3-year outcomes of clinical trial of collagen crosslinking treatment for keratoconus highlighted at American Academy of Ophthalmology 2011 Annual Meeting

		IMAGE:The cornea is normally rounded, but with keratoconus, may bulge and become cone-shaped. Click here for more information.

ORLANDO, Fla. – October 24, 2011 – Patients in the United States who have the cornea-damaging disease keratoconus may soon be able to benefit from a new treatment that is already proving effective in Europe and other parts of the world. The treatment, called collagen crosslinking, improved vision in almost 70 percent of patients treated for keratoconus in a recent three-year clinical trial in Milan, Italy. The treatment is in clinical trials in the United States and is likely to receive FDA approval in 2012. The results of the Milan study are being presented today at the 115th Annual Meeting of the American Academy of Ophthalmology in Orlando, Florida.

In a session titled Long-term Results of Corneal Crosslinking for Keratoconus, Paolo Vinciguerra, MD will describe the treatment and three-year follow up of more than 250 keratoconus patients who received collagen crosslinking at his clinic. Sixty-eight percent of the 500 eyes treated gained significant visual acuity, with their results remaining stable at the end of the follow-up period. Patients over age 18 were most likely to improve.

In the collagen crosslinking procedure, riboflavin (vitamin B) is applied to the cornea, which is then exposed to a specific form of ultraviolet light. Collagen fibers regenerate with new bonds forming between them, increasing corneal stiffness and strength. The treatment also combats the causes of keratoconus, reducing the chance that it will recur. The rest of the eye receives only minimal UV exposure during treatment. Dr. Vinciguerra's new study confirms that adverse effects are rare. Previous research by his team indicated no loss of corneal endothelial cell, a measurement used to assess the safety of corneal treatments, in patients who received collagen crosslinking.

"For many people with keratoconus, collagen crosslinking can provide a better and more permanent solution to their vision problems," said Dr. Vinciguerra. "Given that no current treatment in use in the U.S. offers permanent correction, this effective option represents a significant advance for corneal medicine."

One in 2,000 people in the United States and worldwide are diagnosed with keratoconus, a disease that damages the collagen fibers that form the structure of the cornea, which is the outer surface of the eye. The cornea's crucial task is to focus, or "refract," incoming light toward the eye's lens. To perform properly, the cornea needs to be rounded, like the surface of a ball. As keratoconus worsens and the cornea becomes thinner, it may bulge outward in a cone shape, causing nearsightedness and/or astigmatism, making clear vision impossible. As the number of fibers and links between them decline, the cornea loses up to 50 percent of its normal stiffness.

Standard treatments in the U.S., such as specialized eyeglasses, contact lenses, or implanted lenses, cannot permanently correct keratoconus, and none of these treatments address the underlying causes. Severe keratoconus often requires corneal transplant.

The 115th Annual Meeting of the American Academy of Ophthalmology is in session October 23 through 25 at the Orange County Convention Center in Orlando, Fla. It is the world's largest, most comprehensive ophthalmic education conference. Approximately 25,000 attendees and more than 500 companies gather each year to showcase the latest in ophthalmic technology, products and services. To learn more about the place Where All of Ophthalmology Meets, visit www.aao.org/annual_meeting.

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The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons — Eye M.D.s — with more than 30,000 members worldwide. Eye health care is provided by the three "O's" – ophthalmologists, optometrists, and opticians. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases, infections and injuries, and perform eye surgery. For more information, visit www.aao.org. The Academy's EyeSmart® public education program works to educate the public about the importance of eye health and to empower them to preserve their healthy vision, by providing the most trusted and medically accurate information about eye diseases, conditions and injuries. Visit www.geteyesmart.org to learn more.

Researcher recommends changes to free screening programs

COLUMBIA, Mo.– Women living in rural areas face unique challenges concerning health and wellness issues. Now, an MU researcher has found that rural women are more likely than women living in cities to be diagnosed with late-stage breast cancer, the most severe form of the disease.

"The stage at which the cancer is diagnosed has a tremendous impact on the type of treatment, recovery and survivability," said Faustine Williams, a doctoral student in the Department of Rural Sociology in the College of Agriculture, Food and Natural Resources. "Finding ways to identify and treat breast cancer sooner are keys to increasing survivability."

Williams found that women who travel 50 to 75 miles to a healthcare facility are 10 percent more likely to be diagnosed with late-stage breast cancer. She says women in rural areas are less likely to seek preventative treatment and testing due to the high cost and time necessary. Identifying breast cancer earlier increases survival rates.

Many states offer free breast cancer screening programs; however, programs can be improved to better serve women in rural areas. In Missouri, Williams recommends changes to the Show Me Healthy Women (SMHW) program, a free breast and cervical cancer screening program for Missourians. To receive a free screening, women must meet certain age, income and insurance guidelines. Although there are 180 facilities throughout the state, they are unevenly distributed. Several rural counties do not have a single facility. Williams recommends that programs like SMHW make facilities more accessible to women in rural areas.

"In some cases women in rural areas must spend an entire day seeking routine medical treatment," Williams said. "By strategically placing health screening facilities in poor and rural areas, women would have better access to health care and it would increase the likelihood that rural women would seek medical care and be diagnosed with breast cancer earlier."

Williams analyzed data from the Missouri Information for Community Assessment in her study. She used mapping software to pinpoint the locations of patients diagnosed with each stage of breast cancer, as well as the nearest screening facility. Then, she calculated the distances from patients with each cancer stage to the nearest screening facilities.

In Missouri, eight of the top 10 counties for late-stage breast cancer incidences are considered rural counties by the United States Office of Management and Budget. Of the 55,182 female breast cancer cases reported in Missouri between 1996 and 2007, 17,093, or 31 percent, were diagnosed as late-stage cancer.

Williams presented her research at the Community Development Society and Rural Sociological Society Joint Annual Meetings in Boise, Idaho.