Research Updates

Thyroid Eye Disease

In a recent study, Botulinum toxin (botox) injections were found to be an easily-administered and effective treatment for correcting upper eyelid retraction associated with thyroid eye disease.

In this study, 11 patients with exposed whites of the eyes associated with thyroid eye disease received botox injections in the upper eyelids. All patients had some improvement in eyelid retraction after the injections. The degree of lid lowering varied among the participants and lasted between one and forty months. According to Monica L. Monica, M.D., AAO spokesperson, “the method of injection used...appears to avoid some of the eye alignment problems associated with surgical problems. However, further controlled studies will be necessary to corroborate these promising results” (Sources: Ophthalmology, June 2002; AAO News Release, June 10, 2002).

In the conclusion of a recent study, it was found that photodynamic therapy, an approved treatment for age-related macular degeneration, also appears to be effective in treating ocular histoplasmosis syndrome (a fungus-related disease characterized by abnormal growth of new blood vessels in the retina). The authors noted that ocular histoplasmosis syndrome “is a leading cause of severe, irreversible central vision loss among middle-aged adults [usually] living in the central and eastern United States.”

The histoplasmosis fungus is a soil fungus that gets into the lungs, and then migrates to the eyes. Other studies have associated the spread of this fungus with the exposure to bird droppings and the use of tobacco that has been contaminated by bird droppings.

Paul Sternberg, Jr., M.D., a co-author of the study, stated that “Apparently, photodynamic therapy with vertoporfin selectively seals leakage from the abnormal new blood vessels beneath the retina in this condition with harming the overlying retinal tissue. The resulting improvement of visual acuity in more than half of the patients in this study is impressive. Two-year data from this ongoing study will provide additional information on the safety and effectiveness of the therapy” (Sources: Ophthalmology, August 2002; AAO News Release, Aug. 13, 2002).

In a conclusion of a major, two-part study on laser photocoagulation and cryotherapy (freezing) in the treatment of threshold retinopathy of prematurity (ROP), it was found that the use of a laser beam to eliminate abnormal blood vessel growth in the retinas of premature infants gave significantly better visual, structural and refractive results than use of intense-cold therapy.

In the trial, 118 eyes of 66 patients with threshold ROP were randomly assigned to receive either cryotherapy or laser photocoagulation. Of these, 44 eyes of 25 patients were examined for 10-year follow-up evaluations. Eyes treated with the laser were over five times more likely to have 20/50 best corrected visual acuity or better than eyes treated with cryotherapy.

Also, eyes treated with cryotherapy were over seven times more likely to develop retinal dragging, in which abnormal traction pulls the retina and retinal vessels from their normal position (Sources: Ophthalmology, May 2002; AAO News Release, May 1, 2002).

The Visionary, published as a service of the Illinois Society for the Prevention of Blindness,
is available upon request. The information contained in this issue,
taken from sources considered to be accurate,
does not replace the need for professional eye care consultations and treatments.

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