Laser plus injection improves vision for diabetics

Also: Sheba neurologists identify very early genetic signs of MS; Philadelphia researchers find colonoscopy prep time can be reduced.

By JUDY SIEGEL-ITZKOVICH
”One of the most important things that has happened in ophthalmology in recent years” is how one prominent Israeli ophthalmologist describes the discovery of a combination of eye injection and laser therapy for treating diabetic macular edema. “This is breaking news,” says Prof. Anat Loewenstein, chief of eye medicine at Tel Aviv Sourasky Medical Center. “It brings significant hope to patients with diabetes and eye disease. Previously, we could only stop their deterioration in vision, but now we can actually improve their vision significantly.”
She was commenting on a study funded by the US National Institutes of Health and conducted by the Diabetic Retinopathy Clinical Research Network that showed injections of the drug ranibizumab (Lucentis) into the eye,  combined with laser treatment result in significantly better vision than laser treatment alone for diabetes-associated swelling of the retina. The study was published in the online edition of Ophthalmology.
Laser treatment alone to staunch the leaking of tiny blood vessels in the retina has been the standard for a quarter century. But now, the laser treatment plus the injection of Lucentis cause major improvements in nearly half the patients studies. “These results indicate a treatment breakthrough for saving the vision of people with diabetic macular edema,” Dr. Neil Bressler, chief of the retina division of the Wilmer Eye Institute at Johns Hopkins University, told UPI.
HEADING OFF MS
Sheba Medical Center neurologists have for the first time identified very early genetic signs of multiple sclerosis, the potentially debilitating autoimmune disease in which myelin coating the neurons is destroyed by the body’s immune system. Prof. Anat Achiron and colleagues at Sheba’s MS center found proteins connected with the inflammatory processes in people who were healthy when they had a blood test but within six months to nine years developed the first neurological symptoms of MS. The disease affects women more often than men, and usually appears before the age of 40.
The research, conducted with help from the Israel Defense Forces, examined the expression of over 12,000 genes in blood samples from 100,000 healthy soldiers, comparing those from 31 soldiers who later developed the disease with those who never developed symptoms. What they discovered was a “joint genetic stamp” in soldiers who eventually suffered MS attacks. Although the study group was small, Achiron believe it is significant, and that in the future, MS patients will be identified years before their first symptoms, allowing interventions to alleviate or even prevent them.
COLONOSCOPY PREP CAN BE SHORTER
Some people are put off getting a colonoscopy to detect precancerous polyps in the intestine not so much because of the procedure itself but because of the unpleasantness of the preparation – evacuating the colon. Now researchers at Thomas Jefferson University in Philadelphia have found that colonoscopy-preparation drugs administered the same day as the procedure are as effective as those given the night before, but result in fewer complaints of side effects such as abdominal pain, sleep loss and workday interference.
The randomized, single blind study compared results between 116 colonoscopy patients given a split dosage of colon preparation the night before and morning of their colonoscopy and those given the colonoscopy preparation only on the morning of their colonoscopy. The study shows that both treatments are clinically equal. Lead researcher Dr. David Kastenberg, head of gastroenterology and hepatology at the medical colleague, presented their findings in the latest issue of the American Journal of Gastroenterology.