NEW JERSEY MEDICAL SCHOOL

THE INSTITUTE OF OPHTHALMOLOGY AND VISUAL SCIENCE

 

CLINICAL RESEARCH

 
 
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  NEURO-OPHTHALMOLOGY  
     
  Raynaud’s Disease and Ischemic Optic Neuropathy  
  Larry P. Frohman, MD  
  Non-arteritic ischemic optic neuropathy (NAION), the most common condition affecting the optic nerve in adults older than 40 years, is often a bilateral blinding condition. Although it is seen in patients with known vascular risk factors (diabetes, hypertension), its cause it not known, nor is there a therapy. The best we can do for patients is to offer them aspirin, which reduces the risk to the second eye. It has recently been shown that Raynaud’s disease (RD), the most common of the group of diseases known as collagen vascular diseases, is associated with a reduction in blood flow to the brain, particularly after exposure to cold. Dr. Frohman is studying the incidence of RD in patients with NAION and determining whether cold alters blood flow in the area of the retina around the optic nerve.  
     
  Neuroophthalmic Sarcoidosis  
  Larry P. Frohman, MD  
  Several studies related to this disorder are ongoing, including a review of the clinical features and laboratory assessment of sarcoid optic neuropathy; a study of whether the location of the optic nerve lesion on MRI scan predicts the visual outcome of sarcoid optic neuropathy; and a study as to whether lacrimal gland enlargement on MRI scan is a diagnostic sign of sarcoid optic neuropathy.  
     
  Clinical Features of Autoimmune-Related Retinopathy and Optic Neuropathy (ARRON) Syndrome  
  Larry P. Frohman, MD  
  The goal of this research, performed in conjunction with the University of California at Davis, is to study paraneoplastic or autoimmune retinal or optic nerve degenerations. Specifically, the goal is to describe the clinical features for this group of disorders, conduct laboratory investigation, and determine potential therapies.These conditions cause visual loss because antibodies attack the retina or the optic nerve (or both). Paraneoplastic disease is probably a remote effect of cancer and occurs whjen the immune system attacks the normal visual tissue instead of the cancer. Although cancer is not associated with the autoimmune form of this disease, it is believed that the immune system is “tricked” into attacking the body’s own normal visual tissue. We propose to define the clinical manifestations of these diseases and the appropriate lab tests to identify them, with the ultimate goal of detecting these disorders before irreversible visual damage occurs. This is a retrospective review of the records of previously identified patients with this condition from the neuro-ophthalmology service of NJMS.  
     
  Pseudotumor Cerebri in Pregnancy  
  Larry P. Frohman, MD  
  In conjunction with researchers at SUNY - Syracuse, this project will monitor the outcomes of pseudotumor cerebri in pregnancy, specifically, to determine whether patients require therapy or whether this is a self-limited disorder.  
     
  Traumatic Optic Neuropathy  
  Larry P. Frohman, MD  
  Dr. Frohman is conducting 2 studies in this research area: (1) evaluation and outcome of patients diagnosed with traumatic optic neuropathy during a coma, and (2) examination of outcome data from all cases diagnosed with this disorder.  
     
  Relationship of Myasthenia Gravis to Graves Ophthalmopathy  
  Larry P. Frohman, MD  
  This study at whether the incidence of developing general myasthenia is different in patients with ocular myasthenia with concomitant Graves disease as compared to those without Graves disease.  
     
  Visual Loss in Rosenberg-Chutorian Syndrome  
  Larry P. Frohman, MD  
  This study seeks to verify whether visual loss due to this neurologic condition is associated with the optic nerve—which is part of the classical teaching—rather than the retina.  
     
  ProVision: Development of Patient Simulation Teaching Strategies for Lifelong Education for the Ophthalmologist  
  Larry P. Frohman, MD  
  Dr. Frohman chairs the subcommittee that develops remote assessment/reinstruction tools for the American Academy of Ophthalmology (AAO). The development of these teaching strategies and internet-based programs for patient simulations is linked to the new development of core curriculum by the American Boards of Ophthalmology and the AAO.  
     
  Treatment of Optic Neuritis With Megadose Oral Steroids Versus Intravenous Steroids: MRI Response  
  Larry P. Frohman, MD  
  Dr. Frohman, in conjunction with Drs. Cook and Wolansky, is studying optic neuritis (as well as 2 other common first symptoms of multiple sclerosis). Patients will be randomly assigned to 2 treatment groups: one will receive traditional doses of intravenous steroids and the other will receive a high-dose of oral steroids. MRI results will be compared to determine if there is a difference in radiologic improvement of acute lesions between these 2 groups.  
     
  Radiation Treatment for Optic Nerve Sheath Meningioma  
  Roger E. Turbin, MD  
  Optic nerve sheath meningioma, a neoplastic tumor of the optic nerve sheath, affects people of all ages, although it is most common in middle-aged women. The tumor causes visual loss by compression of optic nerve, as well as mass effect and compression of other important local structures. Treatment is controversial, and no consensus exists among the experts treating this condition. Dr. Turbin is analyzing long-term visual outcomes of patients treated with various modalities, including observation only, surgery, and radiotherapy. Outcomes of the study should help to establish radiotherapy as “standard of care.”  
     
  Leber’s Optic Hereditary Optic Neuropathy  
  Roger E. Turbin, MD  
  Dr. Turbin has secured NJMS as a clinical research site for a 3-year open-label, multi-institutional study, funded by Allergan Pharmaceuticals. The study enrolls patients who have Leber’s hereditary optic neuropathy, which is the phenotypic expression of a hereditary mitochondrial DNA mutation. The study prospectively assesses the ability of the test drug to change the course of this blinding disease, which typically causes irreversible blindness in young healthy men during the prime of their life.  
 
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