Eyecare Center of Maryland – Dr. Norman Shedlo O.D.

Eyecare Center of Maryland

4701 Randolph Rd Suite G02 Rockville MD 20852   301-779-2424    Email:  info@drshedlo.com

 

FDA approves Satralizumab for Neuromyelitis Optica Spectrum Disorder

The US Food and Drug Administration (FDA) has just approved a new drug Satralizumab for adults with anti-aquaporin-4 (AQP4) antibody-positive Neuromyelitis Optica Spectrum Disorder.

Neuromyelitis optica spectrum disorder (NMSOD) is an autoimmune inflammatory disease that damages the optic nerve and spinal cord, causing blindness, muscle weakness, and paralysis.

NMOSD affects up to 15,000 people in the United States and about 200,000 people worldwide.

In one single drug study, 76.5% of satralizumab-treated patients were relapse-free at 96 weeks, compared with 41.1% with placebo.

Symptoms of NMOSD include either optic neuritis or myelitis. Optic neuritis is an inflammation of the optic nerve leading to pain in the eye which is followed by vision loss. Only one eye is usually affected although sometimes both eyes may be involved. Another symptom of NMSOD is inflammation of the spinal cord. Affected individuals have pain in the spine or limbs, and paralysis of the lower limbs with possible loss of bowel and bladder control.

It may be difficult to tell NMOSD from multiple sclerosis because both cause optic neuritis and myelitis as symptoms. Optic neuritis and myelitis tend to be more severe in NMOSD. In many cases of NMOSD, initial symptoms of vision loss improve with the standard treatment of high dose corticosteroids, with a partial recovery of vision, motor, sensory, and bladder function. If NMOSD recurs frequently it causes significant permanent vision loss and/or spinal cord function causing blindness and impaired mobility.

Autoimmune disorders happen when the body’s natural defenses against invading pathogens begin to attack healthy tissue. These immune defenses, for reasons not known, attack some proteins in the central nervous system, especially aquaporin-4.

NMOSD is diagnosed from a detailed patient history, clinical evaluation, physical findings, and specialized testing. Tests include blood tests, cerebrospinal fluid examination and magnetic resonance imaging. A blood test for AQP4-IgG, is highly specific and moderately sensitive for NMOD.

New Contact Lenses Help Control Myopia

A new report from the Bifocal Lenses In Nearsighted Kids (BLINK) study, funded by the National Eye Institute, recently published in the Journal of the American Medical Association presents additional evidence that myopic children wearing multifocal contact lenses were able to reduce the rate of myopic progression by about 43% over a period of three years. 

Children are at increased risk of developing myopia because of increased near work due to increasing screen time on computers and mobile devices and less time playing outdoors.

Myopia, or near sightedness, is defined as a refractive condition of a non-accommodating eye in which parallel rays of light entering the eye are brought to a focus in front of the retina. Therefore, the uncorrected myopic eye has blurry vision when looking at objects in the distance while vision is clear for near objects.

Myopia in children is currently corrected with single vision glasses and contact lenses.  Unfortunately, myopia often worsens with a need for stronger prescriptions as children get older.

Online Eye Exams – Avoiding Air Puff Tonometry

The ‘air puff test’, or non contact tonometer, measures the pressure of fluid in the anterior segment of your eye.  Eye pressure can be measured with several different instruments.  The standard for measuring eye pressure is the Goldmann applanation tonometer which requires drops and uses a probe to touch the front of the eye.  These tests are important as elevated eye pressure is the main cause of glaucoma, a degenerative disease of the optic nerve that may lead to blindness.  Eye pressure testing will not reveal cataracts or many other eye diseases.  It is still an important measure in evaluating eye health.

Using drops to dilate your pupils, then examining your lens with a slit lamp and ophthalmascope will show the doctor if you have any cataracts or retinal disease.  By avoiding a real eye exam with either air or applanation tonometry and a careful slit lamp evaluation of your cornea and retina, you are missing the most important elements of a complete eye health evaluation. 

These exams reveal many eye conditions that are sight threatening and many other ocular changes that may be life threatening.  A virtual eye exam will tell you nothing about this and unfortunately gives the patient a false sense of security that everything is fine when it may not be.  These tools have been developed over the last 150 years and have been indispensable in protecting the vision and saving the lives of millions of people.