Article Date: 11/1/2009

Wise to the World

Wise to the World

By Judith Riddle, Senior Editor

New Factors Predict Risk of Melanoma

EIGHT FACTORS MAY PREDICT whether a choroidal nevus may develop into melanoma, according to a study published in a recent issue of Archives of Ophthalmology.

Benign choroidal nevi and small melanomas share many characteristics, including color, location and size. "The challenge is to identify the single small melanoma among the thousands of choroidal nevi," researchers say. The factors that predicted growth into melanoma included five previously identified factors, such as tumor thickness greater than 2 millimeters, fluid beneath the retina, decreased vision or flashes and floaters, orange pigment and a tumor edge within 3 millimeters of the optic disc. The two new factors identified were hollowness of the growth on ultrasound and the absence of a surrounding halo, or circular band of depigmentation.

According to the study, monitor patients with choroidal nevi twice a year after the initial diagnosis, provided they don't have any of the seven risk factors, then annually if they remain stable. If patients have one or two risk factors, they should be seen every 4 to 6 months. Patients with three or more risk factors should be referred for treatment.

Worldwide Gap in Vision Care Attitudes and Behaviors

ACROSS CULTURES AND NATIONAL boundaries, sight is valued as the most important of the five senses. Yet, a recent global survey shows that across the world, nearly 44% of respondents share the misguided belief that having good vision is the same as having good eye health.

Researchers surveyed more than 6,500 adults from Australia, Brazil, China, France, Hong Kong, Italy, Japan, Korea, Russia, Singapore, Taiwan, the United Kingdom and the United States to better understand the incidence, practice and perception of eye exams for adults and children around the world. Eight in 10 (79%) respondents believe that improving their vision will impact their enjoyment in life, helping them perform better in hobbies (73%), school/career (71%) and sports (65%). But only 54% have had a comprehensive eye exam, and more than 1 in 3 parents/caregivers have never taken their children for a vision assessment.

Based on these findings, you should remind patients that a comprehensive eye exam won�t only assess vision and the need for upgraded prescriptions, it also may help identify and diagnose other health concerns, such as hypertension and diabetes. To view the survey, visit thevisioncareinstitute.com/globalsurvey.

Enzymes Lead to Vascular Damage

A RECENT STUDY found that elevated levels of the enzyme arginase contribute to vascular eye damage, and therapies to normalize its levels could halt progression of diabetic retinopathy and other diseases that can cause vision loss.

The study, published in the August issue of The American Journal of Pathology, is the first to make the connection between eye disease and arginase. Because the researchers can measure arginase blood levels, the enzyme could become a biomarker for a disease process that can work silently in the eye for months or even years.

Understanding how arginase regulates inflammation may lead to new therapies for many acute and chronic inflammatory diseases of the eyes and other organs. Researchers suspect a high level of arginase is a red flag for early vascular damage in the eyes as well as the heart, kidneys and other organs.

Free Meds for the Unemployed

PFIZER HAS LAUNCHED a program to help patients in financial need, so they can continue receiving eye medications, such as the glaucoma drug latanoprost, if they've recently become unemployed and don't have prescription drug coverage.

Beneficiaries of the program will receive their Pfizer meds for free for up to 1 year or until they become reinsured. For more info, visit PfizerHelpfulAnswers.com.



Optometric Management, Issue: November 2009