Fuchs Endothelial Corneal Dystrophy

Discussion in 'Optometry Archives' started by ironjustice, Feb 8, 2011.

  1. ironjustice

    ironjustice Guest

    Scientists have found that free radicals (unstable molecules that
    cause the death of cells as the body ages) may also cause the damage
    in the eyes of patients with Fuchs Endothelial Corneal Dystrophy
    (FECD), a hereditary disease that is one of the most common reasons
    for corneal transplants worldwide.

    The finding, published in the November 2010 American Journal of
    Pathology, holds promise for early and preventative treatments for
    this disease, which impacts nearly four percent of the population over
    age 60.

    "Our discovery is significant, because it gives us the first hope for
    slowing the progression of the disease," says Dr. Ula V. Jurkunas, the
    principal investigator of the study, who is a scientist at Schepens
    Eye Research Institute and a corneal surgeon at Massachusetts Eye and
    Ear Infirmary in Boston. "If we can identify how free radicals are
    involved in this and what antioxidants can fight them, we can create a
    regimen that can help protect the cornea," she adds. (Antioxidants are
    molecules such as vitamins or certain proteins that bind with and
    neutralize free radicals.)

    FECD destroys cells in the endothelial or deepest layer of the cornea,
    which is the clear tissue that makes up the front portion of the eye.
    These endothelial cells are equipped with pumps that expel excess
    water from the cornea and keep it clear. Without these cells, the
    cornea swells and vision clouds, and, in the late stages, vision is
    completely blocked.

    Because corneal endothelial cells do not regenerate themselves, the
    only effective treatment for Fuchs has been corneal transplant, in
    which a surgeon removes the injured layer and replaces it with the
    donor endothelium.

    While scientists have made progress in identifying some genes that
    cause the disease, they have made little or no progress in defining
    the mechanisms at play.

    As a surgeon who performs hundreds of transplants, Jurkunas began to
    believe that a free radical process might be part of what is happening
    within the Fuchs dystrophy-plagued cornea. Free radicals are unstable
    molecules released by the body, which destabilize other molecules
    through a process known as oxidization, which causes cell death.
    Antioxidants are known to bind with and neutralize free radicals.

    To test the theory, Jurkunas and her colleagues took numerous tissue
    samples from patients undergoing corneal transplants and tested them
    for evidence of free radical oxidation and subsequent tissue damage.

    In the significant majority of specimens, the scientists found that
    the level of antioxidants was less than normal (or down-regulated).
    They also found evidence of high rates of damage to the cells' DNA,
    which is particularly susceptible to free radicals.

    According to Jurkunas, the next step is to identify the specific
    antioxidants that would neutralize the free radicals involved in the
    damage and, therefore, could prevent or block their destructive

    What should patients do in the meantime? While no conclusions should
    be drawn from these early results, Jurkunas recommends that patients
    at risk for Fuchs eat a healthy diet rich in leafy green vegetables,
    such as broccoli and Brussels sprouts, take multivitamins and wear UV
    protection outdoors.

    Other scientists involved in the study are: Dr. Maya S. Bitar, Dr.
    Toshinari Funaki, and Dr. Behrooz Azizi, also from both Schepens Eye
    Research Institute and Massachusetts Eye and Ear Infirmary.

    The study was conducted at Jurkunas' laboratory at Schepens Eye
    Research Institute. Tissue samples were donated by the surgeons and
    patients of the Massachusetts Eye and Ear Infirmary and Ophthalmic
    Consultants of Boston

    Schepens Eye Research Institute is an affiliate of Harvard Medical
    School and the largest independent eye research institute in the
    nation. For more information about Schepens Eye Research Institute go
    to Schepens.harvard.edu.

    Founded in 1824, Massachusetts Eye and Ear Infirmary is an independent
    specialty hospital, an international center for treatment and
    research, and a teaching affiliate of the Harvard Medical School.
    Information about Massachusetts Eye and Ear Infirmary is available on
    its website at www.MassEyeAndEar.org.

    Patti Jacobs | Source: EurekAlert!
    Further information: www.MassEyeAndEar.org

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    ironjustice, Feb 8, 2011
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