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John Hasenkam...
Posted: Thu May 15, 2008 10:36 pm
Guest
"Mike Tyner" <mtyner at (no spam) mindspring.com> wrote in message
news:Ce-dnRu6CrIgG7HVnZ2dnUVZ_trinZ2d at (no spam) giganews.com...
Quote:

"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote

Mike T., if you would be so kind, I would appreciate your opinion on this
wild idea!

You didn't say specifically that your diplopia was monocular. If that's
what you mean then yes, it's certainly reasonable to try a sleep mask.

Definitely monocular. I can sympathise with Ray because when I was dealing
with this problem it proved to be very frustrating. The visual distortion
became so severe at times I markedly reduced my driving and I couldn't work
for a long time. I have resolved this problem but am stuck with visual
confusion, sometimes my brain, particularly when driving, won't resolve the
image. Makes for some interesting driving. I have residual binocular vision,
strabimus and amblyopia, ptosis in my good idea, optic nerve damage in my
bad eye from surgery. My visual acuity in my good eye remains very strong,
even as I approach 50 years of age, that is probably a legacy of many years
of post surgical visual therapy *when I was very young(4-7 years)*, just
young enough to boost VI function perhaps. I still don't need reading
glasses but do have v. slight fluctuating myopia. I am an ophthalmologist's
nightmare, which probably explains so many have tried to hurry me out the
door ... .

Thanks Mike.



Quote:
Monocular diplopia can arise from the cornea, where dips and peaks form
images that aren't exactly coaxial. It can also arise from the lens, where
wedge-shaped areas degrade and their refractive index changes and those
areas start to form independent images.

As you might imagine, in the first case, corneal molding and surface
distortions could be affected by a sleep mask. In the second case,
changing the cornea will have no real effect.

Fuch's dystrophy doesn't usually cause topographical changes in the cornea
without real pain. Ray hasn't described any pain and AFAIK has never had
corneal erosions.

That, and his age, lead me to suspect that his diplopia is lenticular. If
he put on a gas-perm contact lens and the diplopia remained, we could be
sure that it's lenticular and would be "cured" by cataract surgery. OTOH,
if it's corneal, it will disappear with a rigid contact lens. This isn't
worth the trouble unless they're considering surgery or other major
treatment.

-MT


"ray" <spammers at (no spam) do.not.reply.com> wrote in message
news:nifo24tr0orbhlfduttg76a42ld9k33nn0 at (no spam) 4ax.com...
On Wed, 14 May 2008 19:04:44 -0700, "Don W" <dwilgus at (no spam) prodigy.net
wrote:

multiple images I do not have.


Don W...
Posted: Fri May 16, 2008 12:43 am
Guest
John,

Like "in my good idea".

Don W.
John Hasenkam...
Posted: Fri May 16, 2008 1:18 am
Guest
I vaguely remember you Don. Were you the one involved in a discussion about
Stargardts? If so, I hope your treatment for AMD(?) is helping.

Nah, that was a typo, rushing too much but I am a terrible proof reader and
I hate reading spreadsheets!


"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:ka9Xj.2303$hJ5.1256 at (no spam) nlpi068.nbdc.sbc.com...
Quote:
John,

Like "in my good idea".

Don W.

Don W...
Posted: Fri May 16, 2008 11:38 am
Guest
John, what is this "vaguely" stuff?? Yup, it was me, but it was about
tossing zinc into some equation. Understand about typo's, but have adopted
it! Hope, besides everything else, you are doing ok, status quo on this
end.

Don W.


"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote in message
news:AKOdnQnNJLM-u7DVnZ2dnUVZ_gWdnZ2d at (no spam) westnet.com.au...
Quote:
I vaguely remember you Don. Were you the one involved in a discussion about
Stargardts? If so, I hope your treatment for AMD(?) is helping.

Nah, that was a typo, rushing too much but I am a terrible proof reader
and I hate reading spreadsheets!


"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:ka9Xj.2303$hJ5.1256 at (no spam) nlpi068.nbdc.sbc.com...
John,

Like "in my good idea".

Don W.



John Hasenkam...
Posted: Fri May 16, 2008 10:46 pm
Guest
Don,

I think during our prior discussion I mentioned the below but just in case.
This seems to be a promising approach and I hope there have been some follow
up studies on this:

Ophthalmologica. 2005 May-Jun;219(3):154-66.Click here to

Improvement of visual functions and fundus alterations in early age-related
macular degeneration treated with a combination of acetyl-L-carnitine, n-3
fatty acids, and coenzyme Q10.



The aim of this randomized, double-blind, placebo-controlled clinical trial
was to determine the efficacy of a combination of acetyl-L-carnitine, n-3
fatty acids, and coenzyme Q10 (Phototrop) on the visual functions and fundus
alterations in early age-related macular degeneration (AMD). One hundred and
six patients with a clinical diagnosis of early AMD were randomized to the
treated or control groups. The primary efficacy variable was the change in
the visual field mean defect (VFMD) from baseline to 12 months of treatment,
with secondary efficacy parameters: visual acuity (Snellen chart and ETDRS
chart), foveal sensitivity as measured by perimetry, and fundus alterations
as evaluated according to the criteria of the International Classification
and Grading System for AMD. The mean change in all four parameters of visual
functions showed significant improvement in the treated group by the end of
the study period. In addition, in the treated group only 1 out of 48 cases
(2%) while in the placebo group 9 out of 53 (17%) showed clinically
significant (>2.0 dB) worsening in VFMD (p = 0.006, odds ratio: 10.93).
Decrease in drusen-covered area of treated eyes was also statistically
significant as compared to placebo when either the most affected eyes (p =
0.045) or the less affected eyes (p = 0.017) were considered. These findings
strongly suggested that an appropriate combination of compounds which affect
mitochondrial lipid metabolism, may improve and subsequently stabilize
visual functions, and it may also improve fundus alterations in patients
affected by early AMD.

PMID: 15947501 [PubMed - indexed for MEDLINE]

"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:pMiXj.1068$BL6.776 at (no spam) nlpi070.nbdc.sbc.com...
Quote:
John, what is this "vaguely" stuff?? Yup, it was me, but it was about
tossing zinc into some equation. Understand about typo's, but have
adopted it! Hope, besides everything else, you are doing ok, status quo
on this end.

Don W.


"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote in message
news:AKOdnQnNJLM-u7DVnZ2dnUVZ_gWdnZ2d at (no spam) westnet.com.au...
I vaguely remember you Don. Were you the one involved in a discussion
about Stargardts? If so, I hope your treatment for AMD(?) is helping.

Nah, that was a typo, rushing too much but I am a terrible proof reader
and I hate reading spreadsheets!


"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:ka9Xj.2303$hJ5.1256 at (no spam) nlpi068.nbdc.sbc.com...
John,

Like "in my good idea".

Don W.





John Hasenkam...
Posted: Sat May 17, 2008 7:37 am
Guest
Don,

Decided to see if there were any follow ups: again good results. Given the
high safety profile of these compounds I think anyone with AMD should think
seriously about these findings. Ask your doctor. Any bods here who would
care to give an opinion? Second abstract from BMC ophthalamo, freely
available. Go to pubmed, key in PMID number, follow links on right hand
side.

I still don't understand why they don't add R Lipoic Acid to the mix. To
understand why look up Professor Ames at www.juvenon.com. CF. PNAS, Feb
19,2002,

Feeding acetyl-L-carnitine and lipoic acid to old rats

significantly improves metabolic function while

decreasing oxidative stress


Thanks,


John.


[Metabolic therapy for early treatment of age-related macular degeneration]

[Article in Hungarian]



Currently, age-related macular degeneration is one of the most common eye
diseases causing severe and permanent loss of vision. This disease is
estimated to affect approximately 300-500 thousand Hungarians. While earlier
no treatment was available, in the recent decade an antioxidant therapy
became very popular using combinations of high dosage antioxidant vitamins
C, E, beta carotene and zinc. Based on theoretical concepts and mostly in
vitro experiences, this combination was thought to be effective through
neutralizing reactive oxygen species. According to a large clinical trial
(AREDS) it reduced progression of intermediate state disease to advanced
state, but did not influence early disease. This original combination, due
to potential severe side effects, is not on the market anymore. However, the
efficacy of modified formulas has not been proved yet. Recently, the
metabolic therapy, a combination of omega-3 fatty acids, coenzyme Q10 and
acetyl-L-carnitine has been introduced for treating early age-related
macular degeneration through improving mitochondrial dysfunction,
specifically improving lipid metabolism and ATP production in the retinal
pigment epithelium, improving photoreceptor turnover and reducing generation
of reactive oxygen species. According to a pilot study and a randomized,
placebo-controlled, double blind clinical trial, both central visual field
and visual acuity slightly improved after 3-6 months of treatment and they
remained unchanged by the end of the study. The difference was statistically
significant as compared to the base line or to controls. These functional
changes were accompanied by an improvement in fundus alterations: drusen
covered area decreased significantly as compared to the base line or to
control. Characteristically, all these changes were more marked in less
affected eyes. A prospective case study on long-term treatment confirmed
these observations. With an exception that after slight improvement, visual
functions remained stable, drusen regression continued for years. Sometimes
significant regression of drusen was found even in intermediate and advanced
cases. All these findings strongly suggested that the metabolic therapy may
be the first choice for treating age-related macular degeneration.
Currently, this is the only combination of ingredients corresponding to the
recommended daily allowance, and at the same time, which showed clinically
proved efficacy.

PMID: 18039616 [PubMed - indexed for MEDLINE]


TOZAL Study: an open case control study of an oral antioxidant and omega-3
supplement for dry AMD.

Vitreo-Retinal Associates of New Jersey, Ridgewood, New Jersey 07450, USA.
franciscangemi at (no spam) aol.com

BACKGROUND: The primary objective of this prospective study was to measure
the change from baseline in visual function--Best-Corrected Visual Acuity
(BCVA) via the Early Treatment Diabetic Retinopathy Study (ETDRS) chart,
contrast sensitivity, central 10 degree visual fields and retinal imaging
(angiograms and photographs) at 6 months in subjects with atrophic (dry)
age-related macular degeneration treated with a targeted nutritional
supplement. METHODS: 37 mixed gender patients with a mean age of 76.3 +/-
7.8 years were enrolled at 5 independent study sites and received standard
of care with a novel formulation of a nutritional supplement. Results were
compared to a placebo cohort constructed from the literature that was
matched for inclusion and exclusion criteria. A paired t-test was used to
test a null hypothesis and a two-sided alpha level of 0.05 was used to
determine statistical significance. RESULTS: 76.7% of subjects receiving the
nutritional supplement demonstrated stabilization or improvement of BCVA at
6 months. Subjects gained an average of 0.0541 logMAR or one-half of a line
of visual acuity (VA) over the 6-month period. There was a statistically
significant improvement in VA from baseline with P = .045. The results
provide strong evidence that the treatment being studied produces an
improvement in VA. CONCLUSION: Treatment with this unique nutritional
supplement increased VA above the expected baseline decrease in the majority
of patients in this population with dry macular degeneration. The results of
the TOZAL study agree with the LAST and CARMIS studies and are predictive
for positive visual acuity outcomes in the AREDS II trial. However, patients
will likely require supplementation for longer than 6 months to effect
changes in additional visual parameters.

PMID: 17324285 [PubMed - indexed for MEDLINE]


"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote in message
news:pPqdnWVey-UaybPVnZ2dnUVZ_gadnZ2d at (no spam) westnet.com.au...
Quote:
Don,

I think during our prior discussion I mentioned the below but just in
case. This seems to be a promising approach and I hope there have been
some follow up studies on this:

Ophthalmologica. 2005 May-Jun;219(3):154-66.Click here to

Improvement of visual functions and fundus alterations in early
age-related macular degeneration treated with a combination of
acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10.



The aim of this randomized, double-blind, placebo-controlled clinical
trial was to determine the efficacy of a combination of
acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10 (Phototrop) on the
visual functions and fundus alterations in early age-related macular
degeneration (AMD). One hundred and six patients with a clinical diagnosis
of early AMD were randomized to the treated or control groups. The primary
efficacy variable was the change in the visual field mean defect (VFMD)
from baseline to 12 months of treatment, with secondary efficacy
parameters: visual acuity (Snellen chart and ETDRS chart), foveal
sensitivity as measured by perimetry, and fundus alterations as evaluated
according to the criteria of the International Classification and Grading
System for AMD. The mean change in all four parameters of visual functions
showed significant improvement in the treated group by the end of the
study period. In addition, in the treated group only 1 out of 48 cases
(2%) while in the placebo group 9 out of 53 (17%) showed clinically
significant (>2.0 dB) worsening in VFMD (p = 0.006, odds ratio: 10.93).
Decrease in drusen-covered area of treated eyes was also statistically
significant as compared to placebo when either the most affected eyes (p =
0.045) or the less affected eyes (p = 0.017) were considered. These
findings strongly suggested that an appropriate combination of compounds
which affect mitochondrial lipid metabolism, may improve and subsequently
stabilize visual functions, and it may also improve fundus alterations in
patients affected by early AMD.

PMID: 15947501 [PubMed - indexed for MEDLINE]

"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:pMiXj.1068$BL6.776 at (no spam) nlpi070.nbdc.sbc.com...
John, what is this "vaguely" stuff?? Yup, it was me, but it was about
tossing zinc into some equation. Understand about typo's, but have
adopted it! Hope, besides everything else, you are doing ok, status quo
on this end.

Don W.


"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote in message
news:AKOdnQnNJLM-u7DVnZ2dnUVZ_gWdnZ2d at (no spam) westnet.com.au...
I vaguely remember you Don. Were you the one involved in a discussion
about Stargardts? If so, I hope your treatment for AMD(?) is helping.

Nah, that was a typo, rushing too much but I am a terrible proof reader
and I hate reading spreadsheets!


"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:ka9Xj.2303$hJ5.1256 at (no spam) nlpi068.nbdc.sbc.com...
John,

Like "in my good idea".

Don W.







Don W...
Posted: Sat May 17, 2008 12:17 pm
Guest
John,

Got your references. Will digest.

I did get a big kick out of "0.0541 logMAR" for being the results of that
one study. I think that is well within the variance of one patient
successively reading the chart.

Lutein is not mentioned. I do know there is some effort to show increases
in macular pigment density by ingestion of this. But.... they don't carry
it forward to show changes in visual acuity, far as I can see (hmmm).

Thanks, good luck to you in everything.

Don W.

PS. Yeah, I do get the freebies of off BJO. Am registered. Nice of them.

****


"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote in message
news:UvednSBXottFSLPVnZ2dnUVZ_vWdnZ2d at (no spam) westnet.com.au...
Quote:
Don,

Decided to see if there were any follow ups: again good results. Given the
high safety profile of these compounds I think anyone with AMD should
think seriously about these findings. Ask your doctor. Any bods here who
would care to give an opinion? Second abstract from BMC ophthalamo, freely
available. Go to pubmed, key in PMID number, follow links on right hand
side.

I still don't understand why they don't add R Lipoic Acid to the mix. To
understand why look up Professor Ames at www.juvenon.com. CF. PNAS, Feb
19,2002,

Feeding acetyl-L-carnitine and lipoic acid to old rats

significantly improves metabolic function while

decreasing oxidative stress


Thanks,


John.


[Metabolic therapy for early treatment of age-related macular
degeneration]

[Article in Hungarian]



Currently, age-related macular degeneration is one of the most common eye
diseases causing severe and permanent loss of vision. This disease is
estimated to affect approximately 300-500 thousand Hungarians. While
earlier no treatment was available, in the recent decade an antioxidant
therapy became very popular using combinations of high dosage antioxidant
vitamins C, E, beta carotene and zinc. Based on theoretical concepts and
mostly in vitro experiences, this combination was thought to be effective
through neutralizing reactive oxygen species. According to a large
clinical trial (AREDS) it reduced progression of intermediate state
disease to advanced state, but did not influence early disease. This
original combination, due to potential severe side effects, is not on the
market anymore. However, the efficacy of modified formulas has not been
proved yet. Recently, the metabolic therapy, a combination of omega-3
fatty acids, coenzyme Q10 and acetyl-L-carnitine has been introduced for
treating early age-related macular degeneration through improving
mitochondrial dysfunction, specifically improving lipid metabolism and ATP
production in the retinal pigment epithelium, improving photoreceptor
turnover and reducing generation of reactive oxygen species. According to
a pilot study and a randomized, placebo-controlled, double blind clinical
trial, both central visual field and visual acuity slightly improved after
3-6 months of treatment and they remained unchanged by the end of the
study. The difference was statistically significant as compared to the
base line or to controls. These functional changes were accompanied by an
improvement in fundus alterations: drusen covered area decreased
significantly as compared to the base line or to control.
Characteristically, all these changes were more marked in less affected
eyes. A prospective case study on long-term treatment confirmed these
observations. With an exception that after slight improvement, visual
functions remained stable, drusen regression continued for years.
Sometimes significant regression of drusen was found even in intermediate
and advanced cases. All these findings strongly suggested that the
metabolic therapy may be the first choice for treating age-related macular
degeneration. Currently, this is the only combination of ingredients
corresponding to the recommended daily allowance, and at the same time,
which showed clinically proved efficacy.

PMID: 18039616 [PubMed - indexed for MEDLINE]


TOZAL Study: an open case control study of an oral antioxidant and omega-3
supplement for dry AMD.

Vitreo-Retinal Associates of New Jersey, Ridgewood, New Jersey 07450, USA.
franciscangemi at (no spam) aol.com

BACKGROUND: The primary objective of this prospective study was to measure
the change from baseline in visual function--Best-Corrected Visual Acuity
(BCVA) via the Early Treatment Diabetic Retinopathy Study (ETDRS) chart,
contrast sensitivity, central 10 degree visual fields and retinal imaging
(angiograms and photographs) at 6 months in subjects with atrophic (dry)
age-related macular degeneration treated with a targeted nutritional
supplement. METHODS: 37 mixed gender patients with a mean age of 76.3 +/-
7.8 years were enrolled at 5 independent study sites and received standard
of care with a novel formulation of a nutritional supplement. Results were
compared to a placebo cohort constructed from the literature that was
matched for inclusion and exclusion criteria. A paired t-test was used to
test a null hypothesis and a two-sided alpha level of 0.05 was used to
determine statistical significance. RESULTS: 76.7% of subjects receiving
the nutritional supplement demonstrated stabilization or improvement of
BCVA at 6 months. Subjects gained an average of 0.0541 logMAR or one-half
of a line of visual acuity (VA) over the 6-month period. There was a
statistically significant improvement in VA from baseline with P = .045.
The results provide strong evidence that the treatment being studied
produces an improvement in VA. CONCLUSION: Treatment with this unique
nutritional supplement increased VA above the expected baseline decrease
in the majority of patients in this population with dry macular
degeneration. The results of the TOZAL study agree with the LAST and
CARMIS studies and are predictive for positive visual acuity outcomes in
the AREDS II trial. However, patients will likely require supplementation
for longer than 6 months to effect changes in additional visual
parameters.

PMID: 17324285 [PubMed - indexed for MEDLINE]


"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote in message
news:pPqdnWVey-UaybPVnZ2dnUVZ_gadnZ2d at (no spam) westnet.com.au...
Don,

I think during our prior discussion I mentioned the below but just in
case. This seems to be a promising approach and I hope there have been
some follow up studies on this:

Ophthalmologica. 2005 May-Jun;219(3):154-66.Click here to

Improvement of visual functions and fundus alterations in early
age-related macular degeneration treated with a combination of
acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10.



The aim of this randomized, double-blind, placebo-controlled clinical
trial was to determine the efficacy of a combination of
acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10 (Phototrop) on the
visual functions and fundus alterations in early age-related macular
degeneration (AMD). One hundred and six patients with a clinical
diagnosis of early AMD were randomized to the treated or control groups.
The primary efficacy variable was the change in the visual field mean
defect (VFMD) from baseline to 12 months of treatment, with secondary
efficacy parameters: visual acuity (Snellen chart and ETDRS chart),
foveal sensitivity as measured by perimetry, and fundus alterations as
evaluated according to the criteria of the International Classification
and Grading System for AMD. The mean change in all four parameters of
visual functions showed significant improvement in the treated group by
the end of the study period. In addition, in the treated group only 1 out
of 48 cases (2%) while in the placebo group 9 out of 53 (17%) showed
clinically significant (>2.0 dB) worsening in VFMD (p = 0.006, odds
ratio: 10.93). Decrease in drusen-covered area of treated eyes was also
statistically significant as compared to placebo when either the most
affected eyes (p = 0.045) or the less affected eyes (p = 0.017) were
considered. These findings strongly suggested that an appropriate
combination of compounds which affect mitochondrial lipid metabolism, may
improve and subsequently stabilize visual functions, and it may also
improve fundus alterations in patients affected by early AMD.

PMID: 15947501 [PubMed - indexed for MEDLINE]

"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:pMiXj.1068$BL6.776 at (no spam) nlpi070.nbdc.sbc.com...
John, what is this "vaguely" stuff?? Yup, it was me, but it was about
tossing zinc into some equation. Understand about typo's, but have
adopted it! Hope, besides everything else, you are doing ok, status quo
on this end.

Don W.


"John Hasenkam" <johnh at (no spam) goawayplease.com> wrote in message
news:AKOdnQnNJLM-u7DVnZ2dnUVZ_gWdnZ2d at (no spam) westnet.com.au...
I vaguely remember you Don. Were you the one involved in a discussion
about Stargardts? If so, I hope your treatment for AMD(?) is helping.

Nah, that was a typo, rushing too much but I am a terrible proof reader
and I hate reading spreadsheets!


"Don W" <dwilgus at (no spam) prodigy.net> wrote in message
news:ka9Xj.2303$hJ5.1256 at (no spam) nlpi068.nbdc.sbc.com...
John,

Like "in my good idea".

Don W.









 
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