The Era of Retina Disease Treatment Options?

HOT TOPIC

Researchers at the Wilmer Eye Institute at Johns Hopkins University School of Medicine have developed an experimental drug (32-134D) that has been found to target a protein associated with diabetic macular edema and proliferative diabetic retinopathy. The drug has shown promise at preventing or inhibiting the development of both conditions in animal models.

The research team published a study that used mouse and human retinal organoids and eye cell lines in the Journal of Clinical Investigation. The results showed that the compound 32-134D, previously shown to slow liver tumor growth in mice, prevented diabetic retinal vascular disease by decreasing levels of a protein called hypoxia-inducible factor (HIF). HIF is known as a transcription factor and has the ability to switch certain genes, including vascular endothelial growth factor (VEGF), on and off throughout the body. In the eye, elevated levels of HIF causes certain genes, such as VEGF, to increase blood vessel production and leakiness in the retina, which contribute to vision loss.

“This paper highlights how inhibiting HIF with 32-134D is not just a potentially effective therapeutic approach, but a safe one, too,” said Akrit Sodhi, MD, PhD, an author of the study. According to Dr. Sodhi, further studies in animal models are needed before moving to clinical trials. (Read more here.)

OUTSIDE THE LANE

Hollywood’s Patch-Crazy for Corneas

Pedro Pascal, the actor who played Oberyn Martell in the hit HBO series Game of Thrones (an all-time favorite for me), recently revealed to late-night talk show host Jimmy Kimmel that a fan gave him an eye infection by recreating his character’s famous death scene, in which he was killed in a fight and had his skull crushed after his eyes were gauged out.

While taking a photo with the fan, the individual pretended to crush Pascal’s head with his hands, similar to what occurred in his death scene, which left the actor with a scratched cornea. Pascal recalled the incident as “traumatizing,” and revealed that he had to wear an eye patch for a few days. He also noted that it wasn’t the first time he had experienced trauma and discomfort due to fans’ reactions to his GoT character. Despite all of this, Pascal remains extremely grateful to the show for seemingly launching his career and states that he enjoys its passionate fan base.

My Two Cents

Personal space aside, here’s another actor (see my previous story) who experienced a corneal issue and was consequently made to wear an eye patch. Do all those Hollywood eye care providers who are taking care of movie stars know something about the benefits of corneal patching that I’m not aware of? Outside of postsurgical cross-linking patients and the occasional cryopreserved amniotic membrane patient, I can’t recall personally patching a patient or seeing one of my coworker's patch a patient. Can someone fill me in?

CAN YOU RELATE

After graduating optometry school, I encountered so many things in the clinic each day that I needed to research and had so many questions that needed answers. My real problem was that, by the time I had a chance to sit down and look up these questions or research these issues, I couldn’t remember what they were! I basically had a mental lapse from the moment I walked in my front door that would not let me focus on anything eyeball-related. Knowing that I needed an efficient way to keep notes, I went about trying everything I could think of to help.

The obvious answer was to use my cell phone’s Notes feature and simply type away whenever something popped into my head. However, I felt odd and a little unprofessional taking out my phone and seemingly composing a text in front of patients, so I would wait until I left the exam room. As soon as I left the room, however, there was often a small gathering of staff immediately asking questions or taking my focus away from the patient I had just seen.

To be more efficient, I started carrying a single, vertical-lined notecard in my front scrub pocket each day. Whenever the need arises, I simply remove the card, jot down my thoughts, and put return the card to my pocket. At the end of the day, I place the card in a stand similar to this one, and then check each item off the list as I review/research them.

I’ve found that this method works phenomenally well, and my older patients seem genuinely impressed when I get my card out and take a few notes! Let me know if you’ve found any unique ways of keeping notes in clinic that don’t involve a tablet, phone, or computer.