-deductible gift by contacting Rebecca Melville, senior director of development, at 323.442.5396 or via email at Rebecca.Melville@med.usc.edu today!

 

How Reliable are Online Eye Exams?

USC Residency Exam Department of OphthalmologyAt a time when more people turn to the internet for everything, from information to shopping to making a living, it is not surprising that the concept of “telemedicine” has become more of a reality each day. Now, psychiatric patients can have Skype therapy sessions from the comfort of home, monthly medication prescriptions can be refilled with the click of a mouse, and even an eye exam can be performed with just a laptop and a smartphone. But for all the convenience and efficiency that telecommunication and information technology has brought to our lives, how well can it replace the thoroughness and expertise of a doctor’s appointment?

What Do Online Eye Exam Companies Promise?

One online company in particular, Opternative, has come under scrutiny recently for claiming to offer refractive eye exams that are just as accurate as an in-person exam with an optometrist. Needless to say, the claim drew the attention of the American Optometric Association (AOA), an organization that represents nearly 40,000 optometrists, optometry students, and paraoptometric technicians and assistants, as well as the American Academy of Ophthalmology (AAO), the largest national membership association of ophthalmologists, osteopathic doctors, and medical doctors in the country.

According to Opternative, in order to take the online refractive eye exam, a patient needs to be between the ages of 18 and 40 and have access to a computer and a smartphone. Following a series of online visual tests and multiple choice questions, the patient’s results are then sent to a physician to approve or deny the patient’s glasses or contact lens prescriptions within at least 24 hours. Based on Opternative’s own clinical study, the results of the online refractive test are just as accurate as a traditional exam and only use technology that has already been approved by the U.S. Food and Drug Administration.

Both the AOA and AAO have openly challenged the online company, stating that Opternative’s claims are misleading to consumers because they highlight convenience, low costs, and FDA approval without providing adequate information about the limitations of the test.

Important Factors to Consider When Taking an Online Vision Test

In order to help the public more accurately evaluate online eye exams, the AAO has issued the following guidelines.

  • First, an online test is not a substitute for a one-on-one eye exam. It may be used as a follow-up tool for patients between the ages of 18 and 39 who do not need severe corrective eyeglasses.
  • If you experience vision problems, schedule an appointment with an ophthalmologist.
  • Patients under 18 years of age or 40 and older should not rely on online eye exams. Instead, they should visit a qualified ophthalmologist or optometrist who can identify risk factors or symptoms of eye disease and begin treatment as soon as possible.
  • Patients between the ages of 18 and 39 should schedule comprehensive eye exams every five to 10 years to detect eye diseases and conditions such as glaucoma, cataracts, or corneal astigmatism that may not present immediate symptoms.
  • Online vision tests cannot offer accurate prescriptions for patients that need irregular or high-power prescriptions.
  • Online vision tests can test the power of eyeglass prescriptions, but are not effective at testing contact lens prescriptions.

Schedule an Eye Exam at USC Roski Eye Institute

Regular, annual eye exams from a professional optometrist or ophthalmologist are the only way to accurately catch vision problems and get effective treatment. An online eye exam may be appealing for its convenience, but it is important that patients are fully aware of the limitations. Please do not wait to make an appointment with a skilled ophthalmologist at USC Roski Eye Institute for a comprehensive eye exam using the most state-of-the-art technology available.

Support the USC Roski Eye Institute by making a tax-deductible gift by contacting Rebecca Melville, senior director of development, at 323.442.5396 or via email at Rebecca.Melville@med.usc.edu today!

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PROSE Treatment Brings Relief to Cancer Survivor

USC Eye PROSE Treatment
“I had lost all hope until I came to the USC Roski Eye Institute. I’m excited about the PROSE treatment because it will take care of my pain so that I can live a normal life.” – Nicole Schultz, USC Roski Eye Institute patient

Nicole Schultz, a two-time cancer survivor, has been suffering from the devastating effects of a condition known as ocular graft-versus-host disease (GvHD).

Medical and Ocular History

Schultz was diagnosed with ocular GvHD following her second bone marrow transplant, which she received during her cancer treatment. Serious complications can arise in patients with GvHD, when donor cells from transplants attack connective tissue of the patient or host. For Schultz, GvHD manifested in her eyes, which were no longer able to produce tears and resulted in painful flare-ups. For years she sought treatment for dry eye, visiting many doctors, who prescribed various eye drops and even punctal plugs to increase tears and moisture in her eyes. Schultz’s life changed dramatically, since she was required to administer drops multiple times a day to diminish the pain she experienced. She says she was on the verge of giving up hope when it was suggested to visit the USC Roski Eye Institute to try a unique contact lens treatment option known as prosthetic replacement of the ocular surface ecosystem (PROSE).

Gloria Chiu, OD, FAAO Assistant Professor of Clinical Ophthalmology and Chief Optometrist Specialty: PROSE and Specialty Contact Lens
Gloria Chiu, OD, FAAO, FSLS, Assistant Professor of Clinical Ophthalmology and Chief Optometrist
Specialty: PROSE and Specialty Contact Lens

After meeting Schultz for the first time, Gloria Chiu, OD, FAAO, FSLS, who is trained in PROSE treatment, immediately knew that she could help relieve Schultz’s symptoms.

PROSE treatment, a non-surgical procedure, is offered to patients who suffer from serious corneal conditions and ocular surface diseases. PROSE therapy reduces symptoms, supports healing and improves vision through the use of a prosthetic scleral device that is tailored for each individual. Schultz is also using non-preserved artificial tears with PROSE therapy to enhance comfort and fit.

Recent studies have demonstrated that patients who received this pioneering treatment experienced a notable improvement in their quality of vision and quality of life as a result.

The USC Roski Eye Institute is the third of 12 sites in the nation to offer PROSE technology to our patients. Chiu is one of only two West Coast eye care providers to offer PROSE treatment.

Outcome

“It is a privilege to be able to provide Nicole with a treatment that can quite simply change her life. These custom devices help to improve her vision, comfort and assist in the healing of her ocular surface,” says Chiu.

For more information on PROSE treatment, please visit eye.keckmedicine.org/PROSE

Join the USC Roski Eye Institute in its quest to preserve, protect and restore the gift of sight by making your tax-deductible donation today. Thank you for your support! GIVETO.USC.EDU/EYE

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