Eyeworld

EW NEWS & OPINION 10 January 2015 W e have many great contemporary innovators in ophthalmology, but Minas Coroneo, MD, has rather quietly distinguished himself as one of the most prolific and productive. Minas is professor and chairman of ophthalmology at the University of New South Wales in Sydney, Australia. His predecessor as chair was the legendary Fred Hollows, who was a giant in the field of global blindness and cataract in the developing world. Minas has continued Prof. Hollows' work by coordinating one of the largest rural outreach programs in Australia, and he developed a telemedicine system for this service. Impressed with the challenges posed by mature cataracts in this setting, Minas originated the concept of using trypan blue dye for capsular staining and is the inventor of the first U.S. patent in this area. Minas has also been an important innovator in the area of suprachoroidal microstents for the surgical management of glaucoma. All told, Minas holds 29 patents in ophthalmology with others currently under application. His research has spanned the entire eye from pterygium and ocular surface malignancy, to CMV retinitis, to bionic eye research. His IOL design to eliminate temporal negative dysphotopsia (based on focusing of peripheral light, the "Coroneo effect") is quite elegant and could potentially eliminate this commonly bothersome symptom. Knowing as I do that Minas' curiosity is inexhaustible, I was not surprised to learn about one of his current and favorite projects—improving ocular health and nutrition through creative culinary recipes. Minas and his wife, Hellene, have published Feast Your Eyes—the Eye Health Cookbook (available through Amazon). In addition to offering dietary advice for better ocular health based on his research, the book offers 42 recipes from international celebrity chefs with ingredients that are good for our eyes. They are working on a second edition featuring recipes from American chefs. As important as his many innovative ideas have been to vision restoration, it's nice to know that some of what Minas is inventing actually tastes good. He explains his passion for this interesting hobby in our interview this month. David F. Chang, MD, chief medical editor by David F. Chang, MD Dr. Chang: How did you go about compiling and then publishing this cookbook? Dr. Coroneo: Fearlessly! Having no formal training or qualifications in nutrition was always a concern, particularly because I ran the risk of suffering the consequences as- sociated with a lack of credibility. I knew my way around the scientific literature from both my research and intellectual property backgrounds and had great support from col- leagues with appropriate expertise. I had been writing a book—an "every person's guide to the eye" based on patient stories and had just about completed the section that explains how the eye works. I shelved that project, recycled this section, and on a cruise to Bermuda from New York City, completed a "mini-review" of the role of diet in eye health. Returning to Sydney, it became ap- parent that we had access to some of Australia's leading chefs, who readily pitched in with recipes, consistent with Mediterranean and traditional diets. My wife Hellene had an inter- est in cooking (culturally "inherit- ed" and from years spent in Europe during my postgraduate studies) and helped to organize and edit the recipes. Over dinner, appropriately at a Greek restaurant in Sydney, one of our community leaders and one Dr. Chang: How did you get interested in the effect of nutrition on ocular health? How strong is the scientific evidence regarding the role of diet? Dr. Coroneo: In 1997 I was consult- ed by a young woman with diabetes whose pregnancy was blinding her. In desperation I sought help from a colleague and by reducing her high saturated fat intake and increasing essential fatty acids, particularly omega-3s, her retinopathy resolved and her pregnancy was completed uneventfully. Had I not seen this happen I would not have believed it because back then, I was a standard issue diet and vitamin supplement skeptic. Scientific evidence that this would work was tucked away in the literature, and I just did not know about it. This primed my interest in the subject, and in 2000 I took my family to the Greek island Kythera (from where our ancestors originat- ed). I set up a small clinic on the island's retirement home and saw all-comers for 2 weeks, starting with those in the home. Of the 60 or so "inmates," whose average age was over 90, only 5% showed clinical evidence of age-related macular degeneration (AMD). One of the few affected was relatively well to do and could afford to smoke. As compared to Australia's Blue Moun- tains Eye Study, one would expect that 40% would have this condition. Previous studies from rural southern Italy had reported similar findings. Having had a long-term interest in the effects of ultraviolet light, it seemed to me that it was more likely that other factors such as diet and genetics were playing a role. As I had grown up on a then unfashionable Mediterranean diet (I hid my lunch box at school), this was of great interest to me. At the university, nutrition teaching was minimal and by this time my diet had morphed into a Western-style diet. Since then I have come to realize that having a medical degree could well be a health hazard on dietary and other grounds. In 2001 findings of the land- mark Age-Related Eye Disease Study (AREDS) were published: High doses of antioxidants and zinc reduce the risk of developing advanced AMD by about 34% in patients with this condition. Also at this time flax seed oil was being used in the management of dry eye syndrome. We have known for decades that diet is critical in the management of eye disease in diabetes and likely retinal vascular disease, and I believe that there is now strong scientific evidence that diet influences the development and evolution of AMD. There is also good evidence that omega-3 supplementation is useful in managing dry eye syndrome. The "final straw" that drove me to teach myself about nutrition came when I had patients on 2 types of supple- ments for eye disease (one each from the retinal and cornea people). What is he cooking up now? Dr. Coroneo and Chef Luke Mangan compare their knives. Source (all): Minas Coroneo, MD Feast Your Eyes cookbook, published in 2010 continued on page 12 Chief medical editor's corner of the world

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