Macular Degeneration Society (Singapore)

Sharing session - The Three Tips

2012-01-28T19:03:00.000+08:00

The fight against macular degeneration is often a lonely process. But it gets better when you are able to pick the brains of others on how to cope. And in our view, the greatest treasure trove of information lies within us - the members of MDS. Come join us in a sharing session among members on your three best tips to live with macular degeneration.

There is no right or wrong answer. There is no good or bad answer too. Your tips can be on anything, ranging from medicinal to exercises, from technology to household changes, from how to connect with a doctor to the best way to get back home after a check-up. In short, it can be on ANYTHING.

What we take for granted in our own struggles with macular degeneration is very likely not familiar to others. And it could make a big difference in all our lives when we share and pick up these unknown "personal strategies".

Date: Feb 11, 2012 (Sat)
Time: 2pm - 4pm
Venue: All For Eyes shop, Tanglin Shopping Centre, 19 Tanglin Road, #05-23, Spore 247909Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now for our first event of 2012!

This event is free for all MDS members. If you know of someone who you feel might benefit from joining our circle, please invite them, just let us know in advance.

REMINDER for members, please arrange to pay your membership fees ($20 for 2 years) if you haven't done so.

Stem cell retinal implants safe

2012-01-25T13:57:00.001+08:00

Early results from the world's first human trial using embryonic stem cells to treat diseases of the eye suggest the method is safe, say researchers. US firm Advanced Cell Technology told The Lancet how two patients who had received the retinal implants were doing well, four months on.

Trials of the same technique have now started at London's Moorfields Eye Hospital. But experts say it will be years before these treatments are proven. The aim of these first human studies is to establish that the treatment is safe to use.

Click here to read the full BBC story. More details here from Reuters.

The man who taught himself to see

2011-12-27T16:55:00.006+08:00

This is an amazing inspirational story to round off the year. Daniel Kish has been sightless since he was a year old. Yet he can mountain bike. And navigate the wilderness alone. And recognize a building as far away as 1,000 feet. How? The same way bats can see in the dark.

Click here to read the full article. It is a long piece, but well worth your time.

Merry Christmas and Happy 2012!

Eylea approved in US

2011-12-14T13:09:00.004+08:00

The United States has approved the use of Eylea, a new drug to treat age-related macular degeneration. It adds an important new weapon to the ongoing battle against the eye disease.

Eylea is similar to the other two main drugs in the market, Lucentis and Macugen. It inhibits a factor that makes unwanted blood vessels grow in the retina. The blood vessels can leak blood and fluid, causing damage to the retina. Eylea blocks all forms of this factor, called VEGF, and also blocks a second similar factor.

But compared to Lucentis and Macugen, Eylea requires fewer injections and is hence cheaper for patients. Lucentis is given once every month, although some patients may need treatment only once every three months. Macugen is given every six weeks. Eylea is given once every two months after three once-a-month injections. All three of these drugs are given by injection into the eye with a tiny needle.

In clinical trials, Eylea has worked as well as Lucentis. But the drug can cause some side effects. In clinical trials, the most common were bleeding in the white part of the eye at the site of injection, eye pain, cataracts, detachment of the gel part of the eye (vitreous) from the retina, floating spots in the vision, and increased pressure within the eye.

Wondrous paths of Botanic Gardens

2011-11-19T00:09:00.005+08:00

By Sharon Siddique
MDS President

About 30 of our “regular” MDSers gathered at the Botany Centre, Green Pavilion for our annual outing on Nov 5. At 10am we were offered a fascinating tour of “Edible and Medicinal Plants, which was conducted by Botanic Garden staff.

They were so well informed, that we all picked up numerous bits of information – rather than walking through “trees and bushes”, we actually were introduced to them, and I don’t think any of us will again walk through the garden ignorant of how dependent we are upon these many “edible and medicinal” plants.

To give just a few examples:

We were introduced to a nutmeg tree – fascinating to see the flowers, the fruits, and to actually see the connection to the tree itself. Now nutmeg has much more meaning than powder in a spice bottle! Or the introduction to a kaffir limebush (limau purut in Malay). The pungent leaf is so familiar to anyone who cooks or indulges in Southeast Asian dishes, but to break off a fresh one for a smell was quite an experience.

Question: And did you know the difference between wild and cultivated bananas?

Answer: wild banana bunches grow down, while cultivated ones grow up.

Multiply these insights by 100, and you have some idea of what knowledge we acquired. Our one and a half hour tour wound around the wondrous paths, ending up at the ginger garden, our next-to-last edible stop. We then retired to the benches outside the Orchid Pavilion for a VERY edible, delicious box lunch, and welcome drinks. (Yes, it was HOT!) We wrapped up at 12pm, with loads of good fellowship, and much food for thought.

For those of you who missed this tour, we would highly recommend it. The tours run every first Saturday of each month, - one at 9am and another at 10am.

They are free of charge, and you can sign up on the spot at the Green Pavilion at the Botany Centre, near the main Holland Road entrance. In addition we found lots of other tours and classes offered on the Botanic Garden website, so those of you who would like to follow-up, you can do so.

We will be holding our next MDS meeting in February 2012, after Chinese New Year, which falls on the Jan 23-24. We wish all MDSers a very happy holiday season, and don’t forget to check the website, blog or facebook for updates and informative entries. Look forward to seeing you all next year!

Phone check-ups for cataract

2011-11-11T15:25:00.001+08:00

The Straits Times

Nov 5, 2011

By Fiona Low

Patients recovering from cataract surgery could be given follow-up consultations over the telephone under an initiative by Tan Tock Seng Hospital. Its eye centre is exploring ways to cut the number of return visits by those who have had the operation.

The idea is to make life more convenient for patients, who will be spared a journey, and free up doctors to focus on more complicated cases. Only patients whose surgery had gone without a hitch and who are deemed to be at low risk of complications are eligible for phone consultations.

Trained nurses will call them and go through a list of eight questions designed to check they are recovering smoothly and are free of problems such as infections. The initiative follows a successful pilot study in 2009. Phone consultations have been used to follow up cataract surgery in places such as the United States and Europe. However, this is the first time the system has been implemented here.

Patients who undergo the operation normally have to return to the hospital for three follow-up visits. The first is the day after surgery, the next is a week later and the third is a month after that. The phone consultations replace only the first visit. Dr Wong Hon Tym, head of the hospital’s ophthalmology department, said the questionnaire used by nurses is a safe way to pick up complications because they are usually easy to identify. Signs include obvious pain, blurry vision and redness in the eye.

Cataracts occur when the crystalline lens in the eye becomes cloudy, blurring the patient’s vision. The surgery involves removing it and replacing it with an artificial lens. Seven of the hospital’s 26 consultants routinely use phone consultations with their patients, and there are plans for all to do so eventually. Cataract surgery is the most commonly performed operation in the department. It is carried out on between 4,000 and 6,000 patients a year.

By the time the programme is implemented fully, about 1,000 10-minute clinic slots will be saved in a year. The eye centre is also looking into using telemedicine to reduce the number of follow-up visits by cataract patients.

This means that instead of returning to the hospital, they can go to an optometrist at a polyclinic instead. Pictures and videos are taken of the eye and sent to the consultant at the hospital, who then conducts the check remotely.

Findings from a pilot study of the technique this year have been encouraging. It found that advances in technology mean the transmitted images are nearly as clear as if the doctor was examining the patient in the flesh. Telemonitoring is intended to be used with the patient’s third follow-up visit. Dr Wong said that although larger studies are needed, the promising data indicates that in future, post-operation visits will be carried out in a non-hospital setting.

fionalow@sph.com.sg

Blindness is avoidable

2011-10-14T15:35:00.004+08:00

Press release by WHO

Oct 13, 2011

MANILA - The World Health Organization (WHO) today said that blindness could be avoided in eight out of 10 cases with appropriate treatment or early prevention.

Worldwide, WHO estimates that 246 million people have low vision and 39 million are blind, with cataracts as the leading cause of avoidable blindness, particularly in developing countries.

At the same time, cataract blindness in most cases can be treated by a 15-minute medical intervention. Other preventable causes of blindness include diabetic retinopathy and uncorrected refractive error. Trachoma remains the main infectious cause of avoidable blindness and is still common in parts of the Western Pacific Region, including Australia and the Pacific islands.

On 13 October, the international community marks World Sight Day to raise awareness of avoidable blindness and visual impairment. World Sight Day is held annually on the second Thursday of October.

Aside from the substantial impact that blindness or low vision has on a person’s quality of life, there is also a strong economic impact, not only for the person affected but also for the family and community giving support, said WHO. Reducing blindness, therefore, alleviates household, community and national poverty and is linked to improving access to educational and employment opportunities.

Surveys indicate that 90% of people with blindness or low vision live in low-income countries. In the Philippines, for example, an estimated half a million people are blind.

In more developed countries, however, there has been a reduction in visual impairment and blindness as a result of investment and the work of governments and international partners in developing national eye-health systems, including the improvement in the quality and quantity of eye-care services.

WHO is coordinating international efforts in reducing visual impairment, with a focus on building and strengthening health systems:

strengthening country-level efforts to eliminate avoidable blindness;
helping national health-care providers treat eye diseases;
expanding access to eye-health services; and
increasing rehabilitation for people with residual visual impairment.

In response to the increasing burden of chronic eye disease, WHO is now developing policies and guidelines for diabetic retinopathy, glaucoma, age-related macular degeneration and refractive errors.

In the last 10 years, WHO has been working with the International Agency for the Prevention of Blindness in the global initiative "Vision 2020: the Right to Sight". WHO, in partnership with Lions Clubs International, also established in 2004 a global network of 35 childhood blindness centres in 30 countries for the preservation, restoration or rehabilitation of sight in children. Fifteen million fewer people are blind today compared with projections made when the initiative was launched in 1999.

MDS Outing - Botanic Gardens

2011-10-07T15:22:00.002+08:00

After our successful maiden outdoor event last year at the Hort Park, we are heading out to the sun again! This year, we are visiting the Botanic Gardens, on a guided "Edible and Medicinal Tour" led by the park's official staff. The tour will explain how edible and medicinal plants can contribute to our daily lifestyle.

Participants will be exposed to some of the edible and medicinal plants in Singapore Botanic Gardens. The mission of this tour is to increase awareness of food as medicine as well as a source of nutrients & to increase awareness of the rich biodiversity of our tropical plants.

Lunch will be served after the tour, so please sign up now so that we can cater for you. You can take the Circle Line MRT to the new Botanic Gardens station.

Please be punctual because the tour will start on time. This is our last event of the year, so please join us!

Date: Nov 5, 2011 (Sat)
Time: 9.45am - 11.30am
Venue: Botany Centre, Green Pavilion (near Tanglin Gate, by Holland Road)

Attire: Light clothes in anticipation of hot weather, please bring a hat or an umbrella for shade if necessary.

Click here for a map of Botanic Gardens.

Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now! This event is free for all MDS members.

Getting the message

2011-09-30T13:28:00.006+08:00

The annual AMD Awareness Week was held from 24 – 30 September 2011. Dr Amy Khor, Minister of State for Health, was Guest of Honour at the launch last Saturday morning.

MDS Singapore was one of the joint sponsors of the event, and as our contribution to the AMD Awareness exhibition, we had a computer with an extra-large screen monitor to introduce visitors to the online MDS sites – our website, blog and facebook page. Some “got the message”, as we have been enjoying a larger volume of visitors since then!

MDS, together with the AMD Awareness Week organising committee, put together a very interesting afternoon session, with speakers covering several topics. These included “The Role of Vitamin Supplements in AMD”, “Coping with Vision Loss”, “Advances in Management of AMD” and a “Healthy Cooking Demonstration”. For some interesting and creative healthy recipes, check out the hospital website.

Narinder Sharma, CEO of AMD Alliance International, based in London, gave an interesting introduction to the organisation, as well as to the topic of coping with vision loss from a patient’s perspective. MDS is a member of the AMD Alliance International. Those of you who would like further information on the Alliance and its activities, please visit their website.

China's bogus "stem cell therapies"

2011-09-22T12:50:00.005+08:00

Reuters

Sept 21, 2011

By Tan Ee Lyn

Hong Kong (Reuters) - Chinese hotel manager Hong Chun had trouble using chopsticks after a minor stroke and sought treatment at a large Shanghai hospital where doctors injected what they said were donor stem cells into his spinal cord and buttocks, according to his father and cousin.

Leaving hospital the next day, Hong, 27, fell so ill he had to be taken off the train and rushed to another hospital. But doctors were unable to save him and he was declared brain dead before dying a month later.

Desperate for help, patients with incurable diseases are admitting themselves into hospitals in China for "stem cell therapies" but experts say such treatments are backed by little or no scientific evidence and are at best experimental.

Some of these cases involve large general hospitals where patients pay thousands, even tens of thousands, of dollars for treatments that are advertised online. Patients have come away with little or no improvement and a number have died, according to patients, doctors and relatives of patients who spoke to Reuters.

Hong paid 30,000 yuan ($4,800) to the Chinese army's 455 PLA Hospital in Shanghai for the treatment last year, according to hospital receipts seen by Reuters.

His father, Hong Gensho, travelled to Shanghai to seek an explanation. But hospital administrators told him his son didn't die in their hospital, paid him 80,000 yuan and told him not to pursue the matter.

"I am miserable, it's like my son was worth only 80,000 yuan. It's not about money. Our human rights, our place in this society, are not respected. I am devastated. If he hadn't sought treatment, he would not have died," said the elder Hong, 61.

"I can't get my son back, but people must know about these stem cell therapies and no one must be deceived."

LACK OF SCIENTIFIC EVIDENCE

Experts have raised the alarm on patients turning up at clinics and hospitals in China, Mexico, India, Turkey, Russia and elsewhere for stem cell therapies that have not undergone clinical trials and which are not recognized as standard treatment.

Patients often pay fees of $20,000 and more for such therapies after exhausting conventional treatments.

"Stem cell tourism is regarded as ethically problematic because patients receive unproven therapies from untrustworthy sources," Dr David Resnik at the U.S. National Institute of Environmental Health Sciences and Zubin Master at the University of Alberta in Canada wrote in a paper published in the journal European Molecular Biology Organization.

Echoing the same concerns, Dr George Daley at the Harvard Stem Cell Institute and Harvard Medical School said he was swamped by enquiries from patients asking about therapies in China and Brazil for diseases from Alzheimer's to spinal cord injuries.

"What I'm talking about are the less legitimate treatments that have not even undergone clinical trials but are directly marketed therapies... We really have no idea how to use stem cells for these treatments," Daley told Reuters.

When contacted by Reuters, a director at the PLA 455 Hospital, who declined to be identified, said: "There are always good and bad outcomes. No therapy can guarantee success to everyone... Besides, you don't have a better alternative.

"As for patients dying, all deaths must be investigated. What caused the death? If our treatment caused the death, the patient (relatives) can seek redress. If it is a death caused by old age and sickness, then there is nothing I can say."

China's Ministry of Health did not respond to questions from Reuters on stem cell therapies being offered in the country.

VICTIMS ARE THOSE FACING DEATH

Suffering from late-stage liver cirrhosis caused by a lifelong hepatitis B virus infection, Fan Hongkun was led to believe her body would spontaneously grow a healthy liver once stem cells were transplanted.

"We saw the therapy advertised online and talked to the doctor over the phone. He said stem cells were like seeds, after being planted on a liver, they grow, divide and spread and finally form a healthy liver," said Fan's son, Zhou Junjie.

Fan, 63, was so convinced, she admitted herself into Beijing Military General Hospital, whose website still carries information on the stem cell therapies it offers.

"My mother said the PLA (Chinese army) doesn't lie. That's why she trusted them," said Zhou.

Doctors there took her off the drug lamivudine for four weeks to "prepare her for the stem cell therapy". But she fell into a coma before doctors could treat her.

Sold under the brand Epivir by GlaxoSmithKline Plc, lamivudine minimizes liver damage by blocking the hepatitis B virus from replicating.

Fan's family learnt later from other doctors that she suffered a sudden surge of the virus after she stopped her medication, which pushed her into a coma and killed her.

According to documents seen by Reuters, her family sued the hospital, but the case was dismissed by a Chinese court.

When contacted, a doctor at the hospital, who declined to be identified, said the entire procedure to transplant stem cells into a patient's liver takes only a day.

"We extract the patient's bone marrow cells and isolate the stem cells, which are then inserted into the liver," said the doctor. "...We extract bone marrow cells in the morning and in the afternoon we inject them (stem cells) into the liver. Yes, all it takes is a day. Very fast."

Advertisements for these treatments remain on the hospital's website. In Ireland, many patients have returned from treatments abroad with no improvement, but they are less willing to talk.

"Virtually none will go on record to state they have been conned. This is mainly because many patients have serious immediate health concerns and they need to focus on that," Stephen Sullivan, chief scientific officer of the Irish Stem Cell Foundation, told Reuters.

"Patients are also reluctant to come forward as they are embarrassed at spending lots of money against professional medical advice. Some patients will even claim improvement when there is no measurable improvement."

POTENTIALLY POWERFUL

Researchers believe regenerative medicine will be a powerful form of therapy in the future. Stem cells are immature, master cells in the body that can grow into any kind of human cell or tissue. Scientists are exploring how to use them to treat a variety of diseases and disorders, including cancer, diabetes and injuries.

But for now, they stress that only one type of stem cell therapy has been proven to work. "Only bone marrow transplants for diseases such as leukemia, lymphoma are backed by solid evidence and are well-established clinical procedures. The others are not up to that level," said David Siu, clinical associate professor at the cardiology division of Hong Kong's Queen Mary Hospital.

"There is evidence that certain stem cells can grow into new tissue but do they provide a therapeutic effect? We don't have the evidence yet. Some are in clinical research."

For the conditions highlighted in this article - disability from strokes and liver cirrhosis - experts say there are no proven stem cell treatments.

In their paper, Resnik and Master said while most countries had rules governing research on people and medical malpractice, they did not apply directly to stem cell therapy. When doctors encounter strict regimes, they can simply move to other countries with more permissive legal environments.

Experimental stem cell therapies, however, may be legitimately offered to patients, but these must be carried out within the framework of clinical trials that are approved by regulatory boards that ensure ethical standards are met.

"When experimental stem cell therapy is used on patients, it is not performed on an ad-hoc basis but within the framework of a proper clinical trial prepared beforehand," Siu said. "It has to follow a rigorous methodology: what are the risks, what can and cannot be done? If the results are negative, what are the rescue and safety measures?"

Sullivan urged patients to be on the lookout for scams. Suspicious signs include being asked for large sums of money up front, being told there are no risks, and being offered no post-therapy care.

Patients should be told how they will be treated, what stem cells are used and where they come from. They should not accept any therapy based on hearsay, or without the treatment being validated at least in part by peer review, he said.

Resnik and Master urged stem cell scientists, who have control over stem cell lines, to help stop these scams by not releasing such materials to doctors or clinics if they cannot produce proof of conducting a genuine clinical trial.

"This would ensure that the stem cells and other materials are going to be used in the course of responsible biomedical research, a legally sanctioned clinical trial or in responsible medical innovation," they said.

Avastin injections cause blindness

2011-09-12T15:37:00.000+08:00

The New York Times

Aug 30, 2011

By Andrew Pollack

At least 16 people in two states have gotten severe eye infections, and some have been blinded, from injections of the drug Avastin, according to health authorities and to lawyers representing the patients.

The cancer drug Avastin has been used by some doctors to treat macular degeneration, an off-label application. The incidents, in Florida and Tennessee, demonstrate the risks associated with the money-saving practice of injecting Avastin into the eye to treat the wet form of age-related macular degeneration, a common cause of severe vision loss in the elderly.

Click here to read the rest of this article.

AMD Awareness Week 2011

2011-09-03T16:23:00.006+08:00

The annual Age-related Macular Degeneration Awareness Week is here again and MDS is happy to play our part in this nation-wide drive.

Date: Sept 24, 2011 (Sat)
Time: 1 - 3pm
Venue: Learning Centre, Khoo Teck Puat Hospital

The event is open to the public.

Here's the programme:

1 - 1.15pm.

Speaker: Mr Narinder Sharma, CEO of AMD Alliance International.

Topic: Support system for patients with macular degeneration: Role of AMDAI

1.15 - 1.30pm

Speaker: Dr Ajeet Wagle, Consultant, OVS, KTPH

Topic: Advances in Management of AMD

1.35 - 1.45pm

Speaker: To be confirmed

Topic: My experience with AMD treatment - a patient's story

1.45 - 2pm

Speaker: Ms Zoe Soo, pharmacist, KTPH

Topic: Role of vitamin supplements in macular degeneration

2 - 2.15pm

Speaker: Dr Yang Wei Wen, psychologist, KTPH

Topic: Coping with vision loss

21.15 - 3pm

Speaker: Ms Gladys Wong, Nutrition and Dietetics, KTPH

Topic: Healthy Cooking Demonstration

Severe drop in quality of life

2011-09-01T17:56:00.001+08:00

Macular degeneration patients suffer a severe drop in quality of life, not unlike those with cancer and kidney dialysis, said Dr Au Eong Kah Guan on Saturday in a talk with our members. Those with moderate age-related macular degeneration, for example, suffers a dip of 40 per cent in quality of life and it is similar to those who need regular kidney dialysis.

Dr Au Eong, who is the advisor of Macular Degeneration Society (MDS), added that those with severe AMD suffer a drop of 63 per cent in quality of life, a rate on par to prostate cancer sufferers. Such heavy impact on the mental well-being of macular degeneration patients is the reason why it is important to have support groups like the MDS.

Furthermore, it is critical for awareness to be drummed up so that patients can make better-informed choices which would help them tell of impending attacks, he observed in a talk titled Latest Trends in Management of Macular Degeneration at the Alexandra Hospital.

Dr Au Eong shared that nutritional supplements can slow progress of AMD by up to 25 per cent, citing Omega-3 fatty acid as useful to those with macular degeneration. He added that authorities in Singapore could soon be carrying pictures of AMD sufferers on cigarette packs here, as smoking is a known threat to macular degeneration.

He also spoke of the clinical trials comparing the effectiveness of Lucentis versus Avastin, stressing again that early diagnosis is often the key to reduce risk of vision loss.

MDS held its annual general meeting after the talk, with its annual statement of account presented. MDS President Sharon Siddique gave a presentation of the society's events in the last year and secretary Peh Shing Huei and treasurer Kym Ong spoke about the online platforms of MDS. In particular, members were briefed on the society's venture into Facebook in the past year.

The iPad's Secret Abilities

2011-08-22T17:34:00.002+08:00

businessweek.com

July 6, 2011

By Rachael King

Jonathan Avila uses his iPad in ways most people might not realize are possible: The device reads e-mail to him while he’s traveling to work, tells him which way to walk when he is lost, and even lets him know if there’s a sidewalk on the other side of the street. Avila needs these features because he’s visually impaired.

"Work bought it as a testing device, but I’ve claimed it as my own since it makes me more efficient," says Avila, chief accessibility officer for SSB Bart Group, a firm that helps companies implement technology for people with disabilities.

Apple has added features that make the iPhone and iPad easily accessible, not only to visually impaired people but also to those with hearing loss and other challenges. The iPhone 4 and the iPad 2, for example, come with VoiceOver, a screen reader for those who can’t read print, as well as FaceTime, video-calling software for people who communicate using sign language. Apple has said that iOS 5—due later this year—will contain improvements to VoiceOver and LED flash and custom vibration settings to let users see and feel when someone is calling.

More such devices as the iPad and iPhone will make their way into the workplace to assist people with physical challenges in the next five years. Disability and aging go hand-in-hand: As baby boomers work past age 65, companies will increasingly face this issue. The incidence of disability in the workplace is 19.4 percent at age 45 and rises to about 50 percent by age 70, according to Jennifer Woodside, chief executive officer of the Disability Training Alliance. Those disabilities can include vision and hearing loss, issues with mobility and dexterity, and learning and cognitive challenges—as well as communications problems.

A Boom in Assistive Technologies
The global market for assistive technologies, including those used in the home, is projected to reach $40.9 billion in 2016, up from $30.5 billion this year, according to a report from BCC Research that’s scheduled to be released this month. In addition to Apple, Microsoft, IBM, Google, and Hewlett-Packard make workplace technologies that are accessible to people with a range of abilities.

"Boomers will demand products, services, and workplaces that adapt to their needs and desires," says Rich Donovan, chief investment officer at WingSail Capital. Crossover technology such as the iPad, which works well both for people with disabilities and the broader consumer market, are the "holy grail" of business and disability efforts and will drive growth in disability-related capital spending, he says. Donovan, who has cerebral palsy, just received his first iPad as a Father’s Day gift. "I love it, it’s simple to use and it’s the ideal accessible technology," he says.

Companies such as Apple are motivated, at least in part, to create products that work for people with disabilities because the population is aging, says Dorrie Rush, marketing director of accessible technology at Lighthouse International, a nonprofit organization dedicated to fighting vision loss.

At the age of 33, Rush was diagnosed with early-onset macular degeneration. Twenty years later, her visual acuity is low, although she retains some peripheral vision. "I used to be on the bus and I would see people reading the newspaper and I’d be so jealous," Rush says. Then she bought an iPhone and downloaded the New York Times app. Her phone now reads the news to her on the bus each morning.

Rapid Technological Improvement
In the past two years, particularly since the release of the iPhone 3GS that came equipped with VoiceOver, Rush says she has noticed a vast improvement in the technology available to visually impaired users. "Previously, I was using and being offered a lot of technology that was obscenely expensive and at best, mediocre," she says.

For people who need to read office memos or other printed materials, Freedom Scientific sells a scanning and reading appliance for $1,800. Alternatively, there’s a free app called SayText that uses the camera from the iPhone 4 to take a photo of a document, prompting the app to read the text aloud. The same app can be used to take photos of business cards, after which the contact info is automatically scanned and uploaded into the phone’s contact directory. Similarly, ZoomReader, an app from Ai Squared that sells for about $20, reads the text in images from the iPhone 4 camera.

Identifying money can be a challenge for visually impaired or blind people because a $1 bill comes in the same size and color as a $100 bill. Reizen sells a portable money reader on Amazon.com for $99.95. In March the LookTel Money Reader app was released for the iPhone, selling for just $1.99. In April the U.S. Bureau of Engraving and Printing released EyeNote, a free money reader.

Workers who find it difficult to speak because they have cerebral palsy or have suffered a stroke once needed to spend thousands of dollars on speech-generating devices. Instead of shelling out $3,000, they can now buy an iPad for $500 and an app called Proloquo2Go from AssistiveWare that sells for about $190, says SSB Bart’s Avila.

IT Departments Lag in Adapting
As prices decrease, many people with disabilities are discovering the benefits of various apps on Apple iPhones and iPads. Yet information-technology departments have been slow to allow these devices into the workplace. Donovan at WingSail Capital says one of his visually impaired clients brought her iPad to work and was told that the company didn’t support it yet. "There’s this dichotomy between what is accepted as assistive technology and what is actually working," he says.

"There’s a perception that the iPhone or iPad is going to be used for games," says SSB Bart Group’s Avila. Yet people who need these devices realize how much more independent they are with them. "The people I work with at the Veteran’s Administration are trying to push to get iPhones into the hands of blind veterans," Avila says.

Rush says that her office at the Lighthouse is PC-based. There are plenty of Windows-based apps for visually impaired people, but they tend to be relatively expensive. Rush says she couldn’t do her job without ZoomText screen magnifier and reader, which costs up to $995. JAWS, another popular screen reader, costs $1,075 for a single professional license.

The iPad isn’t going to suit everyone, Avila says. He finds it a good way to take notes in meetings; previously he would have needed to buy an expensive device. The iPad also lets him easily read e-mail messages and zoom in on items he needs to see more clearly. The best part might be that he’s using "the normal app that everyone else is using," he says. He’s not using a special browser and he can use AOL Instant Messenger, just like anyone else. "That," says Avila, "is a huge difference."

King is a writer for Bloomberg Businessweek in San Francisco.

Photos at AGM

2011-08-21T15:55:00.002+08:00

The speaker for our Double Bill on 27th Aug, Dr Au Eong Kah Guan, is writing a book on AMD. He would like to take photos of our members at the MDS annual general meeting this coming Saturday for his book and has engaged a photographer for this purpose. So, come in your BEST for your photo-taking! See you!

MDS Mid-year Double Bill

2011-07-18T16:47:00.006+08:00

By Sharon Siddique
MDS President

Dear MDS members,

We will be having a mid-year double bill in August. The afternoon’s programme will begin with a talk and question and answer session by our MDS advisor, Dr Au Eong Kah Guan. This will be followed by our AGM, which will include a review of MDS activities since our previous AGM, held on 10 July 2010. Members are encouraged to attend to share your views on past activities and suggestions for MDS activities in 2011/2012.

Talk: “Latest Trends in the Management of Macular Degeneration”

Speaker: Dr Au Eong Kah Guan

Date: Saturday 27 August 2011

Time: 2pm – 2.45pm

Venue: Seminar Room, Alexandra Hospital, Alexandra Road

Tea Break: 2.45pm – 3.15pm

=====================

Agenda of the 4th AGM of MDS

Welcome by MDS President, Sharon Siddique

Annual Report 2010/2011

Financial Report 2010/2011

Overview of MDS online: website, blog and Facebook

Discussion of future activities 2011/2012

Please indicate your attendance by either telephoning Anne (62387387), or sending an email to alleyes@singnet.com.sg.

We hope to see you on the 27th of August!

Bionic spectacles on the way

2011-07-11T14:11:00.001+08:00

The Daily Mail

July 5, 2011

By Fiona Macrae

Bionic spectacles could soon be on sale to help hundreds of thousands of blind people ‘see’. Oxford University researchers are developing ‘smart spectacles’ that use tiny cameras and a pocket computer to alert wearers to objects and people ahead.

They will make it easier for the blind to navigate shopping centres and busy train stations, and could even allow them to ‘read’ bus numbers and the computerised displays on cash machines. The lightweight, inexpensive glasses, which could be ready for general sale as early as 2014 if tests are successful, would be suitable for most of the 300,000 Britons who are registered blind.

Elderly people with age-related macular degeneration are likely to be the biggest beneficiaries. Previous attempts to create such a device have resulted in large dark glasses with clunky cameras and bulky computers. But advances in technology mean it should be possible to create bionic spectacles that look almost indistinguishable from standard glasses.

Importantly, a price tag of less than £1,000 should make them affordable, the Royal Society’s Summer Science Exhibition heard. Dr Stephen Hicks, a clinical neuroscience researcher who is being funded by the Department of Health, said: ‘It is satisfying to think that we will be able to produce this at a cost that is going make it available to the people who will benefit the most.’

Dr Hicks has completed the basic research and is now working on prototype spectacles.

He envisages transparent glasses with lenses studded with small light-emitting diodes and cameras the size of a pinhead at the outside top corners of the frame. The cameras will take in the information the eyes should see and send it down a cable to a mobile phone-sized computer in the wearer’s pocket. The computer will process the information and simplify it into a pattern of dots. The LEDs in the lenses then light up in that pattern, giving the wearer vital information about what lies ahead.

A flickering light could mean there is a person ahead, while a solid block might signify an object such as a flight of stairs. While such information may seem unimpressive to the sighted, it could allow those who have lost much of their vision to regain sufficient independence to go shopping alone or take public transport.

Adding in an earpiece could allow more complex information to be transmitted. For instance, the cameras could capture bus numbers or information on railway departure boards to be analysed by the computer. Once processed, the information would be passed on to the wearer via a voice in their ear.

In time, the same principle could be used to help blind people to ‘see’ the screens on cash machines outside banks or ticket dispensers at train stations. The bionic spectacles rely on the wearer being able to perceive light, so will not be suitable for those who are totally blind. But most of those registered blind, including many sufferers of age-related macular degeneration, still have some vision.

Dr Hicks plans to do small-scale laboratory tests on the blind this year, before enrolling 120 people in a two-year trial that will explore the use of the spectacles in shopping centres and at home.

US advisers back Eylea

2011-07-01T18:06:00.000+08:00

June 17, 2011

By Anna Yukhananov

COLLEGE PARK, Maryland (Reuters) - A new eye medicine from Regeneron Pharmaceuticals Inc and Bayer AG is safe and effective for treating a common cause of vision loss, a panel of U.S. experts said on Friday. The Food and Drug Administration advisory panel voted unanimously to recommend Eylea as a treatment for the most serious form of macular degeneration that affects at least 1.5 million Americans.

The advisers also said the injected drug could be given once every two months, giving it an edge over the typical monthly dosing of its chief competitor, Lucentis, from Roche Holding AG.

"The data is very compelling for equivalence (with Lucentis)," said Dr. Lynn Gordon, a panel member and associate professor at the University of California in Los Angeles.

The FDA usually follows the advice of its advisory panels and is expected to rule on Eylea by August 20. Regeneron shares, halted much of Friday pending the advisory panel decision, lost 4.8 percent on Nasdaq to close at $54.02. Jason Kantor of RBC Capital Markets said Regeneron's share price had reflected an expected favorable opinion, so the decline was likely a case of "selling on the news."

Kantor predicted the drug would fare well, but said the main reason to own Regeneron is its array of antibodies being developed for other diseases in partnership with French drugmaker Sanofi SA. Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, with the wet form the most serious. Some 11 million Americans have signs of AMD. Piper Jaffray analyst Edward Tenthoff sees Regeneron taking 25 percent of the U.S. market by 2016, with annual sales of $1.2 billion.

CHEAPER CANCER DRUG

Eylea and Lucentis could face competition from Roche's cancer drug Avastin, a much less expensive medicine that is often used by doctors to treat macular degeneration even though it has not been approved by the FDA for that purpose. The amount of Avastin needed for an eye injection costs only around $50, against a U.S. price of $1,950 for Lucentis and probably a similar price for Eylea. All three drugs work in a similar way. An April study showed Avastin was as effective as Lucentis, though it had more side effects.

Eylea's advantage over both rivals may be its two-month dosing. In clinical trials, Regeneron showed that Eylea injected into the eye every two months was as effective as monthly doses of Lucentis. The committee said monthly monitoring of patients receiving Eylea was not necessary.

"I think many of my patients are looking for something they can take less often, and that's the exciting possibility of Eylea," said Dr. Jeffrey Heier, a clinical instructor of ophthalmology at Harvard Medical School who spoke on behalf of Regeneron.

Regeneron has full marketing rights to the drug in the United States and would share overseas profits equally with Germany's Bayer if Eylea wins regulatory approval in other countries. "It's a particularly proud day for us because few companies can go from the discovery of the molecule and take it to this point," said Regeneron Chief Executive Officer Leonard Schleifer.

"We started out as good scientists and hopefully we can become good manufacturers too."

MDS Mid-Year Double Bill

2011-06-26T16:05:00.002+08:00

MDS will be having a mid-year double bill in August, holding a talk as well as our Annual General Meeting (AGM).

Our advisor Dr Au Eong Kah Guan will share with members on the "Latest Trends in Management of Macular Degeneration" and take questions after his presentation.

What new therapies are available to treat macular degeneration? Are these new therapies effective? Are they safe? What is the current clinical practice in the management of macular degeneration? Come learn about these and other issues on the latest in the management of macular degeneration.

Date: Aug 27, 2011 (Sat)

Time: 2 - 4pm

Venue: Seminar Room, Alexandra Hospital

We will hold our AGM after the talk, at 3pm. So be there! Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now! This event is free for all MDS members.

Eylea - new drug for MD

2011-06-17T17:09:00.001+08:00

Jun 15, 2011

By Anna Yukhananov

WASHINGTON (Reuters) - A proposed eye medicine from Regeneron Pharmaceuticals and Bayer AG was found by U.S. drug reviewers to be an effective way of treating vision loss from macular degeneration, raising expectations it will be recommended for approval.

The drug, which be marketed under the trade name Eylea, is as effective as the similar Lucentis treatment from Roche Holding, Food and Drug Administration staff said in documents released on Wednesday. But Lucentis has monthly dosing, while Eylea would only have to be taken once every two months, making it more convenient for patients. Analysts forecast Regeneron could reap at least $1 billion in annual Eylea sales.

Both drugs may face competition from Roche's cancer drug Avastin, a much less expensive medicine that is often used by doctors to treat macular degeneration even though it has not been approved by the FDA for that purpose.

Analysts said the FDA did not raise any major issues with Eylea and expect an advisory panel to recommend approval on Friday. Shares of Regeneron closed up 5.1 percent to $57.82 on the Nasdaq, after earlier reaching a high of $61.05.

"This removes both risk and uncertainty," said Edward Tenthoff, senior research analyst at Piper Jaffray. "The FDA documents were very benign, which increases the likelihood of approval.

The drug, known as VEGF Trap-Eye, uses a mechanism similar to the one employed by Lucentis to preserve vision in patients with the wet form of age-related macular degeneration (AMD) -- the leading cause of blindness in the elderly.

Some 13 million Americans have signs of AMD and more than 1 million Americans have the wet form, the most severe type. Both drugs block vascular endothelial growth factor (VEGF), a protein involved in the creation of blood vessels. The condition progressively worsens as blood vessels leak fluid and blood under the retina, creating scar tissue.

In clinical trials, VEGF Trap-Eye injected every two months was as safe and effective in maintaining vision as Lucentis injections given monthly. The FDA will ask the advisory panel to review appropriate dosing and labeling at its meeting.

The FDA also asked the panel to look at higher intraocular pressure after frequent injections of VEGF inhibitors. This is a low-frequency side effect seen in all similar medications, including Lucentis.

Analysts said Eylea's less-frequent dosing should give it a boost over Lucentis and take market share from the rival in the United States and worldwide.

Roche shares closed down 1.6 percent on the Swiss stock exchange. Piper Jaffray's Tenthoff sees Regeneron taking 25 percent of the U.S. market by 2016, with sales of $1.2 billion.

Roche's Avastin is not licensed for use in the eye, but it works in a way similar to Lucentis, and the tiny amount needed for an eye injection costs only around $50, against a U.S. price of $1,950 for Lucentis and probably a similar price for Eylea.

Many doctors, particularly in the United States, already use Avastin "off label" to treat wet age-related macular degeneration. And analysts said more may start to prescribe it after an April study showed Avastin was as effective as Lucentis, though it had more side effects.

"The feedback we've gotten from clinicians is that many of the listed side effects were not plausibly related to Avastin's mechanism of action. So they were largely viewed as noise," said Stifel Nicolaus analyst Maged Shenouda.

"We expect Avastin to grow dramatically based on these (study) results, and for Lucentis to feel significant pressure."

What to say to someone who's sick

2011-06-17T16:57:00.000+08:00

Six Things You Should Never Say to a Friend (or Relative or Colleague) Who’s Sick. And Four Things You Can Always Say.

Read this lovely New York Times article for some great tips on what to say to someone who's sick. Click here.

The right lenses and frames

2011-05-30T22:20:00.022+08:00

By Kym Ong

MDS Treasurer

Great weather, a delicious orange chiffon cake, a great speaker and a very engaging audience …. This sums up our talk on refractive errors, UV protection and glasses.

When I was younger, my world of eyesight revolved around myopia and astigmatism. When my parents aged, I learnt of Hyperopia (long-sightedness). Even then, these were terms I never understood in depth. From last Saturday’s session, my vocabulary increased by another word Presbyopia and Fifianna also went through a thorough and clear explanation of what all these meant.

In short (very short), by definition:

Myopia

Short-sightedness which occurs through i) Axial Myiopia (the length of the eyeball is longer than “normal”) OR ii) Refractive Myopia (refractive power of the eye is higher than “normal”)
Light rays entering the eye are focused in front of the retina.
Myopia increases risks of retinal detachment, cataract, glaucoma and age-related or myopic macular degeneration.

Hyperopia

Long-sightedness which occurs because the length of the eyeball is shorter than normal and the refractive power of the eye is lower than “normal”.
Light rays entering the eye are focused behind the retina.
Hyperopia can cause eye strain, headaches and intermittent blur vision.

Astigmatism

Occurs due to an irregular curvature of the surface of the cornea.
Usually occurs with myopia or hyperopia.
Light rays entering the eye are focused on 2 points, rather than 1.

Presbyopia (Old-Sightedness)

Occurs when the crystalline lens loses its flexibility
Usually begins around the age of 40
May occur in addition to other refractive errors such as myopia, hyperopia or astigmatism
Visual disturbance due to presbyopia
Blurry near vision when reading, sewing, computer work or other near tasks

Prescriptive Glasses - Choosing the right type

Lens Selection

There is a wide variety to choose from for lenses. There are single vision lens, bifocal lens and progressive addition lens. There are also different types of lens materials like glass (with different features like multicoating, UV coating, hard coating etc), plastic and polycarbonate. Again, comfort is key.

Frame Selection

There is a wide variety of metals, plastics and other types of frame (wood/bone/buffalo hone etc) available in the shops. Comfort is key. Frame shapes and colours can help bring out your features. Here’s a tip from Fifianna with regards to frame shapes.

Ultraviolet Light Protection
As most of us are aware, we need to protect our eyes from UV-A and UV-B. Especially in Singapore where the rays are strong because we sit on the equator. Like applying sunblock when we go to the beach, we need constant protection for our eyes. If you are not convinced, here’s a list of eye problems that could arise and hopefully, this will prod you into better eye habits.

Photokeratitis - damage to the outer layers of the cornea due to exposure to intense light
Pterygium - triangular thickening of the conjunctiva that may grow onto the cornea and interfere with vision
Pinguecula - benign yellowish thickening of the normal conjunctival tissue
Cataract - loss of transparency of crystalline lens
Age-related macular degeneration (AMD) - research suggests that UV-A rays may play a role in degeneration of macula
Climatic Droplet Keratopathy - accummulation of translucent materials in the superficial corneal stroma

Medicine's wild east

2011-05-18T18:20:00.000+08:00

South China Morning Post

It's a stem-cell therapy untested and unproven for many 'incurable diseases, but in the mainland's little-regulated system, hospitals are cashing in on the last-chance hopes of the desperate and the dying

By Fiona Tam in Qingdao
Updated on May 17, 2011

The Singaporean doctor has ALS, the incurable degenerative disease of the nervous system. He tried the drug with the best chance of slowing the weakening of his muscles, the compromising of his respiratory system, the steady onset of death. But he is allergic. He figured he had only one hope left.

Dr Poon Lee Kwee, 61, joined the droves of foreigners now flocking to mainland hospitals for stem-cell treatments — therapies that are untested and unproven, but in the mainland's little-regulated climate, are offered far more freely than in the US and other Western countries.

Seven months after being diagnosed with amyotrophic lateral sclerosis (ALS), the general practitioner paid the equivalent of HK$155,420 for a month-long therapy in Guangzhou in March. Poon received six injections of mesenchymal stem cells (MSCs), a kind of adult stem cell from umbilical-cord blood at Guangdong Provincial Hospital of Traditional Chinese Medicine.

The treatment has undergone no clinical trials, yet the hospital's website claims that a wide range of conditions considered incurable by other means are now treatable with its revolutionary stem-cell therapy — from the fatal ALS, cerebral palsy, autism, Parkinson's disease, spinal-cord injuries, and optic-nerve disorder to foot ulcers caused by diabetes.

But there is no convincing evidence published in any reputable journal to support MSCs as a treatment for diseases like these, said Marius Wernig of Stanford University in California.

For the hospital's claims to come true "would be a miracle", Wernig, principal investigator at Stanford's Institute of Stem Cell Biology and Regenerative Medicine, said.

Unlike embryonic stem cells — which in theory give rise to all the body's stem-cell types — tissue-specific stem cells such as MSCs are limited in their potential and largely make the cell types found in the tissue from which they are derived, according to the US-based International Society for Stem Cell Research. Therefore, it's impossible for a single adult somatic stem-cell type to treat multiple unrelated diseases such as diabetes and Parkinson's disease.

Stanford Stem Cell & Regenerative Medicine Institute director Irving Weissman , told reporters last year that stem cells from umbilical cords did have a very limited capacity to make scar, bone and fat. "But they don't make brain, they don't make blood, they don't make heart, they don't make skeletal muscle, despite what various people claim," he said.

The injections' maker, Shenzhen-based Beike Bio-Technology says the treatments are offered by more than 50 mainland hospitals. Chairman Hu Xiang said its stem cells, mainly extracted from umbilical cord blood, had been injected into more than 10,000 foreign patients from 70 countries. He said only 2.8 per cent of patients had slight side effects such as fever or headache. Hu refused, however, to disclose a success rate.

Hua Qing, Beike's coordinator in the Guangdong hospital, concedes the injection can't actually cure serious diseases, but can "improve" patients' conditions to some degree.

That claim isn't based on medical data, but on patients' testimonials — something that the International Society for Stem Cell Research (ISSCR) warns others to be wary of.

A month after getting the treatments, Poon said he felt no substantial improvement or difference. He said he would wait three months before deciding if it had helped.

Foreigners flock to mainland

Despite the lack of a credible track record, the lure of a long-shot cure is drawing anxious Western patients to mainland hospitals for treatments costing up to HK$233,000 a month.

The stem-cell surgery of the little-known Qingdao Chengyang People's Hospital is so popular an entire floor at the top of its complex has been remade into luxurious suites for foreign patients, who fly tens of thousands of kilometres for the treatment. The hospital even hired two full-time translators and a private driver to cater to those who can't speak Chinese.

Lori Hansard, of Houston, Texas, brought her 14-year-old son with cerebral palsy to Qingdao last month after receiving two stem-cell treatments in Mexico in 2009 and 2010. His body became softer and more elastic, and he was able to sleep and eat better, after those treatments, she said. She was hoping for even better results on the mainland, as other parents had told her that the country had leapt ahead in stem-cell therapies.

"China has a big reputation in stem-cell treatment and is the place to be because you can actually see the improvement," she said. "It takes a decade for the FDA [US Food and Drug Administration] to approve something and the Americans can't wait."

With stem cells directly implanted into the boy's brain, Hansard hopes the boy will finally learn how to make normal movements and reactions.

What Hansard and Poon didn't know is that manufacturing one MSC injection can cost as little as 300 yuan (HK$359). And these cells could never cure Poon's disease.

In theory, only neural stem cells from the brain that can give rise to nerve cells and two categories of non-neuronal cells are the right type of stem cells to treat Poon's ALS. But most mainland stem-cell therapy centres provide only MSCs, which are easy and cheap to produce.

Even if Poon had been given the right cells, there are still many barriers to the development of successful stem-cell therapies. Among them: getting the cells to behave in the desired way. "To treat many neurological conditions the cells we implant will need to grow into specific types of neurons, and to work they will also have to know which other neurons to make connections with and how to make these connections," the ISSCR said. "We are still learning about how to direct stem cells to become the right cell type, to grow only as much as we need them to."

Although it is now possible to reprogram adult somatic cells to act like embryonic stem cells (induced pluripotent stem cells, iPSCs), the mainland's stem-cell therapy centres aren't capable of doing it.

A family in mourning

The Singaporean doctor is lucky he didn't feel severe side effects after the six injections.

A 30-year-old man from Jinhua city in Zhejiang who tried to cure his cerebral infarction with stem cells died four days after receiving two injections from the No. 455 Hospital of PLA in Shanghai in July. The victim's elder brother, Hong Chun, said he had seen the injections' packing at the hospital.

"It was made in Shenzhen and the hospital told me that they purchased each injection for 300 yuan from the manufacturer," he said, adding that he had received anonymous calls from Guangdong threatening him not to expose the malpractice.

Yu Shuangfeng, 68, is among 21 mainland patients who have sued the military hospital for fraud. Yu said she nearly died of strong side effects, including fever, after paying 70,000 yuan for two injections last year. Her diabetes has never been cured. Instead, it worsened.

Han Zhongchao, director of National Research Centre for Stem Cell Engineering and Technology, said the mainland's military hospitals, which weren't under the administration of the Health Ministry, were the first to offer stem cell treatments. Many small hospitals eyed the lucrative business and launched their stem-cell centres after that.

"But all of these stem cell therapies are still at the research stage, and none of them has been approved by domestic health watchdog as effective treatment," Chinese Academy of Science academician Wu Zuze was quoted by Century Weekly magazine.

The therapies may be unproved. But some doctors are using them with abandon. In Beijing's military hospitals, cells cultivated from aborted fetuses are being injected directly into patients' brains and spines. Similar fetal-cell treatments are given at the Naval General Hospital of PLA, the General Hospital of Chinese People's Armed Police Forces, Peking University Health Science Centre and many other public hospitals.

In two articles in the Second Military Medical University's journal, Tian Zengmin, the naval hospital's neurologist, detailed how they cultivated fetal brain cells taken from five- to 11-week-old fetuses to treat Parkinson's disease and cerebellum atrophy. The central government funds Tian's research.

A Shanghai father who paid 18,000 yuan for a treatment for his son with cerebral palsy said he believed all hospital-provided cells were taken from induced abortion. "Otherwise you never know whether the cells from spontaneous abortion are good enough to repair injuries," he said. Wernig said it made much more sense medically to use fetal brain tissue than MSCs to repair neural injuries, because the fetal brain actually contains neural stem cells. He said there were some clinical trials using fetal brain tissue, in particular in patients with Parkinson's disease.

"[But] the success rate was very limited and led to uncontrollable severe side effects," he said. "Scientists are trying to find out why the transplants did not lead to the desired effect. Once there is a better understanding of the process such a transplant could become possible.''

Professor Ronald Li, director of Hong Kong University's Stem Cell and Regenerative Medicine Consortium, said that although stem-cell therapy could fundamentally change medicine, almost all treatments being developed were still in the experimental stage or clinical trials, except bone-marrow transplants.

"Many hospitals and centres have obviously overstated their stem cell treatments, with very bold claims," Li said. "Too much hype is going to jeopardise a paradigm-shifting field. Although progress is being made at amazing speeds, we need to distinguish facts from hype. The field needs time and space to grow and mature, before stem cells can be turned into clinical and other applications - it will happen, but not right away."

Avastin as effective as Lucentis?

2011-05-12T15:21:00.000+08:00

WASHINGTON - The anti-cancer drug Avastin is as effective in fighting macular degeneration as Lucentis, which, however is 40 times more expensive than the cancer fighting medicine, according to results of clinical trials published in the United States.

The study compares Avastin (bevacizumab) to Lucentis (ranibizumab), which both have been developed by US firm Genentech, owned by Swiss laboratory Roche.

During the trials, scientists randomly assigned 1,208 patients with neovascular macular degeneration - a condition that leads to the gradual loss of central vision - to receive injections in the eye of ranibizumab or bevacizumab on either a monthly schedule or as needed with monthly evaluation.

"At one year, bevacizumab and ranibizumab had equivalent effects on visual acuity when administered according to the same schedule," reported the authors of the study, including Doctor Juan Grunwald from the University of Pennsylvania.

"Ranibizumab given as needed with monthly evaluation had effects on vision that were equivalent to those of ranibizumab administered monthly."

However, the costs of the treatments were vastly different. The average cost in the ranibizumab group per patient was $23,400 compared to $385 per patient in the bevacizumab group, the researchers said.

The study appears in the latest issue of The New England Journal of Medicine.

MDS Talk: What Glasses to Wear

2011-05-06T20:44:00.001+08:00

Topic: What Glasses Should You be Wearing? Understanding Refractive Errors and Ultraviolet Light Protection

Date: May 21, 2011 (Sat)

Time: 2pm to 4pm
Venue: Seminar Room, Alexandra Hospital

Refractive errors such as myopia, astigmatism, hyperopia and presbyopia are the most common causes of blurring of vision in individuals in all age groups. It is not uncommon for these conditions to be confused with one another. In addition, the awareness of the harmful effects of ultraviolet light on the eye is low among the general population.

What type of glasses do you need? Come learn about the different types of refractive errors and the harmful effects of ultraviolet light on the eye and see what options are available for their management.

Our speaker is Ms Fifiana, DipOptom(Merit) (S’pore). She is an optometrist with the Singapore International Eye Cataract Retina Centre at Mount Elizabeth Medical Centre.

Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now! This event is free for all MDS members.

Pot-bellied men prone to AMD

2011-04-05T21:32:00.003+08:00

Age-related macular degeneration (AMD) is now the most common cause of acquired blindness. An important study conducted by researchers at the University of Melbourne indicate that like heart disease, AMD may be affected by where you carry your weight.

The researchers followed 21,000 men and women between 40 and 69 years of age for several years. tracking how many of them developed AMD. They reported last year that the kinds of food, such as red meat and fatty foods, have a direct relationship to the development of AMD later in life. The latest report reveals that even small increases in a man's waist size can raise the risk of AMD by as much as 75 percent.

Why the difference between men and women? The researchers believe it is because abdominal fat increases the hormone oestrogen into the body. Because women's bodies are accustomed to high levels of the hormone most of their lives, they are not as sensitive to it as men, for whom the oestragen causes inflammation of the blood vessels, all the way to the back of the eyes.

There is evidence that chronic inflammation is involved in AMD and obesity is a pro-inflammatory state," said the scientists. "Our study underlines the importance of abdominal obesity as a risk factor for AMD.

Research by a British team recently suggested that eating more fruits, vegetables, and nuts could reduce AMD risk by as much as 20 percent.

Self-help Guide

2011-04-01T16:08:00.000+08:00

Yes, 99 per cent of common daily activities can be accomplished without the sense of sight. This is good news for for everyone in the low vision community, and it has led to development of "A Self-Help Guide to Non-Visual Skills" available at no cost from Macular Degeneration Support.

Click here to read the guide.

Reading around your blind spot

2011-03-23T18:09:00.000+08:00

By Sharon Siddique

MDS President

Some 25 hardy MDS members braved last Saturday afternoon’s downpour to venture out to the Alexandra Hospital Seminar Room for a talk on Eccentric Viewing by optometrist Mr Yap Tiong Peng, of the IGARD group. And it was certainly worth getting wet for!

Tiong Peng explained that eccentric viewing (reading around your blind spot) cannot “improve” your eyesight. But for MD sufferers (our membership), learning the technique means that you can read at a faster rate, in smaller font, and with greater accuracy. Not to mention more efficient mastery of other difficult tasks, like driving, reading bus numbers, cooking and so on.

He offered us lots of tips on how to identify your blind spot and how to see around it through the “steady eye strategy”. To paraphrase his message. If you were given a tennis racket and a ball, you would not assume that you could immediately play tennis. Similarly, if “given” the eccentric viewing technique, practice is necessary to “see better”.

Unfortunately there is no place in Singapore that offers MD sufferers an opportunity to learn and practice this technique. Several members were keen on exploring the possibility of meeting up with Tiong Peng at a future date to explore the possibility of providing such training for MDS members.

I think most of us who attended are convinced that this could certainly be a useful exercise. Tiong Peng has offered to provide slides of this presentation to MDS members via our website so those who did not attend can get a better idea of what his presentation was all about. So please do let us know if you are interested in participating.

Low-Vision Conference in KL

2011-03-04T15:08:00.002+08:00

Feb 24, 2011

By Sharon Siddique

MDS President

in Kuala Lumpur

As I found on arrival at the 10th International Conference on Low-Vision, this is a biannual conference attended primarily by optometrists specializing in low vision – and there are hundreds of them. The primary organizer is the ISLRR (International Society for Low-Vision Research and Rehabilitation). Country hosts were the Malaysian Association for the Blind and The Tun Hussein Onn National Hospital. The theme this year is Vision Rehabilitation – Towards Better Living.

It was really a packed programme! Each day was full of concurrent plenary sessions, workshops, and symposiums. Not to mention a hall full of exhibitors, and over 80 poster displays over five days. Hard to take it all in! And very frustrating that I was often left to choose between two or three presentations that were running simultaneously.

I’ll try to give you a flavour of what I found most useful from the perspective of a patient with macular degeneration.

• Wow! So many countries have very well-developed national programmes to support low-vision training, rehabilitation, and research. These run in hospitals, universities, and health research institutes. There were practitioners from Netherlands, Canada, Germany, Australia, UK, India, USA, Spain, Japan, Malaysia, Nigeria, Indonesia, Philippines, Hong Kong, Pakistan, Sweden, Ghana, Sudan, France, Vietnam, Korea, Taiwan, Belgium, Switzerland, Saudi Arabia, China, Italy…. I’m sure I have left out some countries, but you get the idea!

• Similarly, the topics of research represented so many areas of interest to us requiring low-vision training, counseling, and equipment. Some topics which I found most informative were:

o Depression & Vision Impairment
o Accessing Low Vision Rehabilitation
o Efficiency of Low-Vision Devices
o Quality of Life & Functional Vision
o Paediatric Vision Rehabilitation
o Impact of Loss of Central Vision
o Training & Rehabilitation Models
o   MD & Coping with Vision Loss
o Vision Field Assessments
o   Enhancement of Reading Performance
o Vision & the Brain
o Use of Distance & Near Vision Aids
o   Vision Impairment & Daily Living
o The Mind and Vision

There were dozens of presentations under all these topics and more. If you want to keep track of what optometrists are thinking and doing, I would suggest you watch this space: ISLRR. The next conference will be in Melbourne in 2014. Some of you might like to plan on attending.

Yoga promotion for MDS members

2011-03-04T14:36:00.004+08:00

Dear MDS members,

The kind people at All About Yoga recently held a free session for us at their studio. They are now offering a special package of yoga lessons. Please see details in this letter from All About Yoga below.

Special Package for MDS Members

10 sessions @ $80 Nett. (U.P. $200)

Bookings must be made in advance.
Can attend different classes.
Expiry period of 2 months.
Recommended class participation of at least twice per week.
Payment by Cash only.

We hope more people will be exposed to yoga and experience the benefits that yoga can bring to their health. We are open to discussions. Do feel free to contact us if you require more information. We hope to hear from you soon. Thank you.

Warmest Regards:
Sharmaine Lee
Sales Associate
All About Yoga Pte Ltd
Website: www.allaboutyoga.com.sg
Contact Number: 6501-9380

Use of Eccentric Viewing strategy

2011-02-23T17:58:00.003+08:00

MDS Talk
Date: 19 March 2011 (Saturday)
Time: 2pm – 4pm
Venue: Seminar Room, Alexandra Hospital

People suffering from Macular Degeneration typically find difficulties in recognising faces, driving, reading, watching television or even seeing in colour. This is because the central part of the retina (“the macular”) has been affected by the disease.

Whilst medical treatment stabilises the condition, the visual outcome usually remains to be challenging for patients to cope with during their activities in daily living. Often, this means that one will have to find new ways of doing things and Eccentric Viewing is a strategy that is commonly prescribed during low vision rehabilitation. This will require one to learn a new technique in seeing and particularly whilst using magnifiers.

In short, Eccentric Viewing strategy involves training a non-affected part of the retina (“the para-foveal region”) to be used whilst reading and the method of training using this strategy will be discussed by Mr Yap Tiong Peng. He will also be conducting a demonstration with MDS President Dr Sharon Siddique who had found this technique helpful.

About the speaker
Yap Tiong-Peng is an optometrist at IGARD Group. He obtained his full registration since 1998. His special interest is in Paediatric Optometry, Low Vision, Contact Lenses, Sports Physio Eye Development, Intuitive Colorimetry and Vision Therapy. He conducts Low Vision assessments routinely and he is also an active prescriber of Bioptic telescopes.

Tiong-Peng received his optometry training in Manchester, where he graduated with a UMIST Honours degree. He also completed a Master degree in Engineering and Physical Sciences in Medicine from Imperial College in London. Tiong-Peng is also a sessional part-time lecturer and clinical supervisor. His most recent teaching assignment was to deliver a full course in Advanced Visual Neurophysiology for Singapore Polytechnic - University of Manchester Bachelor of Science degree programme in Optometry. He was formerly a research fellow in Ophthalmology and Visual Science at Alexandra Hospital.

Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now! This event is free for all MDS members.

Blindness cause clue discovered

2011-02-10T13:18:00.002+08:00

By Jame Gallagher

Health Reporter

BBC News

An international team of researchers has found a clue to one of the leading causes of blindness, which they hope could eventually lead to a cure. Age-related macular degeneration affects 500,000 people in the UK and is incurable.

The study in the journal Nature found an enzyme known as DICER1 that stops functioning, resulting in the illness. UK experts said it had the potential to be an important breakthrough.

The macula is a part of the eye which sits in the centre of the retina and is responsible for the fine detail at the centre of the field of vision. As the disease progresses that central vision declines, making reading, driving and recognising people difficult. It affects one in 50 people over 50 and one in five people over 85. The exact cause is unknown, but risk factors include smoking, high blood pressure and having relatives with the condition.

The researchers noticed the enzyme DICER1 was less active in the retina of people with the more common "dry form" of the illness and when they turned off the gene which makes the enzyme in mice, then the animal's retina cells were damaged. It was then discovered that DICER1 is necessary for destroying small pieces of genetic material called Alu RNA. Without DICER1, the Alu RNA accumulates with toxic consequences leading to the death of the retina.

Professor Jayakrishna Ambati, from the University of Kentucky, told the BBC: "This work opens many new doors of research. First, we need to identify various classes of molecules that can either increase DICER1 levels or block Alu RNA so that these can be evaluated in clinical trials.

"Second, we need to understand more about the biological processes that lead to reduction in DICER1 levels and the precise source of the Alu RNA transcripts."

Professor Ian Grierson, school of clinical sciences at the University of Liverpool, said: "This is a great piece of science which provides another jigsaw piece which we need to put together with other findings. It was done in an animal model which is a long way from the patient, the breakthrough is we've got another player."

Professor Mike Cheetham, head of molecular and cellular neuroscience at UCL, said: "It's a potentially very important breakthrough which gives insight into this dry form of the disease. It could provide new pathways to therapy, but the findings need to be validated by other researchers."

Cathy Yelf, spokesperson for the Macular Disease Society (UK), said: "This is a very interesting piece of research and provides us with another valuable piece of the AMD jigsaw. It will not change a thing for patients immediately but it may lead to new treatments in the long term."

A stretch for health

2011-01-24T19:20:00.010+08:00

A warrior, a cat and a lotus. For MDS members attending our first yoga session yesterday, poses came with colourful names and quite a bit of groans and moans too. As 21 of us attempted to contort our bodies by the commands of instructor Kang Xiao Jing at All About Yoga studio, the simple act of stretching became quite a monumental task.

It looked so easy on the instructor. But for most of us, novices attempting the exercise for the first time, it was a tricky struggle on a warm Sunday morning. Some of us could not balance. Standing on one leg looked effortless for some, but comical for others. Xiao Jing told us to be the warrior. But it was tough to feel like a fighting man when one could barely stand.

Nonetheless, that was what we were looking for - to stay healthy, using yoga to strengthen our muscles through a non-strenuous sport. And our hour-long yoga session certainly gave us a good work out and relaxed our minds.

A big thank you to our lovely instructor Xiao Jing for kindly conducting the session pro bono. Her enthusiasm was infectious and she very kindly attended to the needs of our older members with great patience. Thanks also to All About Yoga for opening their studio for us on a Sunday. MDS members who are interested in taking up yoga should contact them. Click here for their website.

Special thanks also to MDS Treasurer Kym Ong for painstakingly organising this free session, coordinating the shuttle service from Paya Lebar MRT station. She called members individually to ensure all would get proper and punctual transport to the venue, and we are most grateful. Her husband also very kindly sponsored the rental of the yoga studio. Thank you!

Yoga Reminder

2011-01-18T07:26:00.016+08:00

Just a gentle reminder about the yoga date we have this coming Sunday, 23rd Jan 2011. Session starts at 9am. Wear comfortable clothes like shorts, bermudas, track pants, tights, T-shirts, fitting tops.

For those who need the shuttle service, please meet at 8.15am at the Paya Lebar MRT station's pick-up point, which is opposite the Singapore Post Centre.

Those who are going themselves, please make your way to the address below and arrive 15 minutes beforehand.

All About Yoga Studio

605B Macpherson Road

#05-11 Citimac

See Map Below (BLUE DOT)

For a more detailed map, please click here.

Expedition to Antarctica

2011-01-03T18:40:00.002+08:00

In December this year, Alan Lock – a former Royal Navy Officer and current member of the Macular Disease Society of the United Kingdom – is hoping to take on one of the toughest challenges in the world: to trek from the coast of Antarctica all the way to the South Pole.

Alan, 30, is organising the expedition with US and British teammates, including a former successful Antarctic explorer and a decorated US Army Veteran. They will cover a distance of nearly 600 miles, expending over 7000 calories per day and taking on one of the harshest environments on the planet.

If Alan is successful in this attempt he will set a new Guinness world Record for this feat. The ‘Polar Vision’ team will be undertaking this challenge in order to raise awareness and funds for two sight related charities: Guide Dogs for the Blind, and Sightsavers International. Guide Dogs for the Blind is a San Rafael, California – based non-profit that serves blind and visually impaired people in the U.S. and Canada.

Sightsavers International is focused on the developing world, seeking to prevent blindness and provide rehabilitation to some of the world’s most marginalised people. As someone with MD, Alan is also keen to use the expedition to highlight the condition and also to hopefully inspire and motivate other people in a similar situation.

“I am really excited about this project and the positive impact it can have on many people with sight problems. It is going to be a real challenge, both in Antarctica and in trying to organise the endeavour – but if it was easy there would be no challenge!”

“We are trying to reach out to companies who may wish to become corporate sponsors of the team, and if anyone can help us with contacts we would be enormously grateful.”

Click here for the website and here for the promo video. Contact Alan at alan@polar-vision.org

Yoga for eyes

2010-12-22T16:09:00.005+08:00

MDS is organising a FREE yoga session for all members. It is known that there is a deep correlation between the eyes and the mind. Our vision occupies 40 percent of the brain’s capacity.

Therefore, eye health corresponds to the level of relaxation the brain experiences. Yoga helps to do that. Yoga is also a great way to stay healthy, as it strengthens our core muscles which weaken as we grow older. It is also very suitable for MDS patients as it is non-strenuous yet gives the body a good workout.

Venue: All About Yoga Studio, 605B MacPherson Road, #05-11 Citimac

Date: 23 Jan 2011, Sunday

Time: 9 - 10AM

Transport: Shuttle services will be provided to and from Paya Lebar MRT Station. Meet at 8.15am at the MRT station's pick-up point, which is opposite the Singapore Post Centre.

Things to bring: Towel and a bottle of water

What to wear: Anything comfortable. Tights, shorts, T-shirt

Space is very limited, so please register early. Call Anne at 6238-7387, or e-mail alleyes@singnet.com.sg to reserve your places now! This event is free for all MDS members.

AMD can increase risk of stroke

2010-12-07T16:27:00.003+08:00

Dec 4, 2010

The Business Times

By Cheah Ui-Hoon

SO you think eye problems are confined to the eyes? It turns out that having age-related macular degeneration (AMD) can increase your risk of stroke. AMD is a chronic degenerative disease of the macula – the central part of the retina.

In the Atherosclerosis Risk In Communities (ARIC) Study, people with early AMD signs had double the risk of incident stroke over 10 years. This was based on a population study done in the US. The results were published in the Journal of Stroke a few years ago, but it’s a fact that’s rarely known, says Peter Kaiser, a retinal specialist and principal investigator of over 30 clinical trials on AMD and other retinal disorders.

“This is a new finding. It’s not something we thought about in the past,” says Prof Kaiser who was in Singapore for the 5th Congress of the Asia-Pacific Vitreo-Retina Society last month.

It’s a situation that makes sense however, as a lot of the risk factors for AMD are similar to cardiovascular disease, says the professor. “Factors like increased cholesterol levels and high LDL, a large waist circumference and high body mass index are factors for both AMD and stroke.”

If one just looks at the AMD population, there isn’t an increased risk of stroke in that population; only in the population-based study. But it correlates with other studies that suggest there is an increased risk of stroke in AMD patients. “And the risk is two-fold, as suggested by another study of Medicare patients in the US,” says Prof Kaiser.

Risk factors
Previously, AMD was seldom highlighted as a condition because there were few solutions for it. But the situation is different now, as there is an effective gold standard treatment for wet AMD. There are dry and wet forms of AMD, with the wet form being more dangerous because it means blood vessels are growing in the eye, which then bleed and leave scars if left untreated. This can lead to a severe loss of vision and cause blindness.

“It’s the leading cause of blindness in the West,” the professor adds. In dry AMD, there are underlying inflammatory conditions, but it doesn’t cause loss of vision. AMD affects those above 50 years old, and while one may have a genetic propensity for it, smoking increases risk. Caucasian females are also more prone to getting AMD. But all the other risk factors for cardiovascular disease apply, such as being overweight, having high cholesterol and low intake of Omega 3 fatty acids.

Blindness can be avoided, however, if risk factors are modified through diet and exercise. “It’s not a death sentence . . . as you can work on improving the odds. The majority of wet AMD patients need not go blind,” says Prof Kaiser. One in four people in Singapore above 60 years old has AMD.

The causes of AMD are not known, except for general conditions such as a poor diet and low levels of anti-oxidants. “The eye is one of the most active structures in the body as it’s constantly converting light into neural waves. And that takes a lot of energy,” the professor explains.

“If one smokes or is low on anti-oxidants, that lowers the ability to deal with the excess energy, so this causes damage to the eye itself. Because of genetics, there’s baseline inflammatory damage in the eye . . . that is exacerbated by light damage.”

In the beginning, symptoms may not be very noticeable. Only in advanced AMD does one notice distortion and reading becomes more difficult, starting from the centre of vision. By changing lifestyle, and taking dietary supplements such as anti-oxidants, one can reduce the risk of progression from the dry to the wet form of AMD. The condition can’t be reversed however, and there’s no operation that can be done at this time.

AMD is directly related to nutrition, diet and other modifiable risk factors. The treatments for it include laser and photodynamic therapy, and the new anti-VEGF therapy from Lucentis. Lucentis’s new anti-VEGF therapy can now stabilise and even improve vision in about 90 per cent of AMD patients. Some 30 to 40 per cent of patients see significant improvement, so it’s a huge step forward compared with other treatments.

Anti-VEGF (anti-vascular endothelial growth factor) treatment helps reduce vessel formation, bleeding and swelling in the eyes. Lucentis was specifically designed for injection in the eye and is generally safe and well tolerated. Eye specialists usually do three monthly injections first and post frequent monitoring to see if subsequent injections are needed.

It doesn’t hurt, Prof Kaiser assures. “Flu shots hurt more than this,” he adds. The solution blocks the growth factor responsible for the growth of the new blood vessels. The treatment has been available in the US for a while now, and in Singapore since 2008.

Lucentis’s anti-VEGF treatment is now the gold standard for wet AMD. “It prevents loss of vision, but it doesn’t reduce risk of stroke, which can’t be prevented unless the risk factors are improved upon,” says Prof Kaiser.

For the dry version of AMD, there is no proven treatment for it now, but what slows it down is supplemental vitamins, especially anti-oxidants, which can reduce the risk of progression by 30 per cent.