Special eye cells may cure MD

The Straits Times
By Liaw Wy-Cin

SCIENTISTS from the University College London (UCL) have succeeded in coaxing 'master' cells to become specialised eye cells which can be used to replace a diseased portion of the eye. They have done this in pigs and rats, and are hoping for the go-ahead from the British authorities to try out the method in humans in 18 months.

The special eye cells they created are retinal pigment epithelial (RPE) cells, which protect and supply nutrients to the retina. If the retina, which lies at the back of the eye, is starved of nutrients, or clouded by debris, it cannot perform its role of passing visual images from the front of the eye to the brain. The result is blurred vision and eventual blindness.

One in four people above the age of 60 is struck by this condition, known as age-related macular degeneration (AMD), said the project's lead scientist, Professor Pete Coffey, 47, from UCL's Institute of Ophthalmology. For 90 per cent of AMD patients, there is no treatment. A drug called Lucentis, recently approved for use here, can treat a less common form of AMD, affecting about 10 per cent of patients.

Prof Coffey's team has used embryonic stem cells, taken from a stem cell bank, and grown them to form a 6mm-by-3mm oval patch of RPE support cells. Embryonic stem cells are seen as having a lot of potential in medicine because they could one day be used to replace diseased or damaged body parts. In trials on animal eyes, Prof Coffey's team injected a fluid to separate the retina from the RPE cells, and through a small incision, inserted the patch on top of the diseased area of RPE cells.

'The cells then took over the function of the diseased cells in providing nutrients and clearing debris,' he said. In an experiment five years ago, his team found that this newly grown layer of cells restored the sight of about 80 per cent of blind rats.

One eye expert here is excited about the potential of this work, because he expects AMD to become a major cause of blindness in Singapore as the population ages. Said Associate Professor Au Eong Kah Guan, 42, head and senior consultant at the department of ophthalmology and visual sciences at Alexandra Hospital and Jurong Medical Centre: 'If this therapy works, it could be the most ground-breaking work on AMD treatment to date.

'Its impact would be enormous because it could potentially treat people who have already lost vision due to death of light-sensitive cells in the retina, something which all current therapies are unable to do.'

He said that for every patient diagnosed with AMD, an estimated 154 cases go undiagnosed.

Connecting with your doctor

Little gestures by doctors can make a big difference to the patients, said MDS adviser Au Eong Kah Guan at a sharing session yesterday. It can be just a smile or simple eye contact, but it can make a world of difference to the patient.

He shared his views on doctor-patient relations with more than 50 members of MDS, GPAS and RP Society, as the three non-profit organisations came together for a joint-session for the first time.

While doctors, especially those in public hospitals, often have to contend with large number of patients, he believed that doctors should encourage patients to ask questions and avoid medical jargons when explaining the condition to patients.

But it cannot just be a one-way street. Patients should also aim to acquire more knowledge, he said, and be compliant with the treatments advised by the doctors.

He was joined by RP Society president Wong Meng Ee, who also urged patients not to be passive when dealing with doctors. Instead, patients should actively engage the doctors. He offered a tripartite model for doctor-patient relations, saying that it should also include families in the equation.

Look out for more joint-sharing sessions, with the next one coming up in May.

New NY Governor inspires diabled

New York (AP) — When David Paterson takes office Monday to become the nation's first legally blind governor, among those watching with the greatest interest will be those who cannot see. Paterson's rise to governor has served as a great source of inspiration to blind Americans, many of whom believe his newfound power will make the country more open-minded about disabilities.

"We don't see a lot of people with disabilities in positions that important," said Suzanne Ressa, marketing and development director at the Helen Keller National Center for Deaf-Blind Youths and Adults on Long Island. "He could be a great role model to all those individuals who are transitioning into the work world, because he's saying, `Yeah I'm making it happen.' You know, `If I can hold this leadership position, so can other people.'"

Although estimates vary, there are approximately 10 million blind and visually impaired people in the United States, and about 1.3 million of them are legally blind, according to the American Foundation for the Blind.

Paterson, who lost sight in his left eye and much of the sight in his right eye after an infection as an infant, joins a minuscule fraternity of blind politicians to attain high office. Thomas Pryor Gore was totally blind and served as a U.S. senator from Oklahoma from 1907 until 1921 and from 1931 until 1937. Minnesota had a blind congressman and senator, Thomas David Schall, who served from 1915 until his death in 1935.

Paterson succeeds Eliot Spitzer, who resigned Wednesday after being exposed as a client in a high-priced prostitution ring. The 53-year-old Paterson is the state's first disabled governor since Franklin D. Roosevelt, who was stricken with polio several years before he was elected in 1928. Though his sight is limited, Paterson, who spent 20 years in the state Senate before becoming lieutenant governor, walks the halls of the state Capitol unaided. He recognizes people at conversational distance and can memorize whole speeches. He has played pickup basketball games, once ran the New York City Marathon and can read for short periods of time, though aides usually read to him.

Maricar Marquez hopes Paterson's new job will help change people's opinions about disabilities. Marquez, 36, is deaf and blind and communicates with the aid of two interpreters, but still manages to work as an instructor at the Helen Keller center.

"Maybe with this happening the government will be more sensitive to people with disabilities and provide better services for rehabilitation, education and maybe be more willing to be open-minded and understanding of the needs of people with disabilities," she said.

Dr. Marc Maurer, president of the National Federation of the Blind, said Paterson's ascension to the governor's mansion can only help shatter misconceptions and stereotypes. "He will serve as constant proof to the citizens of New York and the nation that blind people can perform any task, from an entry-level position to leading one of the largest states in the nation," Maurer said.

Vincent Norbury, a 19-year-old student from Queens who attends the Helen Keller center, had some suggestions for the incoming governor: "I think he should put Braille on more street signs and make some way that people with no vision can tell if the lights are changing in the street."

Tracey Gilbert-Dallow of Port Washington, a Helen Keller instructor who gets around with her guide dog Marley, predicted Paterson "will have a big influence not just on blind people, but everyone."

"He had all these challenges and look where he is today," she said. "Just because you have sight don't mean you can see. You see within yourself."

Regress abnormal blood vessels?

Clinical trial on a promising new treatment for AMD has kicked off last month in Princeton, New Jersey. Pharmaceutical company Ophthotech enrolled the first patient to test E10030 - an anti-PDGF aptamer, in combination with an anti-VEGF agent.

Pre-clinical trials showed that E10030 has the potential to regress abnormal blood vessels in AMD. The current treatments like Macugen - which rely only on anti-VEGF therapy - are unable to do that.

"We believe E10030 holds great promise for enhancing the visual outcome for patients with AMD," said Samir Patel, Ophthotech's president and CEO.

Dialogue with Eye Doctor

MDS members can look forward to an enriching dialogue with its adviser, Associate Professor Au Eong Kah Guan, this month. Prof Au Eong (right), together with RP Society president Wong Meng Ee, will share with members on how to connect with your doctor when you go for your check ups.

To be held on March 22nd, the two-hour dialogue will allow members to ask questions, interact and obtain insights on doctor-patient relations, especially when it relates to vision problems.

It will be held in MDS' regular sharing session venue: the Seminar Room of Alexandra Hospital. Seats are limited, so please reserve your seats early.

Register with Anne Ang at 6238-7387, alleyes@singnet.com.sg; or Sam Fong: 6744-1286/9109-7226, glaucoma.patients@gmail.com

This event is jointly-organised by MDS, GPAS and RP Society.