Eye centers such as Byers Eye Institute at Stanford and the New York Eye and Ear Infirmary are two of the four centers that participated in the Phase I/II Study of Human Central Nervous System Stem Cells (HuCNS-SC) in Age-Related Macular Degeneration.
Review of the Trial
The purpose of the study was to “determine the safety and preliminary efficacy of the transplantation of HuCNS-SC cells in patients with geographic atrophy (GA) due to age-related macular degeneration.” HuCNS-SC cells are purified adult human neural stem cells. Age related macular degeneration (AMD) is a retinal disease that manifests as either dry or wet AMD. More than 80% of those with AMD have the dry form. Geographic atrophy is an advanced form of dry AMD resulting in significant vision loss. The HuCNS-SC cells are delivered by a single injection into the space behind the retina in one eye in those who had evidence of GA.
Along with monitoring the safety of the injections, the patients are being monitored for any vision improvement or loss. The use of both conventional and advanced state-of-the-art methods are being used to evaluate patients over a one-year period. Patients will continue to be followed for an additional four years in a separate observational study.
Type of Stem Cells
StemCells, Inc. uses what is called homologous cells as defined by, “organ-specific stem cells to treat the same type of organ.” Which means the cells are already “programmed” for a specific organ. These are adult stem cells, not embryonic cells. Healthy donor derived cells (allogeneic) are used rather than those from the patient (autologous) which may carry genetic defects.
Update from June 20, 2014
In a news release from StemCells, Inc from June 20, 2014, “Interim results for the current AMD trial show a 70 percent reduction in the rate of geographic atrophy (GA) as compared to the control eye and a 65 percent reduction in the rate of GA as compared to the expected natural history of the disease following a single dose of the Company’s proprietary HuCNS-SC® human neural stem cells.”
Dr. Stephen Huhn, M.D., FACS, FAAP, vice president, CNS clinical research and chief medical officer, StemCells, Inc. reports, “The strength of the interim results exceeded our expectations. These positive clinical safety and efficacy findings are an important milestone in our goal of developing a first-in-class therapy for dry AMD based on our proprietary HuCNS-SC platform technology.”
Based on these positive results StemCells, Inc. will move forward with a Phase II study to determine efficacy of the HuCNS-SC cells in the treatment of advanced dry AMD. To learn about other research using stem cells for macular degeneration treatment visit:
Macular Degeneration Research Using Stem Cells
Leslie Degner, RN, BSN
Laser therapy was first used as a treatment for wet macular degeneration. The type of laser used is called a thermal laser. It uses an intense beam of light that actually burns the leaking blood vessels under the macula. The burning helps to seal the blood vessels so that there is less fluid buildup under the center of the retina. The goal of the treatment is to delay further loss of one’s straight ahead vision. However, the recurrence of these leaky blood vessels in more than half the patients, makes this treatment temporary. With the use of this type of thermal laser therapy, there is actually some damage to the macula, the portion of the retina responsible for our detailed and central vision, resulting in loss of vision due to the laser treatment. Because very few patients are candidates for this type of wet AMD treatment and because there are now better ways of treating AMD with less risk, this type of laser treatment is not very common.
However, thanks to new research and to the development of new technology, laser treatment for macular degeneration may change how early AMD is treated. Ellex Medical Lasers Limited has spent over 10 years developing Ellex Retinal Rejuvenation Therapy ( Ellex 2RT). The treatment with this laser is different in several ways.
1. First it is a non-thermal laser that does not use heat to treat retinal diseases. Instead it uses short pulses of low level or nanosecond laser energy that “stimulates a natural, biological healing response in the eye to treat a range of degenerative retinal diseases” according to the Ellex website.
2. It is used to treat early dry macular degeneration, rather than wet or choroidal macular degeneration
Early AMD accounts for the vast majority of those with macular degeneration – in fact close to 80%. However, most current treatments that are available are for wet AMD.
The 2RT therapy is being used in a clinical trial at the Center for Eye Research in Australia. Participants will be randomized to receive either the 2RT laser or a sham laser. The purpose of the study is “ to determine whether 2RT nanosecond laser therapy slows the progression to advanced age-related macular degeneration.“
Professor Robyn Guymer, the lead 2RT principal investigator states, “Our research shows that application of 2RT treatment is safe and painless, and results in both improved visual function and drusen resolution. This is an extremely positive result. To date there has been no proven intervention in early AMD that significantly halts or causes regression of the disease process.”
For more information on early macular degeneration go to :
Leslie Degner, RN, BSN
How often and how much do you rely on your computer? Do you use it to check your email, get the weather, shop for a present, or find the latest baseball score? Living without the convenience of a computer can be a big disadvantage. For those with low vision, navigating and seeing what is on the screen can be a challenge as can typing and using the keyboard. However, there are many low vision computer aids and software that can enhance your ability to see what is on the screen, allow your voice to give computer commands, or read out loud any text.
Computer Screen Magnification
You can magnifying your computer screen in three different ways. Computers now have magnification software built right into their computer. How it is done depends on your operating software and whether you have a Mac or PC. You can also purchase an actual monitor magnifier that is placed over your computer screen. They come in different sizes depending on the size of your monitor. For those with more severe vision loss who need more magnification, it is best to buy magnifying screen software. Software such as ZoomText has the ability to magnify up to to 36X. The larger the monitor the better it is for those with more severe vision loss.
Text to Speech Software
When you get tired of trying to read your computer screen and find that even with more magnification your eyes are strained, switch to a text to speech software. This type of software can read to you the weather, your e-mails, the news, or documents. Many computers now have an accessibility setting that provides a text to speech feature for free. You may want to try it first to see how it works for you, however the speech quality is not as good as purchased software. There are several software programs to choose from – they include JAWS, Super Nova, and Dragon Naturally.
Speech to Text Software
Perhaps your low vision is making it difficult to type and to navigate the computer. With a speech to text software you can “write” emails or papers by talking or give the computer voice commands to search the web. Whether you want to look for a new recipe, get the latest news, or research a topic, speech to text software such as Dragon NaturallySpeaking can do it for you.
Large Number Keyboards
Did you know that there are special keyboards for those with low vision? These keyboards use larger letters/numbers with better contrast for better visibility. The color combinations available include white letters on black keys, black letters on white keys, or yellow characters on black.
For more tips on low vision technology visit:
Leslie Degner, RN, BSN
Even though we have found some good reading aids for my 87 year old father-in-law (who has wet AMD) that allow him to read, he still complains that his eyes felt irritated , strained and sore after 30 minutes of reading. At his last eye appointment he shared his symptoms with his ophthalmologist. “Oh, that’s easy enough to explain. You are not blinking.” My father-in-law thought about it, and he recognized that indeed it was true. When he looked at his reading screen, he was concentrating and focusing so much on making out the words and following the story or article that he failed to blink. So the next time he sat down to read his electronic book, he made an effort to blink more often and to close his eyes a little bit longer than normal. To his surprise, this time after 30″ of reading, he didn’t experience the eye strain or dryness that he normally felt.
According to Gary Heiting, OD and Senior Editor of All About Vision, “When working at a computer, people blink less frequently — about one-third as often as they normally do — and many blinks performed during computer work are only partial lid closures…” For different reasons whether we are using a computer, iPad, Kindle or other type of screen, we will often find ourselves just staring at the screen in front of us. As more and more people with low vision turn to different types of screens for reading – whether it is a computer screen, a CCTV magnifying screen, or an electronic book reader, like the Kindle, it is very common to develop symptoms of computer eye strain. Some of the common symptoms of screen fatigue are:
Red, dry, irritated eyes
Eyes feel scratchy
Eyes that water
Eyes feel tired or sore
Why is blinking so important? Blinking creates tears that moisten the eyes to prevent dryness and irritation. The more we blink the more we lubricate our eyes. And it’s not only how often we blink but how long we blink. One eye specialist recommends that, “Every 20 minutes, blink 10 times by closing your eyes as if falling asleep (very slowly). This will help rewet your eyes.”
Computer Vision Syndrome is the name of the eye condition associated with the above symptoms. Eye doctors often see it along with Dry Eyes. Blinking more often and for longer may just be what the doctor orders.
For more suggestions on how to prevent computer eye strain go to:
Leslie Degner, RN, BSN
Have you heard that what is good for the health of your body is good for your eyes? Indeed that seems to be true when it comes to eating foods rich in carbohydrates and foods loaded with sugar. It all has to do with our blood sugar levels. This is how the body works when we consume carbohydrates:
1. The digestive system breaks down the carbohydrates into sugar
2. The sugar enters the bloodstream
3. When the blood sugar rises, the pancreas secretes insulin which helps cells to absorb and store the sugar
4. Cells absorb the sugar
5. Blood sugar levels fall
6. Pancreas produces glucagon a hormone that tells the liver to release the stored sugar
Balancing the insulin and glucagon levels ensures that cells throughout the body have a steady supply of blood sugar.
It is important to understand the effect of carbohydrates on blood sugar levels and the development of chronic diseases. According to the Harvard School of Public Health Nutrition Source, “ Eating many high-glycemic-index foods – which cause powerful spikes in blood sugar – can lead to an increased risk for type 2 diabetes, heart disease, and overweight. There is also preliminary work linking high-glycemic diets to age-related macular degeneration, ovulatory infertility, and colorectal cancer. ‘
Perhaps you are wondering what are high glycemic index foods and how do I avoid them? The glycemic index is a way of assigning a value to carbohydrates using a scale from 0 to 100. Carbohydrate foods are given a ranking based on how quickly they are digested and how much and how fast they raise blood sugar levels. High glycemic index foods are rapidly digested and cause a significant rise and then fall in blood sugar. Foods with a low glycemic index are digested more slowly, causing a more gradual rise in blood sugar.
Carbohydrate foods generally fall into one of three categories:
Low Glycemic Foods
Low-glycemic foods have a rating of 55 or less, and include foods like corn tortilla,s quinoa, slow cooked oatmeal, brown rice, grapefruit, peaches and pears.
Medium Glycemic Foods
Medium-level foods have a glycemic index of 56-69. Pumpernickel bread, couscous, ripe bananas, grapes
and sweet potatoes are in this category.
High Glycemic Foods
These foods are rated 70-100 and include foods like cheese pizza, baked potatoes, waffles, bagels, white and whole wheat bread, corn flakes and instant oatmeal.
Dietary information was obtained from 4099 participants aged 55–80 years old in the Age-Related Eye Disease Study (AREDS). The analyses of the participants’ carbohydrate consumption and their correlating glycemic index “suggest that the quality, but not the quantity, of dietary carbohydrate influences the risk of AMD in both the early and late stages of the disease.”
Find out more about how to improve the quality of your carbohydrate intake here: Low Glycemic Carbs
Leslie Degner, RN, BSN
It is commonly believed that as age increases, visual sensitivity decreases. But what if vision loss as part of the aging process was not inevitable? What if improved nutrition could help slow and even deter vision loss associated with age-related macular degeneration? The role of nutrition is garnering more and more attention from the eye care community with regards to how particular carotenoids can be applied in the treatment and prevention of AMD.
There is certainly no shortage of new research on how nutrition can help prevent the development of macular degeneration. Researchers have tested the efficiency of nearly every nutrient; from zinc to beta-carotene to omega-3. In fact, the recent AREDs-2 trial rendered omega-3 ineffective for the prevention of AMD. Additionally, the study found that beta-carotene is associated with poor absorption of other eye healthy nutrients. Yet another important finding of AREDs-2 was that a combination of three carotenoids found in the eye known as lutein, zeaxanthin and meso-zeaxanthin can successfully protect the macula and ward off AMD. Dr. John Nolan of the Macular Pigment Research Group in Waterford, Ireland has even hailed these ingredients as being “able to change the course of disease.”
So what are carotenoids, exactly? Carotenoids are phytochemicals commonly found in certain fruits and vegetables. They provide the yellow and orange colour in foods such as bell peppers, corn and squash.
But if these carotenoids are readily available in our food, why is AMD so prevalent? The fact is that the majority of Americans do not consume enough lutein and zeaxanthin rich foods in order to receive the protection that they require. Further, meso-zeaxanthin (the third carotenoid found in the central fovea) is not present in typical Western diets. And though it is theorized that meso-zeaxanthin is manufactured from lutein, some individuals may lack the enzyme to ensure this conversion occurs.
When it comes to AMD, the importance of proper nutrition is immeasurable. In fact, scientists have established that diets high in fat can actually increase one’s risk of developing the blinding disease. Thus, it is very important for those concerned about AMD risk to steer clear of saturated fats found in animal products, high fat cheeses, butters and creams. Plant oils including palm kernel oil and canola oil should also be avoided.
Of course, for those of us with busy schedules and a lack of time on our hands, getting an adequate daily dosage of macular carotenoids and avoiding high fat meals is not always easy. This is precisely why it is imperative to supplement with a triple carotenoid formula. A supplement like MacuHealth contains an ideal ratio of lutein, zeaxanthin and meso-zeaxanthin (in its converted form) and makes optimizing macular health a synch.
Talk to your doctor about supplementing with carotenoids.
There has been lots of news recently regarding the FDA approved CentraSight implant for those with end stage macular degeneration. The telescope is implanted in one eye much like a lens is implanted in those with a cataract. After a patient receives the implant, several weeks of training with a low vision clinic is required to optimize the use of this visual aid. With many Medicare insurance policies providing coverage and many new eye specialists being trained, more and more patients are appreciating the benefits of improved vision. Other patients with AMD find that telescope mounted glasses offer improved vision for seeing the world around them. The benefit of being able to see faces, street signs, and pretty gardens outweighs the strange appearance of these binocular glasses.
Another new technology is on the horizon that does not require any surgery or the obvious appearance of odd looking glasses. It is called a telescopic contact lens. Thanks to the collaboration between engineer, Eric Tremblay of École Polytechnique Fédérale de Lausanne in Switzerland and a team of researchers from the University of California San Diego, a telescopic contact lens has been created that in the future may benefit those with macular degeneration. “For a visual aid to be accepted it needs to be highly convenient and unobtrusive,” says Eric Tremblay, the co-author of Switchable Telescopic Contact Lens, an article that was posted in the Optical Society’s journal, Optics Express.
What makes this vision aid different and unique is that a contact lens is less noticeable and more attractive than telescopic glasses and more convenient than surgery and low vision rehab. The lens will work by magnifying incoming light and spreading the light to the undamaged parts of the retina. The magnifying portion of the lens will magnify 2.8 times and will help patients with their ability to read, identify faces and to remain more independent.
Another interesting feature is that the ability to switch between normal vision and magnified vision will be possible. The center of the lens will provide unmagnified vision and the telescope that circles around the periphery of the lens will offer the 2.8 times magnification.
Ever hear of liquid crystal glasses? They are used in some high tech eye glasses where a
simple electrical impulse changes the liquid crystals. The crystals change how the lenses refract or bend light. The wearer can select whether he/she wants to use the magnified feature of the lens or the unmagnified lens.
Look for more updates on this vision aid for macular degeneration and other low vision technology here:
Leslie Degner, RN, BSN
The topic of using stem cells for treating medical conditions can generate strong feelings of support and/or serious ethical concerns. In the most simple terms there are basically two categories of stem cells – embryonic and adult. While the use of some, but not all, embryonic stem cells results in the death of the embryo, umbilical cord stem cells are considered adult stem cells and come from tissue that in the past was simply tossed away – the umbilical cord and the placenta. However, that is quickly changing.
According to the author of The Stem Cell Dilemma, Dr. Leo Furcht, “It is thought by some medical scientists that umbilical cord blood harbors adult stem cells that have many, if not all, of the important attributes of embryonic stem cells.” Even now stem cells derived from umbilical cord blood are being used in clinical trials to treat cerebral palsy, traumatic brain injury, autism, pediatric stroke and juvenile diabetes. As a result of many positive outcomes, cord blood banking is now becoming more prevalent and common.
Cord Blood Banking
An expectant couple can opt to harvest and store their child’s cord blood for their own purposes in the event that their child develops a future condition or experiences a trauma that requires its use. The couple is required to pay for the harvesting and storage costs. Or the couple can donate the cord blood to a public cord blood bank at no cost to themselves.
Stem Cell Sources
Transplanted stem cells can come from 4 different sources – embryos, umbilical cord blood, the bone marrow or circulating blood. When a child receives and uses his/her own cord blood stem cells it is called an autologous transplant. Transplanted stem cells that come from a donated source are called an allogeneic transplant.
So what do umbilical cord stem cells have to do with macular degeneration? There is currently a clinical trial that is transplanting umbilical cord stem cells into the retina of those who have an advanced form of macular degeneration, called geographic atrophy. It is a Phase I study which means it is looking at the safety. The name of the study is A Safety Study of CNTO 2476 in Patients with Age-Related Macular Degeneration. Eligible patients will receive a one-time sub-retinal administration of Human Umbilical Tissue Derived- Cells (CNTO 2476) using a micro-catheter. The sponsor is Janssen Research & Development, LLC. To find out more about this study and where it is being conducted go to:
Leslie Degner, RN, BSN
There are many super-antioxidant berries being promoted to benefit our health and well being. From acai berries to goji berries these so called superfoods are reported to help us fight cancer, improve our vision, and reverse diabetes. No wonder with claims like these it’s easy to discount the true benefits found in these more exotic fruits. Not readily accessible in our grocery stores, one may wonder if these berries rank up there with other powerhouse berries like blueberries and blackberries.
Wolfberries (another name for goji berries) are one of the few foods rich in zeaxanthin. So why do we want to include food rich in this antioxidant? Zeaxanthin is found in very high concentrations in the cone cells of the macula. Cone cells are responsible for giving us our sharp, distinct, clear vision as well as our straight ahead or central vision.
Dr. Lylas Mogk in her book Macular Degeneration: The Complete Guide to Saving and Maximizing Your Sight, writes that there are very few foods that are rich in zeaxanthin but wolfberries have some of the highest concentrations of this antioxidant.
What are Goji Berries?
Just like other berries, they grow on a bush that is more like a vine in Asia and in North and Central America. There are over 80 different species which means they come in a variety of colors, shapes and sizes. Typically they are dried and look like a red/orange raisin. Because of the different species and varied growing conditions we have found there is also a difference in how they taste.
How to Get Them Into Your Diet
Although it is hard to substantiate claims for improving health or vision, I do know that it is wise to include foods that are rich sources of nutrients. Why not choose a berry that is known for it’s nutrient density? We incorporate this superfood into our diet two ways – one is by drinking a small glass of organic goji berry juice in the morning (on an empty stomach) and the other is snacking on the dried berries or adding them into a smoothie.
Goji Berry Benefits
Let’s start with the author of SuperFoods, David Wolfe. He writes, “Goji berries are perhaps the most nutritionally rich berry-fruit on the planet.” For starters they are a complete protein source, contain many trace minerals such as zinc, iron and calcium, as well as many vitamins like B1, B2 and vitamin E. And let’s not forget their rich concentration of zeaxanthin.
Find out more about the benefits of this superfood on your health and your eyes here:
Leslie Degner, RN, BSN
Omega 3 fatty acids are essential for not only our vision but for our brain, our skin, our heart, our joints and even our moods. Who wouldn’t want some improved health in any of these areas? However, getting enough of these essential fatty acids (EFA) in our diet has become more of a challenge for several reasons.
1. Today’s meats are much lower in omega-3 fatty acids than they were a hundred years ago. Animals that were at one time free range are now given feed that is high in omega-6s so their meat is high in this type of EFA.
2. Processed or packaged foods use oils that are high in omega 6s. This includes foods like mayonnaise, granolas and granola bars, salad dressings, margarine, fast foods and many vegetable oils.
3. The ratio of omega 6s to omega 3s is unbalanced. When the amount of omega 6 foods in our diet accounts for more than the omega 3s, our bodies find it difficult to benefit from the omega 3s because they both compete for the same cell receptor sites.
So at the same time we are trying to include more foods high in omega 3s we need to decrease foods high in omega 6s. A grilled salmon for dinner is not going to benefit one’s health if it follows a lunch from a fast food restaurant.
The three main types of EFAs are DHA (docosahexaenoic acid), EPA (eicosapentaenoic acid) and ALA (alpha linolenic acid). DHA is necessary for healthy retinal function. According to Molecular Vision 2010:
“Studies over several decades have shown that DHA is essential for maintaining the normal structure and function of the retina . Reduction of DHA in the retina can lead to diminished retinal electrical responses to light in rodents, reduced visual acuity in nonhuman primates, and delayed photoreceptor development and function in preterm and term human infants.” So how can we get more of these important fats incorporated into our diet? There are two options.
Animal sources of omega 3s provide DHA and EPA. They include wild salmon, canned sockey salmon, Alaskan halibut, canned albacore tuna, sea bass, and sardines packed in water or olive oil . Other fish include herring, sablefish, and butterfish. Animals that graze on grass rather than on grains.
Plant sourced EFA is called alpha linolenic acid (ALA). To benefit from this EFA the body needs to convert ALA to DHA and EPA. There is some concern as to how efficient the body is able to make this conversion. Food sources include flaxseed (freshly ground) and flaxseed oil, walnuts and walnut oil, soybeans and tofu, hemp seeds, omega 3 fortified eggs, canola oil and in lesser amounts in leafy greens like kale, spinach and collard greens.
Leslie Degner, RN, BSN
Better Health For Better Vision