Clinical News
MEDICAL AND PRODUCT UPDATES

SYSTEMIC SYMPTOMS
Retinal arteries and heart disease

Research conducted by the National Heart, Lung and Blood Institute has found that narrowing of retinal blood vessels may be a warning sign of heart disease -- but only in women. The same connection wasn't found in men.

The study involved 9,648 men and women, ages 51 to 72, who had three eye exams over a period of 6 years. Serious heart trouble occurred in 84 women and 187 men during the study.

Researchers used retinal photography to determine arteriolar diameter. Women with the narrowest arteries faced nearly double the risk of developing serious heart problems, compared with women with the widest arteries. This was true whether or not they had diabetes and/or high blood pressure (which contribute to heart disease).

CLINICAL RESEARCH
Drug updates

Data from recent studies:

* Researchers at the University of Illinois Medical Center at Chicago have found that the drug Leukeran (chlorambucil), a chemotherapeutic agent known to cause cancer in some patients when used long-term, is a highly effective treatment for noninfectious uveitis when administered in high doses for a short time.

Of patients treated in this manner between 1973 and 1999; 77% experienced no recurrence of uveitis, and all patients remained cancer-free. (In contrast, as soon as treatment using drugs such as prednisone and cyclospor-ine is stopped, patients usually relapse.)

The study's author, Debra Goldstein, M.D., emphasizes that patients must be closely monitored, and only doctors familiar with immunosuppressive agents should offer this treatment.

* Arturo Perez-Arteaga, M.D., in private practice in Tlalnepantla, Mexico, recently completed a 4-year study showing that using 0.2% preserved lidocaine for anterior segment eye surgery -- instead of the nonpreserved 1% lidocaine more commonly used -- was equally effective, with fewer side-effects and at lower cost.

Dr. Perez-Arteaga monitored pain, speed of recovery, intraocular inflammation and other complications in 5,000 patients. He found no differences in corneal endothelial cell count, analgesic use, postoperative intraocular inflammation, speed of visual recovery or pain as a result of using the more dilute lidocaine formula. (Only 68 of the 5,000 patients required a second anesthetic injection.) Side-effects such as cardiac events and allergic reactions, however, disappeared.

* A study recently reported in the British Journal of Ophthalmology found that sodium hyaluronate, an ingredient in some eye drops, not only improved dry eye symptoms but also reduced ocular surface damage. The study, conducted by Giovanni Milazzo, M.D., in Lavinaio-Catania, Italy, found that treatment with hyaluronate was associated with a significant improvement in impression cytology scores compared with treatment with saline drops.

*  A 12-month study comparing travoprost (Travatan), latanoprost (Xalatan) and timolol (Timoptic) found that Travatan -- which worked effectively on all patient groups -- had a significantly greater beneficial effect on African-American patients.

This is especially significant because African-Americans are four times more likely to develop glaucoma and six times more likely to be blinded by the disease than non-African-Americans.

NUTRITION AND DISEASE
Vitamin C and cataracts

One study, reported in Ophthalmic Epidemiology, was a 3-year clinical trial involving 297 adults who had already been diagnosed with early age-related cataracts. The study found that taking antioxidant supplements containing 750 mg of vitamin C, 600 IU of vitamin E and 18 mg of beta-carotene significantly slowed cataract development.

A second study, reported in the American Journal of Clinical Nutrition, examined long-term vitamin use among 492 nondiabetic women aged 53 to 73 who participated in the Nurse's Health Study in Boston. Researchers found:

*  Among women less than 60 years old, taking at least 362 mg/day of vitamin C was associated with a 57% lower risk of developing cortical opacities.

*  Taking vitamin C supplements for at least 10 years correlated with a 60% reduction in cataract risk, compared with those not taking supplements.

Earlier studies were mixed: In 1999, the Second National Health and Nutrition Examination Survey found that individuals with higher plasma vitamin C concentration had a lower risk of cataracts. However, the National Eye Institute's Age-Related Eye Disease Study failed to show a similar correlation.