Hyperopia and Educational Attainment

Vision screening addresses the visual impairments that impact on child development. Tests of farsightedness are not found in most school screening programs. The evidence linking mild to moderate hyperopia and lack of progress in school is insufficient, although strengthened by recent findings of developmental problems in infants. This study examined the relation between hyperopia and education test results in a cohort of primary school children.

A total of 1,298 eight-year-old children were screened for hyperopia on the basis of fogging test results. Standardized test results were compared between groups categorized by referral status and refractive error. A total of 166 (12.8 percent) fogging test failures were referred for ocular examinations, yielding 105 children diagnosed with a vision defect.

Fifty percent of the children examined by optometrists required a prescription change, glasses prescribed or referral. Standardized test scores of children with refractive errors summing greater than +3.00D or greater than +1.25D in the best eye were lower than the respective scores of children with less hyperopic refractions, the non-referred group or total sample. A high proportion of the fogging test failures (16 percent) and confirmed hyperopes (29 percent) had been referred to an educational psychologist, and the latter group contributed substantially to the poor education scores. The results of this study provide further evidence for a link between hyperopia and impaired literacy standards in children.

SOURCE: Williams WR, Latif AH, Hannington L, Watkins DR. Hyperopia and educational attainment in a primary school cohort. Arch Dis Child 2005;90(2):150-3.

Because of the high rate of allergy associated with Alphagan, this study explored the relation of prior Alphagan allergy and allergy to subsequently prescribed medications. A database was created from the entire glaucoma treatment histories for consecutive patients examined at Glasgow Royal Infirmary in Scotland between May 1999 and September 2001. All patients had undergone medical treatment for primary open angle glaucoma, ocular hypertension, or normal tension glaucoma. Patients with any other form of glaucoma and patients for whom a full record of treatment was not available were excluded from the study.

Alphagan was discontinued due to allergy for 73 of 100,000 patient treatment days. This was a far higher frequency than for other preparations. In patients allergic to both Alphagan and another preparation (Timoptic, Trusopt and Xalatan), the mean interval between the first and second allergy was shorter when Alphagan allergy occurred first. This was statistically significant with Timoptic and Trusopt cross-reactivity. The authors conclude that Alphagan has high allergenicity and may increase the likelihood of allergy to subsequently used preparations.

SOURCE: Osborne SA, Montgomery DM, Morris D, McKay IC. Alphagan allergy may increase the propensity for multiple eye-drop allergy. Eye 2005;19(2):129-37.

Central Corneal Thickness and Nerve Fiber Layer Thickness

This study examined the relationship between retinal nerve fiber layer (RNFL) measurements and central corneal thickness (CCT) measurements in ocular hypertension (OHT) patients. Forty-four OHT patients and 48 healthy subjects with normal optic discs and normal standard automated perimetry visual fields (SAP) underwent imaging with the GDx VCC scanning laser polarimeter. The relationship of GDx VCC measurements and age, IOP, SAP pattern standard deviation and vertical cup-to-disc ratio were also evaluated.

CCT measurements in OHT patients were significantly higher than those in healthy subjects (575 +/- 30 microns vs. 555 +/- 32 microns). Higher GDx VCC parameter nerve fiber indicator (NFI) scores, indicating thinner RNFL, correlated significantly with thinner CCT measurements in OHT patients. OHT patients with thinner corneas had significantly higher NFI scores than OHT patients with thicker corneas and the controls. The NFI values were not significantly different between OHT patients with thicker corneas and healthy subjects. In multivariate statistical analysis, only age and CCT measurement associated significantly with GDx VCC RNFL measurements in OHT eyes.

SOURCE: Henderson PA, Medeiros FA, Zangwill LM, Weinreb RN. Relationship between central corneal thickness and retinal nerve fiber layer thickness in ocular hypertensive patients. Ophthalmol 2005;112(2):251-6.

NEWS & NOTES

PEDIAMED AND ALLERGAN FORM CO-PROMOTION AGREEMENT FOR ZYMAR. PediaMed Pharmaceuticals, a company that identifies, develops and markets branded prescription pharmaceuticals for children, has entered into a co-promotion agreement with Allergan, Inc. in the United States pediatric market for Allergan's Zymar ophthalmic solution, a treatment for bacterial conjunctivitis. The agreement marks the second transaction between Allergan and PediaMed in the last year; in August 2004, Allergan and PediaMed agreed to co-promote Allergan's Tazorac product in the United States. PediaMed will be responsible for Zymar commercialization in the United States pediatric market, with Allergan continuing to promote to ophthalmologists, optometrists and other eyecare professionals. For more information, go to www.pediamedpharma.com.

ALIMERA AND CONTROL DELIVERY SYSTEMS COLLABORATE ON PHARMACOLOGIC TREATMENT FOR DME. Alimera Sciences Inc., and Control Delivery Systems, Inc. (CDS) have forged a worldwide agreement to co-develop and market a new pharmacologic treatment for treatment of diabetic macular edema (DME), a major cause of vision loss in people suffering from diabetic retinopathy. Alimera Sciences also has the option to develop three additional products using CDS' drug delivery technology. The companies are in discussions with the FDA to initiate clinical trials to determine the effectiveness of injecting an implantable form of CDS' technology into the vitreous of the eye to treat DME. The implant is small enough to be injected into the eye via a 25-gauge needle and is expected to provide delivery of drug to the back of the eye for up to three years. Currently, the only approved method of treating DME involves laser photocoagulation therapy, which can leave irreversible blind spots. Many systemic compounds will not produce a therapeutic effect in the back of the eye. The compounds being studied to treat DME must be injected repeatedly because of a lack of true long-term release characteristics. For more information, go to www.alimerasciences.com or www.controldelivery.com.

 

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