StemCell Therapy

"I got a 20-year contract. Giannis is going to play for 20 more years" - Mike Budenholzer on the longevity of Giannis Antetokounmpo and the Milwaukee Bucks  Basketball Network

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"I think Nadal has been doing a great job of that in the last four or five years": McEnroe believes Murray needs to shorten points for longevity  TennisUpToDate.com

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Eye exercises can help alleviate vertigo. A doctor may recommend eye exercises as part of an extended therapy programme that includes other types of physical therapy.

Vertigo is not a condition but a symptom of several potential underlying conditions.

When a person follows the recommendation of a doctor or health professional, eye exercises can provide safe and effective therapy for vertigo.

This article reviews different eye exercises that can alleviate vertigo, as well as other exercises and treatments that may help.

Vertigo involves the sensation of spinning. A person with vertigo may feel like they or their surroundings are moving or spinning.

There are two types of vertigo: peripheral and central.

According to a 2021 publication, 80% of vertigo cases are due to peripheral vertigo. This type is often the result of benign paroxysmal positional vertigo (BPPV), which occurs when carbonate crystals in the ear become displaced.

Central vertigo accounts for the remaining 20% of cases. This type of vertigo results from lesions on the brain stem or other issues that affect the brain.

Both multiple sclerosis and migraine can cause central vertigo.

Eye exercises make up part of a type of therapy called vestibular rehabilitation therapy (VRT). VRT can provide effective therapy for vertigo resulting from:

Eye exercises may work to alleviate vertigo because they help a person adjust and maintain balance.

Doing exercises that involve moving the eyes and head can help people adapt to these movements, training their bodies to adjust to vertigo triggers.

The hope is this will reduce vertigo as a person gets used to the movements over time.

However, a doctor will recommend different exercises depending on the underlying cause of vertigo.

A person should speak with a doctor or healthcare professional before trying any of these exercises as they could be ineffective or worsen vertigo, depending on the underlying conditions.

Several eye-related exercises may help a person improve their vertigo.

Before beginning any exercise program, a person should consult a physical therapist or doctor. They may have other recommendations or exercises they would like the person to practice.

The following exercises are part of a VRT program. A person should make sure to conduct the exercises in a safe and comfortable environment, as they could trigger dizziness.

It is best to start the exercises slowly, doing them for a few seconds and gradually increasing the time as a person adjusts to each exercise.

However, how long and how often a person should do these exercises depends on the underlying cause of the vertigo. Therefore, a person should talk with a doctor about the following exercises before trying them.

To do this exercise, a person should follow these steps:

This exercise involves keeping the head still while moving the eyes.

To do this exercise, a person should:

This exercise involves keeping the head still and moving the eyes quickly.

To conduct this exercise, a person can:

To do this exercise, a person should:

To follow this exercise, a person should:

Several other exercises can help with treating vertigo. The following are two examples of exercises that may effectively treat vertigo associated with BPPV.

A person should talk with their doctor or therapist before starting any new exercises. They should follow their treatment recommendations.

This is a canalith repositioning exercise that may help treat BPPV.

To conduct this exercise, a person can follow these steps:

A person should repeat the same movement on the opposite side. This means they would face the left at the beginning.

A person can perform this exercise up to three times per day.

Learn more about the Epley maneuver with a step-by-step video guide.

The half somersault maneuver (HSM) is also known as the Foster maneuver. A 2021 study found that the HSM was more effective in treating BPPV than the Epley maneuver.

To conduct this exercise, a person should:

A person may feel dizzy between the steps. If this happens, they should allow the dizziness to subside before going to the next step. Each position should be held for 15 seconds if there is no dizziness.

Learn about other exercises that can alleviate vertigo.

In addition to exercises, a doctor may recommend other treatments for vertigo.

Experts have found that certain medications can help with vertigo, such as antihistamines, benzodiazepines, and antiemetics. A doctor may recommend a combination of medication and exercises or may prescribe one or the other.

For some causes of vertigo, a person may find that dietary changes help. For example, a person living with Mnires disease may find that reducing their intake of salt, alcohol, and caffeine may help.

With treatment, a person should find that their vertigo improves over time. However, it is possible for symptoms to return.

For example, about 50% of people living with BPPV experience a relapse within 5 years. Also, about one-third of people who experience vertigo from anxiety will still experience symptoms after 1 year.

If vertigo is a symptom of an underlying condition, treating the condition should help to alleviate or eliminate vertigo.

A person should talk with a doctor to determine the underlying cause and find out how they can treat it.

Eye exercises may help people improve their vertigo when paired with head movements. Additionally, several other exercises, such as the Epley maneuver and the half somersault maneuver, can help a person alleviate vertigo.

In some cases, a doctor may recommend medication and lifestyle changes to help alleviate or eliminate vertigo.

Most people should see at least some improvement in their vertigo following treatment, though it is possible to experience a return of symptoms after some time.

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Eye exercises for vertigo: Exercises to try at home - Medical News Today

Forensics expert explains 'genetic genealogy' process believed to be used in Kohberger's arrest  KTVB.com

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Forensics expert explains 'genetic genealogy' process believed to be used in Kohberger's arrest - KTVB.com

Idaho student murders: What is genetic genealogy, a tool reportedly used to help capture the suspect?  FOX 10 News Phoenix

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Idaho student murders: What is genetic genealogy, a tool reportedly used to help capture the suspect? - FOX 10 News Phoenix

For Immediate Release: December 18, 2017

Espaol

The U.S. Food and Drug Administration today approved Luxturna (voretigene neparvovec-rzyl), a new gene therapy, to treat children and adult patients with an inherited form of vision loss that may result in blindness. Luxturna is the first directly administered gene therapy approved in the U.S. that targets a disease caused by mutations in a specific gene.

Todays approval marks another first in the field of gene therapy both in how the therapy works and in expanding the use of gene therapy beyond the treatment of cancer to the treatment of vision loss and this milestone reinforces the potential of this breakthrough approach in treating a wide-range of challenging diseases. The culmination of decades of research has resulted in three gene therapy approvals this year for patients with serious and rare diseases. I believe gene therapy will become a mainstay in treating, and maybe curing, many of our most devastating and intractable illnesses, said FDA Commissioner Scott Gottlieb, M.D. Were at a turning point when it comes to this novel form of therapy and at the FDA, were focused on establishing the right policy framework to capitalize on this scientific opening. Next year, well begin issuing a suite of disease-specific guidance documents on the development of specific gene therapy products to lay out modern and more efficient parameters including new clinical measures for the evaluation and review of gene therapy for different high-priority diseases where the platform is being targeted.Luxturna is approved for the treatment of patients with confirmed biallelic RPE65 mutation-associated retinal dystrophy that leads to vision loss and may cause complete blindness in certain patients.

Hereditary retinal dystrophies are a broad group of genetic retinal disorders that are associated with progressive visual dysfunction and are caused by mutations in any one of more than 220 different genes. Biallelic RPE65 mutation-associated retinal dystrophy affects approximately 1,000 to 2,000 patients in the U.S. Biallelic mutation carriers have a mutation (not necessarily the same mutation) in both copies of a particular gene (a paternal and a maternal mutation). The RPE65 gene provides instructions for making an enzyme (a protein that facilitates chemical reactions) that is essential for normal vision. Mutations in the RPE65 gene lead to reduced or absent levels of RPE65 activity, blocking the visual cycle and resulting in impaired vision. Individuals with biallelic RPE65 mutation-associated retinal dystrophy experience progressive deterioration of vision over time. This loss of vision, often during childhood or adolescence, ultimately progresses to complete blindness.

Luxturna works by delivering a normal copy of the RPE65 gene directly to retinal cells. These retinal cells then produce the normal protein that converts light to an electrical signal in the retina to restore patients vision loss. Luxturna uses a naturally occurring adeno-associated virus, which has been modified using recombinant DNA techniques, as a vehicle to deliver the normal human RPE65 gene to the retinal cells to restore vision.

The approval of Luxturna further opens the door to the potential of gene therapies, said Peter Marks, M.D., Ph.D., director of the FDAs Center for Biologics Evaluation and Research (CBER). Patients with biallelic RPE65 mutation-associated retinal dystrophy now have a chance for improved vision, where little hope previously existed.

Luxturna should be given only to patients who have viable retinal cells as determined by the treating physician(s). Treatment with Luxturna must be done separately in each eye on separate days, with at least six days between surgical procedures. It is administered via subretinal injection by a surgeon experienced in performing intraocular surgery. Patients should be treated with a short course of oral prednisone to limit the potential immune reaction to Luxturna.

The safety and efficacy of Luxturna were established in a clinical development program with a total of 41 patients between the ages of 4 and 44 years. All participants had confirmed biallelic RPE65 mutations. The primary evidence of efficacy of Luxturna was based on a Phase 3 study with 31 participants by measuring the change from baseline to one year in a subjects ability to navigate an obstacle course at various light levels. The group of patients that received Luxturna demonstrated significant improvements in their ability to complete the obstacle course at low light levels as compared to the control group.

The most common adverse reactions from treatment with Luxturna included eye redness (conjunctival hyperemia), cataract, increased intraocular pressure and retinal tear.

The FDA granted this application Priority Review and Breakthrough Therapy designations. Luxturna also received Orphan Drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases.

The sponsor is receiving a Rare Pediatric Disease Priority Review Voucher under a program intended to encourage development of new drugs and biologics for the prevention and treatment of rare pediatric diseases. A voucher can be redeemed by a sponsor at a later date to receive Priority Review of a subsequent marketing application for a different product. This is the 13th rare pediatric disease priority review voucher issued by the FDA since the program began.

To further evaluate the long-term safety, the manufacturer plans to conduct a post-marketing observational study involving patients treated with Luxturna.

The FDA granted approval of Luxturna to Spark Therapeutics Inc. The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines, and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nations food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Luxturna is the first gene therapy approved in the U.S. to target a disease caused by mutations in a specific gene

Andrea Fischer301-796-0393

888-INFO-FDAOCOD@fda.hhs.gov

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FDA approves novel gene therapy to treat patients with a rare form of ...

Ever since the dawn of mankind, diseases have plagued humans over the ages. Years of innovations and advancements in science has provided us with a deeper understanding of how diseases work. This has led to lower mortality rates and longer lifespans. But there are some diseases that just cannot be cured using traditional medicine or surgery. Gene therapy is an experimental technique that caters to patients with such diseases.

Gene therapy is a technique which involves the replacement of defective genes with healthy ones in order to treat genetic disorders. It is an artificial method that introduces DNA into the cells of the human body. The first gene therapy was successfully accomplished in the year 1989.

The simple process of gene therapy is shown in the figure below:

In the figure, the cell with the defective gene is injected with a normal gene which helps in the normal functioning of the cell. This technique is employed mainly to fight against the diseases in the human body and also to treat genetic disorders. The damaged proteins are replaced in the cell by the insertion of DNA into that cell. Generally, improper protein production in the cell leads to diseases. These diseases are treated using a gene therapy technique. For example, cancer cells contain faulty cells which are different from the normal cells and have defective proteins. Hence, if these proteins are not replaced, this disease would prove to be fatal.

Basically, there are two types of gene therapy

This type usually occurs in the somatic cells of human body. This is related to a single person and the only person who has the damaged cells will be replaced with healthy cells. In this method, therapeutic genes are transferred into the somatic cells or the stem cells of the human body. This technique is considered as the best and safest method of gene therapy.

It occurs in the germline cells of the human body. Generally, this method is adopted to treat the genetic, disease causing-variations of genes which are passed from the parents to their children. The process involves introducing a healthy DNA into the cells responsible for producing reproductive cells, eggs or sperms. Germline gene therapy is not legal in many places as the risks outweigh the rewards.

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Gene Therapy - Discover How It Works Its Types And Applications - BYJUS

IVERIC bio Subsidiary Sells Assets of Gene Therapy Product Candidates for Treatment of Retinal Diseases  Marketscreener.com

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IVERIC bio Subsidiary Sells Assets of Gene Therapy Product Candidates for Treatment of Retinal Diseases - Marketscreener.com

Eye movement desensitization and reprocessing, or EMDR, is a technique that some psychotherapists use to treat people experiencing psychological distress.

Research suggests that EMDR is a relatively safe and effective therapy. Organizations such as the World Health Organization (WHO) and the American Psychiatric Association (APA) recommend it for people with post-traumatic stress disorder (PTSD).

In this article, we discuss the potential benefits of EMDR and look at the research behind it.

Francine Shapiro, an American psychologist, developed EMDR therapy in the late 1980s.

Practitioners initially used it to treat people with traumatic memories, but they now use it to treat a variety of disorders, including:

The therapy consists of eight phases. During the treatment, people recall traumatic experiences while moving their eyes back and forth. The therapist will direct this eye movement.

The aim is to allow people to process and integrate these traumatic memories into their standard memories. The theory behind this method is that remembering times of distress while distracted is less upsetting. Over time, exposure to these memories should reduce their effects.

EMDR is similar in some respects to cognitive behavioral therapy (CBT) another PTSD treatment as it involves remembering or discussing the traumatic event as well as identifying and altering the thoughts.

These processes are called exposure and cognition.

The theory behind EMDR is that traumatic memories make changes in the brain. These changes stop the mind from processing information properly, which causes anxiety and intrusive thoughts.

Experts believe that remembering the traumatic events while performing rapid eye movements allows the brain to process these memories correctly and integrate them into the story of the persons life.

The eight phases of EMDR therapy are as follows:

The therapist will evaluate the clients case, including their ability to tolerate exposure to distressing memories.

They will then formulate the treatment plan based on the persons symptoms and the behaviors that need modifying.

The therapist will lay the groundwork for the treatment by establishing a therapeutic relationship with the client and educating them on EMDR.

They will also teach the person self-control techniques, which are ways to cope with distressing memories that arise.

During this phase, the therapist will identify the traumatic memories that the client needs to address.

The client will then choose an image to represent each memory, noting the negative beliefs and physical sensations that accompany these memories. They will then identify a positive thought to replace the negative beliefs.

Desensitization involves reducing the clients disturbing reactions to the traumatic memory, including the physical sensations that they have when thinking of it.

Physical sensations may include a rapid heart rate, sweating, or stomach problems.

The therapist facilitates desensitization by directing the clients eye movements while they focus on the traumatic material.

The focus of this stage is on installing the positive thoughts that the client identified in phase 3.

A body scan is a meditative technique in which a person scans their body from head to toe to notice the physical sensations that are occurring.

During EMDR, the therapist will target these physical sensations for further processing.

At the end of each session, the therapist will stabilize the client using the self-control techniques that they discussed in phase 2.

The therapist will explain what the client can expect between sessions. They will also ask the client to keep a record of any negative experiences that occur so that they can target them in the next meeting.

The final phase involves a review of the effectiveness of the treatment so far. The therapist and client will also identify any additional traumatic effects to target.

Most of the research on EMDR looks at its benefits for people with PTSD and other trauma-related symptoms.

Research suggests that EMDR may also treat symptoms that accompany a traumatic experience, such as self-harm, stress, and anger.

However, practitioners use it to treat a variety of other conditions and issues, including:

Preliminary research supports its application for some of these issues, such as psychotic symptoms and chronic pain.

In some cases, people may choose to do EMDR alongside other treatment options for the best results.

According to the EMDR Institute, more than 30 controlled outcome studies on EMDR therapy have shown that it has positive effects.

In some of these studies, as many as 90% of trauma survivors appeared to have no PTSD symptoms after just three sessions.

Other studies that the EMDR Institute cite showed very positive outcomes for the majority of participants after six to 12 sessions.

Organizations such as the WHO, the APA, and the Department of Veterans Affairs currently recommend EMDR as a treatment option for PTSD.

A 2014 research study looked at 24 randomized controlled trials that support the effectiveness of EMDR therapy for the treatment of trauma. The results of some of these studies suggested that EMDR therapy is more effective than CBT for trauma.

Some research indicates that EMDR may be effective for other mental health issues. For example, it may have a positive effect on psychotic symptoms (in people with both psychosis and PTSD), such as:

Research also suggests that the benefits of EMDR persist over time. The authors of a small 2015 study reported that people who underwent EMDR treatment for depression were less likely than those in the control group to experience relapse or problems relating to depression in the year following treatment.

However, many of the studies on EMDR have small sample sizes and limited follow-up information.

As a result, several researchers have called for additional research into the treatment.

Doctors generally consider EMDR therapy to be a safe treatment. It typically causes fewer adverse reactions than medications for depression and trauma symptoms.

Also, unlike some medications, EMDR may maintain its effectiveness after treatment ends.

Even so, EMDR and other forms of psychotherapy may cause some side effects, such as:

These symptoms will typically resolve as treatment continues. Individuals should tell their therapist about their experiences between sessions so that they can work on new memories and symptoms in future sessions.

Individuals who would like to know more about EMDR should speak to a doctor or mental health professional who specializes in the practice.

Questions to ask include:

Therapists have been using EMDR for more than 25 years to treat PTSD and other mental health conditions. A growing body of research suggests that it is effective and safe in reducing distress, anxiety, and other symptoms.

People who would like to know more about EMDR treatment should speak to their doctor or a licensed therapist.

Originally posted here:

EMDR therapy: Everything you need to know - Medical News Today

Eye floaters are dots or specks in a persons vision that seem to float away when the person tries to look directly at them. They are made up of the vitreous of the eye, and in most cases, they are completely normal. The vitreous is the clear, gel-like substance that fills out most of the eye.

Eye floaters do not usually require treatment, as they themselves do not cause any harm to the sight. However, in some cases, eye floaters may make it difficult to see and will require removal to restore sight.

Eye floaters may also be an early sign of an underlying issue, such as damage to the retina.

Eye floaters are a natural phenomenon due to the vitreous body of the eye. The vitreous helps give the eye its round shape.

Floaters occur when this vitreous body starts to shrink. As it shrinks, little fibers can break away and become stringy. This is what doctors call vitreous detachment.

This detachment causes stringy masses of vitreous that can disrupt light coming into the retina. This casts a tiny shadow into the eye, which is what makes floaters noticeable.

Eye floaters are a normal part of the aging process. The American Society of Retina Specialists note that conditions such as vitreous detachment, which causes more floaters, are more common after the age of 60.

Everyone can get eye floaters at some point, though most people ignore them. Many may only notice them when they look at a blank, bright surface or area such as the sky.

Although they can be distracting at first, most eye floaters tend to settle down to the bottom of the eye, beneath the field of vision.

However, the American Society of Retina Specialists recommend that a person who notices sudden symptoms such as floaters get checkups with an ophthalmologist within the first few months after the symptoms appear, to check for any signs of more serious issues.

Although some floaters in the eye may be a normal part of the aging process, experiencing a sudden increase of floaters in the eye may be a sign of another issue, such as retinal detachment.

When retinal detachment occurs, it is not uncommon for people to experience other symptoms along with eye floaters. They may experience flashes of light that are not there, especially in the side of their fields of vision. They may also experience a loss of vision in the sides of their eyes.

Retinal detachment is serious and may lead to blindness without treatment. Anyone who notices a sudden and noticeable increase in floaters, along with other symptoms, should see an eye doctor immediately.

There are also more serious causes of floaters in the eye, including:

Anyone who notices a sudden increase in eye floaters should see an eye doctor to obtain a complete diagnosis.

The main symptoms of eye floaters are small areas in a persons field of vision that seem out of place.

Floaters can take different shapes, including:

They may also appear as a dark or lighter area of vision. Sometimes, the area where the floater is will look slightly blurry compared with the rest of the field of vision.

Floaters are tiny but can significantly affect the vision, as they are very close to the input of the eye.

One characteristic of eye floaters is that they seem to dart back and forth across the field of vision. Trying to look directly at a floater will cause it to move away in the direction the person looks.

When the person rests their eyes, the floaters seem to drift on their own.

Although it may not be possible to prevent eye floaters, it is still helpful to follow some basic practices to keep the eyes healthy. These include:

Eye floaters do not require treatment in most cases.

Although floaters may be irritating when a person notices them, they do not pose any direct threat to the sight.

In most cases, floaters settle down to the bottom of the eye, beneath the field of vision. The Columbia University Department of Ophthalmology estimate that it can take up to 3 months for a persons first floater to completely detach.

In rare circumstances, floaters may become very dense and potentially disrupt a persons vision. In these cases, a doctor may recommend a procedure called a vitrectomy.

During a vitrectomy, a healthcare professional will surgically remove the vitreous gel causing the floater. They will then replace this vitreous gel with a saline solution, or a bubble filled with gas or oil. Most people notice no difference between the vitreous and the saline solution after surgery.

Doctors generally reserve this procedure for serious circumstances, as it comes with its own set of potentially serious complications. These include cataracts and retinal detachment.

There are some alternatives to surgery for removing floaters.

A laser treatment method called laser vitreolysis may break apart or dissolve larger floaters, making them less noticeable. However, laser therapy is not for everyone.

An ophthalmologist will need to do a complete diagnosis in each case to see if the person could benefit from laser therapy.

Many people will experience eye floaters at one point or another. They can be annoying but are often harmless. Eventually, they may settle outside the field of vision, and most do not require treatment.

In very rare circumstances, eye floaters may disrupt vision and require surgical treatment. A sudden, very noticeable increase in eye floaters may also be a sign of other serious issues, such as retinal detachment, which could lead to blindness if a person does not receive prompt medical treatment.

Anyone who notices a sudden increase in eye floaters should visit an eye doctor for a full diagnosis.

Continued here:

Eye floaters: What causes them, and what can you do? - Medical News Today

Individual who provides a service related to the eyes or vision

An eye care professional (ECP) is an individual who provides a service related to the eyes or vision. It is any healthcare worker involved in eye care, from one with a small amount of post-secondary training to practitioners with a doctoral level of education.

Ophthalmologists are Doctors of Medicine (M.D./D.O.)(physicians) who specialize in eye care - this includes optical, medical and surgical eye care. They have a general medical degree, not a degree in eye care specifically.[1] In the US, this usually includes four years of college, four years of medical school, one year surgical internship and three years of eye specific training (ophthalmology residency). Some surgeons complete additional training (fellowship) in specific areas of the eye. Ophthalmologists are qualified to manage any eye disease, perform invasive eye surgery (including injections) and provide general medical care (non eye related) also.[2]

While Ophthalmologists can provide comprehensive care, typically they manage late state eye disease and perform surgery (specialty care). Their training is heavily focused on surgery.

An ophthalmic medical practitioner is a physician who specializes in ophthalmic conditions but who has not completed a specialization in ophthalmology. This title only relates to providers in Europe.

Optometrists are healthcare professionals with a degree in eye care, specifically. In the United States and Canada, they are Doctors of Optometry (O.D.) - this includes optical, medical and some surgical eye care. Their training typically includes four years of college followed by four years of eye specific training (Optometry school). Some complete an additional 5th year in a specialty area. Optometry school is a specialized program - specific to the eyes and related structures. Optometrists receive their medical eye training while in Optometry school and during internships (hospitals, private practices, universities, VA's etc.). Education is provided by professors, optometrists and physicians. Often, Optometry students and Ophthalmology residents will work together to co-manage medical cases. O.D.'s are trained and licensed to manage any eye disease (infections, glaucoma, macular degeneration, etc.) and practice medicine for eye related conditions - including topical medications (eye drops) or those taken by mouth including some schedule controlled substances. They may also order imaging tests (CT/MRI), remove ocular foreign bodies and perform some laser procedures. They are also qualified to perform some surgical procedures. Optometrists have the most optical training of any eye care professional and are the only eye care providers with a degree specific to eye care.

In the United States, Optometrists are considered physicians within their scope of practice and bill medical insurances according to Medicare.[3]

Outside of the United States and Canada, Optometrists typically do not hold a doctorate degree and may be limited in providing surgical treatments. However, some countries such as the UK, include a combination of providers where some Optometrists hold postgraduate doctorate degrees and some do not.

Orthoptists specialize in diagnosis and management of eye movement and coordination problems, misalignment of the visual axis, convergence and accommodation problems, and conditions such as amblyopia, strabismus, and binocular vision disorders, as outlined by the International Orthoptic Association.[4] They may assist ophthalmologists in surgery, teach orthoptic students, students of other allied health professions, medical students, and ophthalmology residents and fellows, act as vision researchers, perform vision screening, perform low vision assessments and act as clinical administrators.[5]

Ocularists specialize in the fabrication and fitting of ocular prostheses for people who have lost eyes due to trauma or illness.

Opticians specialize in the fitting and fabrication of ophthalmic lenses, spectacles, contact lenses, low vision aids and ocular prosthetics. They may also be referred to as an "optical dispenser", "dispensing optician", "ophthalmic dispenser". The prescription for the corrective lenses must be supplied by an ophthalmologist, optometrist or in some countries an orthoptist. This is a regulated profession in most jurisdictions.

A collective term for allied health personnel in ophthalmology. It is often used to refer to specialized personnel (unlike ocularists or opticians). In many countries these allied personnel may just be known as an "ophthalmic assistant". Their training is usually combined with a two or three year applied science degree and they assist an ophthalmologist or optometrist in the hospital or clinic with vision testing.

In the USA the Joint Commission on Allied Health Personnel in Ophthalmology administers OMP certifications:

Oculist is an older term that was primarily used to describe eye care professionals that are trained and specialized in the eye care field, specifically ophthalmologists and optometrists. The term is no longer used in the United States.

A vision therapist, usually either an orthoptist or optometrist, works with patients that require vision therapy, such as low vision patients. Commonly, vision therapy is performed in children who develop problems with their vision mostly because they are using their eyes up close. This type of therapy is however generally used in patients who need visual correction but for whom the corrective lenses are not enough to reverse the condition. Visual therapy in children is performed by optometrists who specialize in children's eye care. To specialize in vision therapy, doctors must complete extensive post-graduate training beyond their optometric degree, at which time they are eligible to sit for their national boards to become fully certified as specialists in children's vision. A doctor's title after passing the national board in vision therapy is Fellow in the College of Optometrists in Vision Development, or F.C.O.V.D. Optometrists who provide vision therapy but who have not yet sat for their certification exams are board-eligible Associates in the College of Optometrists in Vision Development.Vision therapists typically use prisms, eye patches, filtered lenses, and computerized systems to conduct therapy sessions.

Most eye care professionals do not practice iridology, citing a significant lack of scientific evidence for the practice.

Ophthalmologists generally provide specialty eye care and manage late stage eye disease (often only mitigated with surgery).

Optometrists typically provide comprehensive eye care - including medical, up to a moderate stage (managed with prescription medications). There is considerable overlap in scope of practice between professions. Optometrists are licensed to provide exactly the same medical care as ophthalmologists, but not invasive surgery.

Orthoptists specialize in the diagnosis and management of problems with eye movement and coordination, such as misalignment of the visual axis, binocular vision problems, and pre/post surgical care of strabismus patients. They do not directly treat ocular disease with medications or surgery. Orthoptists are trained to treat patients using optical aids and eye exercises[6][failed verification]. Orthoptists are primarily found working alongside ophthalmologists and optometrists to co-manage binocular vision treatment, visual field loss management and accommodative therapy. They often do standard eye and vision testing along with computerised axillary testing.

All three types of professional perform screenings for common ocular problems affecting children (such as amblyopia and strabismus) and adults (such as cataracts, glaucoma, and diabetic retinopathy).[7] All are required to participate in ongoing continuing education courses to maintain licensure and stay current on the latest standards of care.

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Eye care professional - Wikipedia

Alberta has become the first province in Canada to use new gene therapy to treat a rare and debilitating genetic eye disease.

The first three patients two young children and an adult received the treatment Dec. 14 at the Royal Alexandra Hospital in Edmonton.

The Royal Alex is the first of four places in Canada that will offer the gene therapy.

It will give people who previously have been relegated to seeing life getting increasingly blurred and eventually dark a brighter future, said Dr. Matthew Tennant, a clinical professor at the department of ophthalmology and visual science at the University of Alberta.

Tennant was one of the doctors who conducted the surgeries.

"All those people who now are relegated to continue to lose vision throughout their lives they will have hope and they will have the possibility of stability," he said.

"The next generation of people with retinitis pigmentosa will have treatment when they're born, or early in their lives, so that their vision will be normal. They'll never have deterioration."

The gene therapy involves a drug called Luxturna, developed by the American biotech company Spark Therapeutics.

Luxturna treats an aggressive form of retinitis pigmentosa, a group of diseases caused by some 300 gene mutations that all involve the retina and cause progressive decline and loss of vision.

The type of retinitis pigmentosa treated by Luxturna is caused by a faulty gene called RPE65.

When the gene malfunctions, photoreceptors stop working over time.

Photoreceptors are the cells in the retina that convert light into electrical signals that get sent to the brain, which allows people to see.

Photoreceptors are kept alive by an underlying layer of cells called retinal pigment epithelium. When the RPE65 gene doesn't work properly,the cells in the retinal pigment epithelium and photoreceptors don't work correctly.

Photoreceptors don't get enough nutrition and can't process and eventually they die.

Luxturna helps replace the malfunctioning gene with a normal one.

"It involves delivery of a healthy copy of a gene like RPE65 into the retinas," said Shannon Boye, a professor and associate chief of the division of cellular and molecular therapy at the University of Florida.

"Once inside the retina, that healthy gene will go on to make a healthy protein that can then go on to interact properly with all of the other proteins in the retina and ultimately restore the patient's ability to process light into an electrochemical signal" and see normally, she said.

The healthy gene is delivered into the cell using a modified virus. Scientists have managed to rip the original DNA out of a virus and replace it with the healthy gene.

When the virus makes its way into the cell, the faulty gene is switched off. The cell begins to function normally and photoreceptors receive enough nutrients.

"There is some ability to save damaged cells that have not died, but we are not able to fix all that have already gone. It doesn't replace dead cells, so that means that early treatment is the way for maximum success," Tennant said.

The treatment is performed by injecting the modified therapeutic viruses between the retina and the retinal pigment epithelium. This requires significant surgical skills the space between the two is only two or three microns. There, the viruses are injected into the fluid pocket.

Gene therapy is expensive. It costs $1 million to treat both eyes with Luxturna. However, it is a one-time procedure, and the fix is permanent.

The disease that this gene therapy treats is extremely rare. There are probably just 300 people in Canada who have it, said Dr. Ian MacDonald, an ophthalmologist and AHS Edmonton Zone clinical chief of ophthalmology.

"We would estimate that we would treat one new Albertan every year," said MacDonald, who noted that patients from across Western Canada will be treated at the Royal Alex.

There is no waiting period for Albertans to receive Luxturna and there are no out-of-pocket expenses, said Charity Wallace, assistant director for communications at Alberta Health, in an email.

Using gene therapy to treat hereditary eye disease has shown the medical and commercial viability of gene therapies, Boye said.

"I think that every one of these therapies that gets approved is going to bring our regulatory agencies to a point where they're more and more comfortable with this type of medicine becoming mainstream."

See original here:

New gene therapy to treat rare eye disease now available in Alberta ...

Symptoms from peripheral neuropathy depend on the type of nerves damaged. The three types are motor nerves, sensory nerves, and autonomic nerves.

Your motor nerves send messages from the brain to the muscles so you can control your movements.

If your motor nerves are affected, you may experience symptoms including:

Sensory nerves send messages from other body parts to the brain and trigger your senses. When you experience a cold sensation or touch something sharp, you are using your sensory nerves.

If your peripheral neuropathy affects your sensory nerves, you may experience:

These nerves control involuntary and semi-voluntary functions including blood pressure, heart rate, bladder functions, and sweating.

If your autonomic nerves are affected from peripheral neuropathy, you may experience symptoms including:

Treatment for peripheral neuropathy depends on the cause. Some common treatments involve physical therapy, surgery, and injections for increased nerve pressure. Other treatments focus on reducing pain and discomfort with over-the-counter painkillers such as ibuprofen or aspirin.

There are also a number of natural treatments to help reduce symptoms and peripheral neuropathy.

Some cases of peripheral neuropathy are related to vitamin deficiencies. Vitamin B is essential for your nerve health. A deficiency can lead to significant nerve damage.

While you can get vitamin B from your meals, your doctor may also recommend taking a supplement. Stick to the recommended dose to prevent toxicity and worsening symptoms.

Vitamin D can also help prevent nerve pain. Your skin typically produces vitamin D in response to sunlight. A deficiency can cause neuropathy pain. Taking a supplement can help reduce the symptoms of neuropathy.

Cayenne pepper contains capsaicin, an ingredient in hot peppers that makes them spicy. Capsaicin has been used in topical creams for its pain relief properties. It decreases the intensity of pain signals sent through the body.

Incorporating cayenne pepper in your diet or taking a capsaicin supplement can help to reduce neuropathy pain.

Topical capsaicin ointments can also be used on the body. Although it may initially burn, continued use will gradually reduce neuropathy sensations.

Be sure to discuss this treatment method with your doctor before using it to prevent adverse symptoms.

Smoking affects your blood circulation. The blood vessels narrow and less oxygenated blood can get through. Without proper blood circulation, you may experience increased numbness and pain from your peripheral neuropathy. Eliminating smoking habits can help to improve your symptoms. Let this motivate you to make positive changes.

Taking a warm bath can be soothing and can also alleviate pain symptoms from neuropathy. Warm water increases blood circulation throughout the body, decreasing pain symptoms from numbness.

If your sensory nerves are affected from peripheral neuropathy and youre not as sensitive to temperature, be careful not to make your bath water too hot.

Regular exercise can help to combat pain and improve your overall health. Being active can reduce your blood sugar, which, in turn, can reduce or slow down nerve damage. Exercise also increases blood flow to your arms and legs and reduces stress. These are all factors that help to reduce discomfort and pain.

Some essential oils, including chamomile and Roman lavender, help to increase circulation in the body. They also have pain-relieving and anti-inflammatory properties that could boost healing.

Dilute essential oils (a few drops) in 1 ounce of a carrier oil such as olive oil. Applying these diluted oils to the affected area can reduce stinging and tingling pains from peripheral neuropathy.

Meditation techniques can help people struggling with neuropathy symptoms live through their pain. It can help to lower stress, improve your coping skills, and decrease your pain intensity. Taking a mind-body approach is a noninvasive technique that provides you with more control over your condition.

Acupuncture promotes natural healing by stimulating the bodys pressure points. This technique triggers the nervous system to release chemicals that can change the pain experience or threshold. Acupuncture helps to provide an energy balance to the body that can affect your emotional well-being.

Prevention works so much better than treatment. Keeping your blood sugars within the normal range will help prevent your neuropathy from worsening. If your neuropathy is related to alcohol intake, stop drinking now to prevent the condition from getting worse.

Natural remedies have some success in alleviating the pain symptoms of peripheral neuropathy. However, be sure to consult with your doctor prior to participating in a new treatment method. If you begin experiencing irregular symptoms from natural remedies, or if your conditions worsen, visit a doctor immediately.

See more here:
Natural Treatments for Peripheral Neuropathy - Healthline

When you have diabetes, nerve damage can occur as a result of high blood sugar. This is known as diabetic neuropathy. There are four main types of this condition. You may have just one type or you may have symptoms of several types. Most types of diabetic neuropathy develop gradually, and you may not notice problems until considerable damage has occurred.

Talk with your health care provider if you have any of the following symptoms. The sooner they can be diagnosed and treated, the better the chance of preventing further complications.

Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Possible signs and symptoms of peripheral neuropathy include:

The autonomic nervous system controls your blood pressure, heart rate, sweat glands, eyes, bladder, digestive system and sex organs. Diabetes can affect the nerves in any of these areas, possibly causing symptoms including:

Unlike peripheral neuropathy, which affects the ends of nerves in the feet, legs, hands and arms, proximal neuropathy affects nerves in the thighs, hips, buttocks or legs. This condition is more common in people who have type 2 diabetes and in older adults.

Symptoms are usually on one side of the body, though in some cases symptoms may spread to the other side, too. Most people improve at least partially over 6 to 12 months. This condition is often marked by symptoms including:

Mononeuropathy involves damage to a single, specific nerve. The nerve may be in the face, torso, arm or leg. Mononeuropathy, which may also be called focal neuropathy, often comes on suddenly. It's most common in older adults.

Although mononeuropathy can cause severe pain, it usually doesn't cause any long-term problems. Symptoms usually lessen and disappear on their own over a few weeks or months. Symptoms depend on which nerve is involved, and may include:

Sometimes mononeuropathy occurs when a nerve is compressed. Carpal tunnel syndrome is a common type of compression neuropathy in people with diabetes.

Symptoms of carpal tunnel syndrome include:

Be sure to talk with your health care provider if you notice any of these symptoms. The sooner treatment begins, the better the chance of reducing complications.

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Diabetic neuropathy types: Symptoms tell the story - Mayo Clinic

Neuropathy is a term used to describe several conditions that affect the nerves and can cause irritating and painful symptoms. Neuropathy is a particularly common complication of diabetes and a side effect of chemotherapy.

Conventional treatments are available for neuropathy. However, research is underway to investigate the use of supplements. You may find these supplements preferable to other treatment options since they have fewer side effects. They may also benefit your health and well-being in other ways.

Always talk with your doctor before starting any new supplements or changing your treatment plan in any way. You may wish to combine these supplements with complementary therapies, pain medications, and adaptive techniques to help you manage your symptoms, but be cautious.

Herbs and supplements can interfere with each other and with any medications youre taking. Theyre not meant to replace any treatment plan approved by your doctor.

B vitamins are useful in treating neuropathy since they support healthy nervous system function. Peripheral neuropathy is sometimes caused by a vitamin B deficiency.

Supplementation should include vitamin B1 (thiamine and benfotiamine), B6, and B12. You may choose to take these separately instead of as a B complex.

Benfotiamine is like vitamin B1, which is also known as thiamine. Its thought to lower pain and inflammation levels and prevent cellular damage.

A deficiency in vitamin B12 is one cause of peripheral neuropathy. Without treatment, it can cause permanent nerve damage.

Vitamin B6 may help to maintain the covering on nerve endings. But its important that you dont take more than 200 milligrams of B6 per day. Research from 2021 shows that taking higher amounts can lead to nerve damage and cause symptoms of neuropathy.

Foods rich in B vitamins include:

A 2017 review indicates that supplementing with B vitamins has the potential to promote nerve repair. This may be because B vitamins can speed up nerve tissue regeneration and improve nerve function. B vitamins may also be useful in relieving pain and inflammation.

The results of studies showing the benefit of benfotiamine in treating neuropathy have been mixed. A small 2005 study and a 2008 study found benfotiamine to have a positive effect on diabetic neuropathy. It was shown to decrease pain and improve the condition.

But a small 2012 study found that people with type 1 diabetes who took 300 milligrams per day of benfotiamine showed no significant improvements in nerve function or inflammation. People took the supplement for 24 months.

Further studies are needed to expand upon these findings. Its also important to examine the effects of benfotiamine in combination with other B vitamins.

Alpha-lipoic acid is an antioxidant that may be useful in treating neuropathy caused by diabetes or cancer treatment. A 2021 study says it may lower blood sugar levels, improve nerve function, and relieve uncomfortable symptoms in the legs and arms such as:

It can be taken in supplement form or administered intravenously. You may take 600 to 1,200 milligrams per day in capsule form.

Foods that have trace amounts of alpha-lipoic acid include:

Alpha-lipoic acid has been shown to have a positive effect on nerve conduction and to reduce neuropathic pain. A small 2017 study found that alpha-lipoic acid was useful in protecting against oxidative damage in people with diabetic neuropathy.

One important note of caution: If you are deficient in thiamine, or vitamin B1, as a result of excessive alcohol use or for another reason, alpha-lipoic acid may have a toxic effect on your system.

Acetyl-L-carnitine is an amino acid and antioxidant. It may raise energy levels, create healthy nerve cells, and reduce pain in people with neuropathy. You can take it as a supplement. A typical dosage is 500 milligrams twice per day.

Food sources of acetyl-L-carnitine include:

According to a 2016 study, acetyl-L-carnitine significantly improved:

Participants received either a placebo or 3 grams per day of acetyl-L-carnitine for 8 weeks. Researchers noted significant differences between the groups at 12 weeks. This indicates that the neurotoxicity persists without further clinical intervention.

NAC is a form of cysteine. Its an antioxidant and amino acid. Its many medicinal uses include treating neuropathic pain and reducing inflammation.

NAC isnt found naturally in foods, but cysteine is in most high protein foods. You can take it as a supplement in amounts of 1,200 milligrams once or twice per day.

Results of a 2010 animal study showed that NAC may be useful in treating diabetic neuropathy. It reduced neuropathic pain and improved motor coordination. Its antioxidant properties improved nerve damage from oxidative stress and apoptosis, or cell death.

Curcumin is a compound found in the herb turmeric, known for its anti-inflammatory, antioxidant, and pain relieving properties. It may help to relieve numbness and tingling in your hands and feet.

Curcumin is available in supplement form, or you can take 1 teaspoon of turmeric powder with 1/4 teaspoon fresh ground pepper three times per day.

You can also use fresh or powdered turmeric to make tea. You can add it to foods such as curries, egg salads, and yogurt smoothies.

A 2014 animal study found that curcumin reduced chemotherapy-induced neuropathy in mice who took it for 14 days. It had a positive effect on pain, inflammation, and functional loss. Antioxidant and calcium levels were significantly improved. Larger studies on humans are needed to expand upon these findings.

Another animal study from 2013 indicates that curcumin is helpful when taken during the early stages of neuropathy. This may prevent chronic neuropathic pain from developing.

Fish oil is useful in treating neuropathy due to its anti-inflammatory effects and its ability to repair damaged nerves. It also helps to relieve muscle soreness and pain. Its available in supplement form. You can take 2,400 to 5,400 milligrams per day.

The omega-3 fatty acids found in fish oil are also found in these foods:

A 2017 review examined the potential for fish oil as a treatment for diabetic peripheral neuropathy. Studies have shown that fish oil can slow progression and reverse diabetic neuropathy. Its anti-inflammatory properties are useful in reducing pain and discomfort. Its neuroprotective effects can help to stimulate neuron outgrowth.

While the results are promising, further studies are needed to expand upon these findings.

Talk with your doctor before starting any supplements for your neuropathy symptoms. They can provide personalized information about safety and effectiveness given your health situation.

If youre given the go-ahead, you may find that some of these supplements ease the discomfort associated with the condition.

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Supplements for Neuropathy: Vitamins and More - Healthline

Background: Peripheral neuropathy can significantly impact the quality of life for those who are affected, as therapies from the current treatment algorithm often fail to deliver adequate symptom relief. There has, however, been an increasing body of evidence for the use of cannabinoids in the treatment of chronic, noncancer pain. The efficacy of a topically delivered cannabidiol (CBD) oil in the management of neuropathic pain was examined in this four-week, randomized and placebocontrolled trial.

Methods: In total, 29 patients with symptomatic peripheral neuropathy were recruited and enrolled. 15 patients were randomized to the CBD group with the treatment product containing 250 mg CBD/3 fl. oz, and 14 patients were randomized to the placebo group. After four weeks, the placebo group was allowed to crossover into the treatment group. The Neuropathic Pain Scale (NPS) was administered biweekly to assess the mean change from baseline to the end of the treatment period.

Results: The study population included 62.1% males and 37.9% females with a mean age of 68 years. There was a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group when compared to the placebo group. No adverse events were reported in this study.

Conclusion: Our findings demonstrate that the transdermal application of CBD oil can achieve significant improvement in pain and other disturbing sensations in patients with peripheral neuropathy. The treatment product was well tolerated and may provide a more effective alternative compared to other current therapies in the treatment of peripheral neuropathy.

Keywords: CBD; cannabis sativa; diabetic neuropathy; hemp; nerve pain; review..

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The Effectiveness of Topical Cannabidiol Oil in Symptomatic ... - PubMed

Diagnosis

Autonomic neuropathy is a possible complication of some diseases. The tests you'll need depend on your symptoms and risk factors for autonomic neuropathy.

If you have diabetes or another condition that increases your risk of autonomic neuropathy and have symptoms of neuropathy, your health care provider will perform a physical exam and ask about your symptoms.

If you are undergoing cancer treatment with a drug known to cause nerve damage, your provider will check for signs of neuropathy.

If you have symptoms of autonomic neuropathy but no risk factors, the diagnosis can be more involved. Your health care provider will probably review your medical history, discuss your symptoms and do a physical exam.

Your provider might recommend tests to evaluate autonomic functions, including:

Tilt-table test. This test monitors the response of blood pressure and heart rate to changes in posture and position. It simulates what occurs when you stand up after lying down. You lie flat on a table, which is then tilted to raise the upper part of your body. Typically, blood vessels narrow and heart rate increases to compensate for the drop in blood pressure. This response may be slowed if you have autonomic neuropathy.

A simpler test for this response involves checking your blood pressure when lying, sitting and standing after three minutes. Another test involves standing for a minute, then squatting for a minute and then standing again while blood pressure and heart rate are monitored.

Treatment of autonomic neuropathy includes:

Your health care provider may recommend:

Your health care provider may suggest:

For men with erectile dysfunction, health care providers might recommend:

Medications that enable erections. Drugs such as sildenafil (Viagra), vardenafil, tadalafil (Cialis) and avanafil (Stendra) can help you achieve and maintain an erection. Possible side effects include low blood pressure, mild headache, flushing, upset stomach and changes in color vision.

If you have a history of heart disease, arrhythmia, stroke or high blood pressure, use these medications with caution. Also avoid taking these medications if you are taking any type of organic nitrates. Seek immediate medical assistance if you have an erection that lasts longer than four hours.

For women with sexual symptoms, health care providers might recommend:

Autonomic neuropathy can cause heart rate and blood pressure problems. Your health care provider might prescribe:

Medications to raise your blood pressure. If you feel faint or dizzy when you stand up, your health care provider might suggest medications. Fludrocortisone helps your body retain salt, which helps regulate your blood pressure.

Midodrine (Orvaten) and droxidopa (Northera) can help raise blood pressure. But these drugs can cause high blood pressure when you're lying down. Octreotide (Sandostatin) can help raise blood pressure in people with diabetes who have low blood pressure after eating, but it can cause some side effects. Pyridostigmine (Mestinon) may help keep blood pressure stable when standing.

If you sweat too much, your health care provider might prescribe a medication that decreases sweating. Glycopyrrolate (Cuvposa, Robinul, others) can decrease sweating. Side effects can include diarrhea, dry mouth, urinary retention, blurred vision, changes in heart rate, headache, loss of taste and drowsiness. Glycopyrrolate can also increase the risk of heat-related illness, such as heatstroke, from a reduced ability to sweat.

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Posture changes. Stand up slowly, in stages, to decrease dizziness. Sit with your legs dangling over the side of the bed for a few minutes before getting up. Flex your feet and make fists with your hands for a few seconds before standing up, to increase blood flow.

Once standing, try tensing your leg muscles while crossing one leg over the other a few times to increase blood pressure.

Several alternative medicine treatments might help people with autonomic neuropathy. Talk with your health care provider about any treatments you want to try. This can help make sure that they won't interfere with your medical treatments or be harmful.

Research suggests this antioxidant might improve the measures of autonomic nerve function. More study is needed.

This therapy involves placing thin needles in specific points in the body. It might help treat slow stomach emptying and erectile dysfunction. More studies are needed.

This therapy sends low-energy electrical waves through electrodes placed on the skin. Some studies have found that it might help ease pain associated with diabetic neuropathy.

Living with a chronic condition presents daily challenges. Here are some suggestions to help you cope:

First, you'll probably see your primary care provider. If you have diabetes, you might see your diabetes doctor (endocrinologist). However, you might be referred to a doctor specializing in nerve disorders (neurologist).

You might see other specialists, depending on the part of your body affected by neuropathy, such as a cardiologist for blood pressure or heart rate problems or a gastroenterologist for digestive difficulties.

Here are some tips to help you prepare for your appointment.

Ask if you should do anything before your appointment, such as fasting before certain tests. Make a list of:

Take a friend or family member with you to help you remember the information you receive and to learn how to support you. For example, if you pass out from low blood pressure, people around you need to know what to do.

Questions to ask your health care provider about autonomic neuropathy include:

Don't hesitate to ask other questions.

Your health care provider is likely to ask you questions, such as:

More:
Autonomic neuropathy - Diagnosis and treatment - Mayo Clinic

Diabetes is the most common cause of peripheral neuropathy in the UK.

Neuropathy can also be caused by other health conditions andcertain medicines.

In some cases, no causecan beidentifiedand this is termed idiopathic neuropathy.

Peripheral neuropathycaused byeither type 1 diabetes or type 2 diabetesis called diabetic polyneuropathy.

It's probably caused by high levels of sugar in your blood damaging the tiny blood vessels that supply your nerves.

Peripheral neuropathy becomes more likely the longer you have had diabetes.

Up to 1 in 4 people with the condition experience some pain caused by nerve damage.

If you have diabetes, your risk of polyneuropathy is higher if your blood sugar is poorly controlled or you:

If you have diabetes, examine your feet regularly to check for open wounds or sores (ulcers) or chilblains.

As well as diabetes, there are many other possible causes of peripheral neuropathy.

Some of the health conditions that can cause peripheral neuropathy include:

A few medicines may sometimes cause peripheral neuropathy as a side effect in some people.

These include:

Page last reviewed: 10 October 2022Next review due: 10 October 2025

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Peripheral neuropathy - Causes - NHS

Purpose: Diabetic peripheral neuropathy (DPN) is the commonest cause of neuropathy worldwide, and its prevalence increases with the duration of diabetes. It affects approximately half of patients with diabetes. DPN is symmetric and predominantly sensory, starting distally and gradually spreading proximally in a glove-and-stocking distribution. It causes substantial morbidity and is associated with increased mortality. The unrelenting nature of pain in this condition can negatively affect a patient's sleep, mood, and functionality and result in a poor quality of life. The purpose of this review was to critically review the current literature on the diagnosis and treatment of DPN, with a focus on the treatment of neuropathic pain in DPN.

Methods: A comprehensive literature review was undertaken, incorporating article searches in electronic databases (EMBASE, PubMed, OVID) and reference lists of relevant articles with the authors' expertise in DPN. This review considers seminal and novel research in epidemiology; diagnosis, especially in relation to novel surrogate end points; and the treatment of neuropathic pain in DPN. We also consider potential new pharmacotherapies for painful DPN.

Findings: DPN is often misdiagnosed and inadequately treated. Other than improving glycemic control, there is no licensed pathogenetic treatment for diabetic neuropathy. Management of painful DPN remains challenging due to difficulties in personalizing therapy and ascertaining the best dosing strategy, choice of initial pharmacotherapy, consideration of combination therapy, and deciding on defining treatment for poor analgesic responders. Duloxetine and pregabalin remain first-line therapy for neuropathic pain in DPN in all 5 of the major published guidelines by the American Association of Clinical Endocrinologists, American Academy of Neurology, European Federation of Neurological Societies, National Institute of Clinical Excellence (United Kingdom), and the American Diabetes Association, and their use has been approved by the US Food and Drug Administration.

Implications: Clinical recognition of DPN is imperative for allowing timely symptom management to reduce the morbidity associated with this condition.

Keywords: diabetes; diagnosis; epidemiology; neuropathy; pharmacotherapy.

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Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and ... - PubMed

Basel, 23 December 2022 - Roche (SIX: RO, ROG; OTCQX: RHHBY) today announced that the U.S. Food and Drug Administration (FDA) has approved Lunsumio® (mosunetuzumab-axgb) for the treatment of adult patients with relapsed or refractory (R/R) follicular lymphoma (FL) after two or more lines of systemic therapy. This indication is approved under accelerated approval based on response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial. Lunsumio, a CD20xCD3 T-cell engaging bispecific antibody, represents a new class of fixed-duration cancer immunotherapy, which is off-the-shelf and readily available, so that patients do not have to wait to start treatment. Lunsumio will be available in the United States in the coming weeks. “This approval is a significant milestone for people with relapsed or refractory follicular lymphoma, who have had limited treatment options until now,” said Elizabeth Budde, M.D., Ph.D., Haematologic Oncologist and Associate Professor, City of Hope Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, and Lunsumio clinical trial investigator. “As a first-in-class T-cell engaging bispecific antibody that can be initiated in an outpatient setting, Lunsumio’s high response rates and fixed-duration could change the way advanced follicular lymphoma is treated.”“Despite treatment advances, follicular lymphoma remains incurable and relapse is common, with outcomes worsening following each consecutive treatment,” said Levi Garraway, M.D., Ph.D., Roche’s Chief Medical Officer and Head of Global Product Development. “Lunsumio represents our first approved T-cell engaging bispecific antibody and builds on our legacy of more than 20 years of innovation in blood cancer.”The FDA approval is based on positive results from the phase II GO29781 study of Lunsumio in people with heavily pre-treated FL, including those who were at high risk of disease progression or whose disease was refractory to prior therapies. Results from the study showed high and durable response rates. An objective response was seen in 80% (72/90 [95% confidence interval (CI): 70-88]) of patients treated with Lunsumio, with a majority maintaining responses for at least 18 months (57% [95% CI: 44-70]). The objective response rate is the combination of complete response (CR) rate (a disappearance of all signs and symptoms of cancer) and partial response rate (a decrease in the amount of cancer in the body). The median duration of response among those who responded was almost two years (22.8 months [95% CI: 10-not reached]). A CR was achieved in 60% of patients (54/90 [95% CI: 49-70]). Among 218 patients with haematologic malignancies who received Lunsumio at the recommended dose, the most common adverse event (AE) was cytokine release syndrome (CRS; 39%), which can be severe and life-threatening. The median duration of CRS events was three days (range: 1-29). Other common AEs (?20%) included fatigue, rash, pyrexia and headache.Lunsumio is administered as an intravenous infusion for a fixed-duration, which allows for time off therapy, and can be infused in an outpatient setting. Hospitalisation may be needed to manage select AEs, should be considered for subsequent infusions following a Grade 2 CRS event, and is recommended for subsequent infusions following a Grade 3 CRS event.Lunsumio was developed based on the Roche Group's broad expertise in creating bispecific antibodies. Lunsumio is designed to address the diverse needs of people with blood cancer, physicians, and practice settings, and is part of the company’s robust bispecific antibody clinical programme in lymphoma. Lunsumio is being further investigated as a subcutaneous formulation (i.e., administered under the skin) and in phase III studies that will expand the understanding of its impact in earlier lines of treatment in people with non-Hodgkin lymphoma.About the GO29781 studyThe GO29781 study [NCT02500407] is a phase II, multicentre, open-label, dose-escalation and expansion study evaluating the safety, efficacy and pharmacokinetics of Lunsumio® (mosunetuzumab-axgb) in people with relapsed or refractory B-cell non-Hodgkin lymphoma. Outcome measures include complete response rate (best response) by independent review facility (primary endpoint), objective response rate, duration of response, progression-free survival, safety, and tolerability (secondary endpoints).About follicular lymphomaFollicular lymphoma (FL) is the most common slow-growing (indolent) form of non-Hodgkin lymphoma, accounting for about one in five cases.1 It typically responds well to treatment but is often characterised by periods of remission and relapse. The disease typically becomes harder to treat each time a patient relapses, and early progression can be associated with poor long-term prognosis. It is estimated that, in the United States, approximately 13,000 new cases of FL will be diagnosed in 2022 and more than 100,000 people are diagnosed with FL each year worldwide.1,2About Lunsumio® (mosunetuzumab-axgb)Lunsumio is a first-in-class CD20xCD3 T-cell engaging bispecific antibody designed to target CD20 on the surface of B-cells and CD3 on the surface of T-cells. This dual targeting activates and redirects a patient’s existing T-cells to engage and eliminate target B-cells by releasing cytotoxic proteins into the B-cells. A robust clinical development programme for Lunsumio is ongoing, investigating the molecule as a monotherapy and in combination with other medicines, for the treatment of people with B-cell non-Hodgkin lymphomas, including follicular lymphoma and diffuse large B-cell lymphoma, and other blood cancers.About Roche in haematologyRoche has been developing medicines for people with malignant and non-malignant blood diseases for more than 20 years; our experience and knowledge in this therapeutic area runs deep. Today, we are investing more than ever in our effort to bring innovative treatment options to patients across a wide range of haematologic diseases. Our approved medicines include MabThera®/Rituxan® (rituximab), Gazyva®/Gazyvaro® (obinutuzumab), Polivy® (polatuzumab vedotin), Venclexta®/Venclyxto® (venetoclax) in collaboration with AbbVie, Hemlibra® (emicizumab) and Lunsumio® (mosunetuzumab-axgb). Our pipeline of investigational haematology medicines includes T-cell engaging bispecific antibodies, glofitamab, targeting both CD20 and CD3, and cevostamab, targeting both FcRH5 and CD3; Tecentriq® (atezolizumab), a monoclonal antibody designed to bind with PD-L1 and crovalimab, an anti-C5 antibody engineered to optimise complement inhibition. Our scientific expertise, combined with the breadth of our portfolio and pipeline, also provides a unique opportunity to develop combination regimens that aim to improve the lives of patients even further.About Roche Founded in 1896 in Basel, Switzerland, as one of the first industrial manufacturers of branded medicines, Roche has grown into the world’s largest biotechnology company and the global leader in in-vitro diagnostics. The company pursues scientific excellence to discover and develop medicines and diagnostics for improving and saving the lives of people around the world. We are a pioneer in personalised healthcare and want to further transform how healthcare is delivered to have an even greater impact. To provide the best care for each person we partner with many stakeholders and combine our strengths in Diagnostics and Pharma with data insights from the clinical practice.In recognising our endeavour to pursue a long-term perspective in all we do, Roche has been named one of the most sustainable companies in the pharmaceuticals industry by the Dow Jones Sustainability Indices for the thirteenth consecutive year. This distinction also reflects our efforts to improve access to healthcare together with local partners in every country we work. Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan.

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FDA approves Roche’s Lunsumio, a first-in-class bispecific antibody, to treat people with relapsed or refractory follicular lymphoma