Updated Retinal Bulletin

CATT Trial
After a one year delay the CATT Trial will begin recruiting patients in January 2008. It will have two primary purposes:

• Compare the safety and efficiency of Lucentis and Avastin
• Determine whether or not as�needed dosing can produce a visual result that is as robust as what has previously been demonstrated with fixed dosing

The study chairman is David F. Martin, M. D., at Emory University.

High Dose Avastin More Effective than Low Dose
Avastin dose of 2.5 mg is associated with greater visual acuity and fewer follow-up injections than the 1.25 mg dose of Avastin.

Reported at the Retina Society meeting by P. Yoganathan, M. D. from the University of Toronto.

Promising Results with Lutein and Zeaxanthin
Dietary intake of Lutein/Zeaxanthin is independently associated with decreased likelihood of neovascular AMD, geographic atrophy and large or extensive intermediate drusen in AREDS report No. 22.

If these cross-sectional results can be confirmed in prospective samples and experimental studies Lutein and Zeaxanthin may be considered an useful agent in food or supplement-based interventions designed to reduce the risk of AMD.

TruSopt
TruSopt (dorzolamide) reduces cystoid macular edema in patients with Retinitis Pigmentosa. Gerald Fishman, M.D., University of Illinois at Chicago, demonstrated that all patients in his study showed a significant reduction in swelling in at least one eye after using TruSopt three times a day for one to two months. Results of the study were published in the January 10, 2007, issue of the British Journal of Ophthalmology.

POT-4
POT-4 is a derivative of Compstatin, a peptide that inhibits complement activation. Complement activation plays a significant role in the cause of AMD. POT-4 is initially being developed for treatment of AMD. Potentia Pharmaceuticals, Inc. is beginning Phase I clinical trials in Tucson and Miami.

Nutrition for the Well-Being of the Eye
Omega 3 fatty acids have been shown to increase the general sense of well-being and promote high health. They are present in fish and are highest in mackerel, white fish, tuna, and salmon.

Zinc has a specific role in the normal functioning of photoreceptors in the eye. Zinc is found in high protein foods such as beef, pork, and whole grain cereals.

Recently, it has been suggested that the carotenoids, Lutein (pronounced loo-teen) and Zeaxanthin (pronounced zee-uh-zan-thin) play an important role in eye health.

In the Eye Disease Case Control Study, medical researchers found that individuals experienced a significantly lower risk for developing age related macular degeneration when they had high amounts of Lutein and Zeaxanthin in their blood.

Sources of Lutein include yellow peppers, mango, blueberries, and green leafy vegetables such as kale, spinach, chard, and broccoli. Sources of Zeaxanthin include orange sweet peppers, broccoli, corn, lettuce, spinach, tangerines, oranges, and eggs.

"Implantable Telescope Not Recommended for Approval, But There is Reason for Optimism"
by Conni Bergmann Koury, Editor-In-Chief, Macula

Us Food and Drug Administration (FDA) advisory panel found the Implantable Miniature Telescope (IMT) "not approvable" in July by a 10-to-3 vote. The FDA Ophthalmic Devices Advisory Panel is an outside panel of experts that is called on to recommend if a device should be approved. Historically, the FDA usually follows the advice of the panel, although it is not required to do so. Ultimately, continuing dialogue with FDA will be necessary to get the investigational telescope prosthesis to an "approvable" form.

Manufactured by Visioncare Ophthalmic Technologies (Saratoga, Calif), the IMT was developed by Isaac Lipshitz, MD. IT is designed for patients with bilateral visual impairment due to age-related macular degeneration (AMD), according to Visioncare. The device is designed to improve visual acuity by reducing scotoma size relative to objects in the central visual field.

Testing a new long acting drug for wet age related macular degeneration!
Regeneron Pharmaceuticals, Inc., will be testing the investigational drug, VEGF Trap, in a Phase III clinical trial. VEGF Trap is a human Fc-fusion protein that binds and blocks VEGF in the retina when injected intravitreally. VEGF Trap may prove to be a long acting therapy since it is able to more potently bind VEGF than currently available anti-VEGF therapies. This trial will compare VEGF Trap to Lucentis.