Clinical Research In Ophthalmology Research Articles

Clinical research in ophthalmology: Medical prerequisites

The shortage of principal investigators is increasingly constricting the rising demand for clinical trials in Germany. This is partly because clinical trials training is outside the field of ophthalmology but another issue is that clinical trials research often has to be performed on top of the regular workload. Medical personnel in university ophthalmology departments can be motivated for clinical trials research by means of only a few structural improvements. Long-term commitment could be improved through new career tracks in the field of clinical trials. The broad adoption of these proposals could convey sustainable growth of clinical ophthalmological research in German.

Therapies for Neovascular Age-Related Macular Degeneration: Current Approaches and Pharmacologic Agents in Development

As one of the leading causes of blindness, age-related macular degeneration (AMD) has remained at the epicenter of clinical research in ophthalmology. During the past decade, focus of researchers has ranged from understanding the role of vascular endothelial growth factor (VEGF) in the angiogenic cascades to developing new therapies for retinal vascular diseases. Anti-VEGF agents such as ranibizumab and aflibercept are becoming increasingly well-established therapies and have replaced earlier approaches such as laser photocoagulation or photodynamic therapy. Many other new therapeutic agents, which are in the early phase clinical trials, have shown promising results. The purpose of this paper is to briefly review the available treatment modalities for neovascular AMD and then focus on promising new therapies that are currently in various stages of development.

Adaptive optics technology for high-resolution retinal imaging.

Adaptive optics (AO) is a technology used to improve the performance of optical systems by reducing the effects of optical aberrations. The direct visualization of the photoreceptor cells, capillaries and nerve fiber bundles represents the major benefit of adding AO to retinal imaging. Adaptive optics is opening a new frontier for clinical research in ophthalmology, providing new information on the early pathological changes of the retinal microstructures in various retinal diseases. We have reviewed AO technology for retinal imaging, providing information on the core components of an AO retinal camera. The most commonly used wavefront sensing and correcting elements are discussed. Furthermore, we discuss current applications of AO imaging to a population of healthy adults and to the most frequent causes of blindness, including diabetic retinopathy, age-related macular degeneration and glaucoma. We conclude our work with a discussion on future clinical prospects for AO retinal imaging.

Innovation and application are vital for translational research in ophthalmology

Although the resource devoted for scientific research increased substantially in recent years, the quality of our basic and clinical study still leaves much to be improved. Besides the shortcomings in administration of research funding, our researchers, as the entity of scientific work, should fully recognize that innovation and application are vital for basic and clinical research in ophthalmology. It is emphasized that the principles and methods in an innovative study, including comprehensive grasp for up-to-date information, proposal of a key project, collaboration of multi-disciplines, through design of a study, and acceleration of application in practice, should be followed in order to make new advances in our cause in ophthalmology.

Developing an international network for clinical research in ophthalmology: the European Vision Institute Clinical Research Network (EVICR.net)

There is a well-identified need for patient-oriented clinical research and this can only be achieved by creating active collaboration between academic centers with competence for clinical research, following GCP guidelines and supported by an infrastructure that provides appropriate management of clinical trials at a realistic cost. The European Vision Institute Clinical Research Network (EVICR.net) is a legal entity established as an independent European Economic Interest Grouping in accordance with the Council Regulation (EEC) #2137/85 and was built and developed to function as the necessary structure to perform clinical research in ophthalmology in the EU according to ICH GCP Guidelines and European Directives.

Beitrag Sloweniens zur Forschung in der Ophthalmologie (1991 - 2009)

The purpose of our study was to evaluate Slovenia's contribution to research in ophthalmology over a period of 18 years (1991 - 2009) including not only ophthalmologists but also other researchers. The aim of the study was to determine the relative contribution, quantitatively and qualitatively, to research in ophthalmology and to determine the trend over the period. The first authors as well as their institutes were evaluated. A bibliometric analysis was performed using the database of the Institute for Scientific Information (ISI) 2007 report. All articles published in the top 45 ophthalmology journals listed in the ISI 2007 report were analysed. A total of 187 170 articles have been published in these journals in the given period of time. Slovenia's ophthalmologists and other researchers published 75 articles or 0.040 % of all publications. The articles were published in 21 of the 45 listed journals. Two were excluded from the study because they were only abstracts. In 8 articles the first author was not a Slovenian ophthalmologist. At the end, 65 articles remained in the study. 22 different Slovenian ophthalmologists were found as first author among these journals. Comparing ophthalmologists and other researchers, ophthalmologists produced 57 from 65 articles or 87.69 %. 13 from 22 ophthalmologists had published only one paper, accounting for 22.8 % (13 of 57) of total first authors. There were 47 articles with one or more co-authors (82.5 %) and 10 papers with a single author, which represent 17.5 % of total papers. There was only one first author who issued more than 10 articles (13 from 57 or 22.8 %). All the contribution came from two university clinical centres, Ljubljana (27 articles or 47.37 %) and Maribor (30 articles or 52.63 %). Three authors contributed to 45.6 % of all papers. Two-thirds of articles were published in English and one-third in German language. Although the number of articles published by Slovenia's ophthalmologists is increasing over the last 8 years there is a need to increase the quality and quantity of clinical research in ophthalmology and to involve more ophthalmologists in research work to support these trends.

Adhesion mechanisms of human lens epithelial cells on 4 intraocular lens materials

Purpose: To evaluate lens epithelial cell (LEC) adhesion on different intraocular lens (IOL) materials with particular attention to the distribution of proteins located in the focal contacts. Setting: Center of Biotechnological and Clinical Research in Ophthalmology, University of Bologna, Italy. Methods: The IOL materials tested were poly(methyl methacrylate) (PMMA), heparin surface-modified PMMA (HSM PMMA, polyHEMA, and silicone. Primary cultures of human LECs were established from human anterior capsules obtained during cataract surgery. The mean number of cells attached per square millimeter was calculated for each material after 24 and 72 hours. Transmission electron microscopy and immunocytochemical analysis were performed to detect the proteins actin, vinculin, and talin. Results: Mean adhesiveness of human LECs increased over time with PMMA and decreased with the other materials. At 72 hours, mean LECs ranged from 54.8 cells/mm 2 ± 12.8 (SD) on PMMA to 2.1 ± 0.7 cells/mm 2 on silicone. The means for HSM PMMA and polyHEMA fell in between. The cytoskeletal proteins were arranged to produce focal contacts in only the LECs cultured on PMMA. The LECs cultured on polyHEMA, HSM PMMA, and silicone attached but failed to develop focal contacts or stress fibers. Conclusion: This study confirms the multifactorial pathogenesis of posterior capsule opacification and suggests its incidence will be reduced by improving surgical techniques and using IOL surfaces that discourage cell adhesion.

Outcomes of Eye Care From Medicare Data

Clinical research in ophthalmology has increasingly shifted from isolated case reports and retrospective analyses of case series to randomized prospective trials and cross-sectional population-based studies of eye disease, enabling investigators to draw broadly applicable inferences about treatment, disease prevalence, and risk factors. Because clinical trials and population-based studies consume considerable scarce research resources in terms of research funds, personnel, and space, they are appropriately employed only to answer questions of major interest that cannot be answered through other means. In proper circumstances, the implementation of recommendations resulting from multicenter trials can generate positive economic and clinical outcomes. 1,2 See also p 1085. Study of the outcomes and effectiveness of medical care (so-called outcomes research) based on insurance databases and similar secondary sources shows promise for studying issues not practically addressed by clinical trials and population-based studies. At comparatively lower cost and research resource consumption, outcomes research can provide an overview