Visual field loss involving the nasal area is the most common pattern in the early stage of chronic angle-closure glaucoma (CACG), according to a prospective, consecutive observational case series by Taiwan's National Yang-Ming University School of Medicine. Results showed that the mean deviation of the nasal area was worse than those of the arcuate and the paracentral areas within the same hemifield in mild, moderate and severe groups of CACG patients.

Some 146 Asian patients with well-controlled CACG were included in the study. Researchers performed visual field tests using program 24-2 of the Humphrey Field Analyzer (Humphrey Instruments) with the Swedish interactive thresholding algorithm standard. They scored 110 eligible visual fields with the system adopted by the Advanced Glaucoma Intervention Study and categorized them accordingly into four groups: Group 1, mild CACG; Group 2, moderate CACG; Group 3, severe CACG; and Group 4, end-stage CACG. Each hemifield was divided into the nasal, paracentral and arcuate areas, and researchers defined field loss that involved respective areas as nasal step, paracentral scotoma and arcuate scotoma. They evaluated the distribution of field defect patterns in each group and compared mean deviation among the three areas within one hemifield and between each pair of corresponding areas across the median raphe.

In Group 1, the nasal area was the most commonly damaged area, noted in 52 percent of eyes in the superior hemifield and 58 percent of eyes in the inferior hemifield. In Group 2, field loss involving both the nasal and arcuate areas dominated the superior hemifield, whereas field loss involving all three areas dominated the inferior hemifield. The mean deviation of the nasal area was worst among the three areas in each hemifield of Groups 1 and 2, as well as in the inferior hemifield of the Group 3. No significant differences were evident in the mean deviation of each area between the superior hemifield and their inferior counterparts; however, the superior hemifield as a whole showed a better mean deviation than the inferior hemifield in Group 1.

• ALCON LAUNCHES NEW TRIALS OF RETAANE. Alcon, Inc. will initiate two new Phase III studies of Retaane (anecortave acetate for depot suspension) for treatment of age-related macular degeneration (AMD). The new trials will evaluate the safety and efficacy of treatment every six months with the depot suspension of the investigational drug versus placebo, in patients with advanced dry AMD who are at risk of progressing to wet AMD. After the enrollment period, scheduled to begin in January 2004, the four-year studies will include approximately 2,500 patients at 100 sites worldwide. The FDA has assigned "fast track" status to Retaane, since the drug represents a significant unmet medical need for a serious condition. Anecortave acetate is a member of a class of compounds known as angiostatic cortisenes; it works by slowing or stopping new blood vessel growth in AMD so that less leakage and retinal damage occurs. Retaane is currently in clinical trials evaluating its safety and efficacy in treating patients with wet AMD; a recently completed two-year study in such patients showed that treatment with a Retaane 15-mg Depot every six months inhibited all aspects of choroidal neovascularization lesion growth.

• PHASE II/III CLINICAL TRIALS: SURGICAL IMPLANT FOR UNTREATABLE AMD. VisionCare Ophthalmic Technologies, Inc., has completed patient enrollment for a Phase II/III clinical trial of its recently developed Wide Angle Implantable Miniature Telescope (WA IMT) for patients with untreatable late-stage age-related macular degeneration (AMD). The company's IMT-002 trial will assess the safety and efficacy of the device in individuals with moderate to severe bilateral central vision impairment associated with late-stage dry or scar-stage wet AMD, or Stargardt's macular dystrophy. The WA IMT, which is smaller than a pea, is implanted in one eye in an outpatient surgical procedure. In the implanted eye, the WA IMT renders enlarged central vision images over a wide area of the retina to improve central vision, while the non-operated eye provides peripheral vision for navigation. The trial is being conducted at 28 ophthalmic centers throughout the United States. More than 200 study patients with late-stage AMD have met the trial criteria. Patients will be followed up one year for efficacy (visual acuity) and an additional year for safety. For more information on the WA IMT, go to www.visioncareinc.net.
  

• B&L, OASIS MEDICAL SETTLEMENT PATENT INFRINGEMENT SUIT. Bausch & Lomb and Oasis Medical, Inc., have agreed to settle a patent infringement lawsuit involving blades used in pivoting microkeratomes. The agreement resolves the lawsuit that B&L filed against Oasis in October 2000 in the Los Angeles U.S. District Court. The settlement terms acknowledge the validity and infringement of the B&L patent and include an agreement by Oasis to stop manufacturing and selling blades for the B&L Hansatome microkeratome. They also include an agreement by B&L to license its patented technology to Oasis to manufacture pivoting microkeratome blade assemblies for microkeratomes not owned by B&L. In exchange for other financial consideration, B&L will acquire the Oasis microkeratome blade patent granted on April 1, 2003, and it will license the Oasis proprietary manufacturing technology for microkeratome blades. Under the settlement agreement, both parties will provide no further details regarding the lawsuit.

• NEW TRANSNASAL LACRIMAL STENT IMPROVES DCR SUCCESS RATE. FCI Ophthalmics, Inc., has introduced a new Transnasal Lacrimal Stent that addresses the limitations previously encountered with balloon catheter dacryocystorhinostomy (DCR) and other forms of endoscopic DCR. The new stent is brought into position through the nose; because the physician does not need to pass the very large diameter end of the stent through the canaliculus, it can have a much greater diameter than a tube placed in the traditional fashion. The designer of the stent, Bruce B. Becker, MD, believes that the larger stent results in an ostium of larger diameter and may thus boost the success rate of balloon catheter or endoscopic DCR. The Transnasal Lacrimal Stent requires no external incision as an external DCR would, and has recently been approved for marketing by the FDA. For more information, call 800-932-4202.