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Imaging the Eye

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There are many diseases that cause vision loss. NIH funded the development of optical coherence tomography (OCT) technology to diagnose these diseases non-invasively, and there are now over 30 million OCT procedures performed annually in eye clinics worldwide.

Image credit: ×îÐÂÂ鶹ÊÓƵ Eye Institute, NIH

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• OCT assessment is fast, painless, and noninvasive, and OCT-based devices are now standard in eye care clinics.
• OCT is a noninvasive technology that enables imaging of the eye's light-sensing retina to help clinicians identify early signs of disease, monitor disease progression, and evaluate treatment response.
• The most common vision-threatening diseases in the U.S. affect the retina. These include age-related macular degeneration, diabetic retinopathy, and glaucoma.

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Treatments for Blindness

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Thanks to NIH, there are now standard therapies that both stop disease progression and restore vision lost due to vascular diseases of the retina—including diabetic retinopathy and wet age-related macular degeneration (AMD)—which are common causes of blindness. In the case of wet AMD, these medications reduce legal blindness by 50%.

Image credit: ×îÐÂÂ鶹ÊÓƵ Eye Institute, NIH

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• AMD is a leading cause of vision loss for older adults. Wet AMD cases account for 10-30% of all cases of AMD but contribute to more than 80% of AMD-related blindness. 
• More than half of people with diabetes will develop diabetic retinopathy, another leading cause of blindness.
• NIH supported development of a class of drugs that block blood vessel formation, which are now standard therapies for vascular diseases of the retina.
• This class of drugs was the first to stop disease progression and restore vision in patients with these diseases.

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Treatment for Lazy Eye

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Roughly 1.5% of U.S. children have amblyopia, known as lazy eye. NIH-supported research informed the guidelines for early treatment of amblyopia, resulting in decreased treatment burden and better outcomes.

Image credit: ×îÐÂÂ鶹ÊÓƵ Eye Institute, NIH

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• Amblyopia is a condition where the brain favors visual input from one eye, weakening sensory input from the other. Due to a loss of brain plasticity, treatment becomes increasingly less effective by adolescence, resulting in permanent unilateral vision loss.
• NIH-funded research has defined the standard for treating amblyopia in children with eyedrops or by temporarily patching the stronger eye. 
• Studies revealed that a large proportion of children with amblyopia can be successfully treated with less intense treatment regimens than previously thought.

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Gene Therapy for Eye Disease

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NIH-funded scientists helped develop the first FDA-approved gene therapy for a degenerative eye disease, Leber Congenital Amaurosis (LCA). This therapy can safely restore normal function and vision in patients, paving the way for other gene-based therapies to treat eye diseases.

Image credit: Wei Li, ×îÐÂÂ鶹ÊÓƵ Eye Institute, NIH

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• LCA is caused by defects in a gene essential for normal retinal function.
• This new gene therapy, Luxturna, was found to be safe, and patients receiving this therapy reported having brighter and clearer vision within weeks of treatment. 
• Luxturna is the first FDA-approved gene-replacement therapy of any kind to be approved.

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Hearing Loss Screening

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As a result of NIH efforts, nearly all infants born in the U.S. today are screened for hearing loss, compared to under 10% screened prior to the universal newborn hearing screening program launched in the 1990s. Early screening allows infants to receive interventions and services during their developmental years when the interventions will be most effective.

Image credit: CanStockPhoto

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• Approximately two to three in every 1,000 children in the U.S. are born with a detectable level of hearing loss in one or both ears.
• Around 98% of newborns are now screened for hearing loss in the U.S. through a program developed by Congress as a joint effort by NIH, HRSA, and CDC, with methods and technology developed by NIH-supported researchers.
• Early identification of hearing loss allows children to receive early interventions and services for healthy language, social, and behavioral development.

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Cochlear Implants

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NIH research contributed to the development of cochlear implants, which have become the most common and successful intervention for children who are profoundly deaf or severely hard-of-hearing. Over 80% of children implanted before 18 months of age develop spoken language skills comparable to children with normal hearing.

Image credit: ×îÐÂÂ鶹ÊÓƵ Institute on Deafness and Other Communication Disorders, NIH

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• A cochlear implant is a small electronic device that provides a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. 
• FDA first approved cochlear implants in the mid-1980s to treat hearing loss in adults. Today, cochlear implants are approved for use in children ages 9 months and older.
• As of December 2019, approximately 736,900 cochlear implants had been implanted worldwide. In the U.S., roughly 118,100 devices have been implanted in adults and 65,000 in children.

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References

Imaging the Eye

1. Fujimoto J, et al. Invest Ophthalmol Vis Sci. 2016;57(9):OCTi-OCTii. PMID: .
2. Special Issue: 25 years of optical coherence tomography. Invest Ophthalmol Vis Sci. 2016. 

Treatments for Blindness

1. Article: NIH study finds Avastin and Lucentis are equally effective in treating age-related macular degeneration: 
2. Bloch SB, et al. Am J Ophthalmol. 2012;153(2):209-213.e2. PMID: .
3. Brown GC, et al. Am J Ophthalmol. 2021;223:405-429. PMID: .
4. Eye Health Data and Statistics: 
5. Solomon SD, et al. Cochrane Database Syst Rev. 2019;3(3):CD005139. PMID: .
6. Common Eye Disorders and Diseases: 
7. Am I at risk for diabetic retinopathy?: 

Treatment for Lazy Eye

1. Pineles SL, et al. Ophthalmic Epidemiol. 2022;29(5):537-544. PMID: .
2. Statement on the Success of Reduced Daily Eye Patching to Treat Severe Amblyopia: 

Gene Therapy for Eye Disease

1. Article: NIH vision researcher T. Michael Redmond recognized with Champalimaud Vision Award: 

Hearing Loss Screening

1. Article: New law to strengthen early hearing screening program for infants and children: 
2. Hearing Program: 
3. ×îÐÂÂ鶹ÊÓƵ Institute on Deafness and Other Communication Disorders: /about-nih/what-we-do/nih-almanac/national-institute-deafness-other-communication-disorders-nidcd
4. Early identification of hearing impairment in infants and young children. NIH Consensus Statement. 1993;11(1):1-24. PMID: .
5. Olusanya BO. Int J Pediatr Otorhinolaryngol. 2011;75(3):316-21. PMID: .
6. van Dyk M, et al. Int J Pediatr Otorhinolaryngol. 2015;79(7):1034-40. PMID: .
7. Data and Statistics About Hearing Loss in Children: 
8. Joint Committee on Infant Hearing 1994 Position Statement: 
9. World Health Organization: Global costs of unaddressed hearing loss and cost-effectiveness of interventions. 2017. 
10. Grosse SD. Volta Voices.Ìý2007;14(6):38-40.
11. Quick Statistics About Hearing: 

Cochlear Implants

1. Cochlear Implants: 
2. Semenov YR, et al. Ear Hear. 2013;34(4):402-12. PMID: .
3. Crowson MG, et al. Audiol Neurootol. 2017;22(4-5):236-258. PMID: .
4. Bond M, et al. Health Technol Assess. 2009;13(44):1-330. PMID: .
5. Semenov YR, et al. Otolaryngol Clin North Am. 2012;45(5):959-81. PMID: .
6. Quick Statistics About Hearing: 
7. Nucleus 24 Cochlear Implant System: