Sunday, October 31, 2004

Ethical concerns focus on eye surgery

By Laura Ungar
The (Louisville, Ky.) Courier-Journal

LOUISVILLE - Elizabeth Bryant of Louisville was legally blind and could see only outlines of nearby objects when Dr. Norman D. Radtke transplanted fetal tissue into her left eye as part of a clinical trial.

More than two years later, she said, she can see well enough to read large print and sew.

Bryant, 65, has retinitis pigmentosa, a group of inherited diseases in which there is progressive degeneration of the retina that can cause blindness. She said she participated in the research to help herself and other sufferers - including her daughter.

"Anything was worth a try. I was losing my eyesight," she said. "I felt like I had nothing to lose and a lot to gain."

This week, the British magazine New Scientist published an article on Bryant and the transplant, saying her improvement has been "a remarkable transformation."

Radtke, an eye surgeon and owner of Retina Vitreous Resource Center in Louisville, said Bryant's sight in the treated eye gradually improved from about 20/800 to about 20/200.

"This particular patient would be a really good success story, so we're encouraged to go further," said Radtke, who also co-authored a report on the case published in the August issue of the medical journal Archives of Ophthalmology.

But the use of fetal tissue is controversial. In Bryant's case, retinal tissue came from a fetus with a gestational age of 13 weeks, obtained by informed consent from a donor who had already decided to terminate her pregnancy, according to the medical journal.

Radtke said the controversy surrounding the use of fetal tissue may prevent the surgical procedure from becoming a widespread cure for retinitis pigmentosa. But he said researchers are looking into the possibility of transplanting retinal sheets from genetically engineered pigs in the future.

The procedure as it stands now, however, is "extremely sad," according to Margie Montgomery, executive director of the Kentucky Right to Life Association.

"Restoring one's sight, we're totally in favor of. But the end doesn't justify the means," Montgomery said. "Killing a human being in order to further science is just wrong."

Bryant said she suffered with poor eyesight for decades, wearing glasses as a child and being unable to see at night. Doctors diagnosed her with retinitis pigmentosa in her early 20s.

Bryant said she personally doesn't believe in abortion. But she said it's going to happen whether it's legal or not. She said she thought about the fact that the tissue that restored her sight came from an aborted fetus.

Macular degeneration

What: An age-related disease that blurs the sharp, central vision needed for such "straight-ahead" activities as reading, sewing and driving. It is the leading cause of loss of vision in Americans 60 and older.

How: It affects the macula, the part of the back of the eye that allows fine detail to be seen.

Details: The disease advances so slowly that many people notice little change in their vision. In others, however, the disease progresses more quickly and may lead to a loss of vision in both eyes.

On the Web:

Source: National Eye Institute

Retinitis pigmentosa

What: A group of inherited eye diseases that affect the retina. Symptoms are most often recognized in children, adolescents and young adults.

How: It causes degeneration of photoreceptor cells that capture and process light. As these cells degenerate and die, patients experience progressive vision loss.

Details: While the effects can take various forms, some victims describe their vision as "looking through a straw."

On the Web:

Source: Foundation Fighting Blindness

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