Submited on: 04 Apr 2012 02:17:53 AM GMT
Published on: 04 Apr 2012 04:15:51 PM GMT
 
N-acetylcarnosine Eye Drops
Posted by Dr. Marios Kyriazis on 07 Dec 2012 12:50:59 PM GMT

  • What are the main claims of the paper and how important are they?

    The author claims that use of n-acetylcarnosine eye drops improved the subjects cataract


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The claims are not novel, as there have been many hundreds of such benefits. However, it is rare that a case study is presented formally in a learned publication


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes. The finds reported by the author ar typical to those reported informally bothers


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    This is only one case report, with the obvious limitations


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Yes


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    There is a need for a more full and complete clinical trial with many participants


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No


  • Other Comments:

    As a single case report it is interesting to notice that the results confirm other published and unpublished literature. The improvement of sensitivity to glare is typical. There has been a lot of commercial interest in these drops and it is necessary to reportany further cases in a way that is separate from commerciall bias

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    Yes
  • References:

    Kyriazis M, The Cataract Cure, iUniverse publishing 2012

  • Experience and credentials in the specific area of science:
    None
  • How to cite:  Kyriazis M .N-acetylcarnosine Eye Drops[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(12):WMCRW002383
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Dr. Marios Kyriazis, Thank you for your esteemed review of this case report. I appreciate and agree with your comments thus acknowledge the limitations of a single-subject case report...nevertheless, we need to start somewhere in order to generate more conclusive objective findings. Bill Misner
Responded by Dr. Bill Misner on 08 Dec 2012 05:51:46 PM

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    The conclusions drawn are scientifically sound and correct, as far as a case report concerns. The author acknowledges similar work done before and provides references to that.

     

    I`d suggest to change the title as follows: Positive effects of Topical N-Acetylcarnosine (eye drops) on Cataract-Inhibited Vision in an Elderly subject - A Case Report...

     

    The 1st phrase in the Introduction section needs revision.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    As cardiologist I have no specific ophtalmology therapeutic area expertise.......it is the methodological part that I can judge on.

  • How to cite:  Pater C .What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report . [Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(5):WMCRW001783
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Dear Dr. Pater, Thank you for your review, especially specific comments I must take into consideration. As you eloquently stated a single subject case report must present method with objective findings that justify the title "Positive" effects of_________. With high regards, Dr. Bill Misner PhD {Emeritus}
Responded by Dr. Bill Misner on 07 May 2012 03:53:13 PM

1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? No
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? No
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? No
  • Other Comments:

    The topic is interesting. However nothing has been said on ethical cosniderations applied in this study. Moreover, the conclusion based on the study on one person is not so much strong.

     

    I think if there was a few patients as control to the patient in the intervention, the conclusion would be stronger. Please add a few sentences on suggestions for future studies and limitations

     

    Best wishes for the author

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I am a nurse and in the nursing science the conclusion on new measures to replace known and previous treatments should be with caution.

  • How to cite:  Vaismoradi M .What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(5):WMCRW001775
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Mr. Mojtaba Vaismoradi, Thank you for your review comments. This paper is intended to be a Case Report publishing conclusive comments of one subject based on the four objective eye test numbers determined by separate teams of Optometrists. The pre-treatment regimen was compared to the post-treatment regimen to determine efficacy of N-Acetylcarnosine eye drops in one subject only. There are indeed limits to what a Case Report should declare. Dr. Bill Misner PhD {Emeritus}
Responded by Dr. Bill Misner on 04 May 2012 05:27:50 PM
Review
Posted by Dr. Ajit S Narang on 24 Apr 2012 05:07:30 PM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:
    • General. Typographical corrections such as “self-administered for 90 days” in abstract; “solution of N-acetylcarnosine eye drops”. Writing style may benefit from certain changes as well. Quite a bit of repetition of information in the writing, which can be avoided.
    • Method. Methods used for determination of clinical efficacy for vision improvement should be discussed in general and the method used in this paper should be critically assessed. For example, authors mention % improvement of visual acuity and glare sensitivity along with a general mention of ‘considerable evidence’ in Introduction without further discussion. Prior use of the method used by the author in the current paper and the variability associated with this method should be discussed as well.
    • Data. The first paragraph of the Conclusions section describes data, but it is somewhat confusing. Data presented in Tables 1 and 2 should include annotation for abbreviations used and an equation for calculation for % vision improvement. A consideration of normal variability in measurements by this method should be included in the discussion of whether the presented results are significantly different.
  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    None

  • How to cite:  Narang A S.Review[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001726
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Dear Dr. Narang, Thank you for posting this review. The comments are appreciated, though conclusive norms for cataract progression will not be discussed because they are unknown. A case report is here presented to present findings in order to identify a single subject response that was positive, though others may not be positive. Regards with appreciation, Dr. Bill Misner PhD - {Emeritus}
Responded by Dr. Bill Misner on 24 Apr 2012 05:38:53 PM
Research Assistant Professor (Chiropractic)
Posted by Dr. Lafayette Briggs on 14 Apr 2012 06:17:17 AM GMT

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    1. Too many references for a case report.

     

    2. Babizhayev references could be condensed.

     

    3. Conclusion (A mechanism of action for this drug needs to be established through additional research in this

        area.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Research Assistant Professor.

  • How to cite:  Briggs L .Research Assistant Professor (Chiropractic)[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001683
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Dear Professor Briggs, Thank you for posting your review of this case report; I agree with your comments completely! The mechanism for this effect is somewhat multiple, hence any discussion of what is known to date in a case report seems too hypothetical. At least that is my excuse for leaving that for a future article that has evidence supporting the discussion. Regards, thank you, Dr. Bill Misner PhD - {Emeritus}
Responded by Dr. Bill Misner on 14 Apr 2012 04:03:48 PM

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    This case report is of interest, and the manuscript is well written, documented and organized.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    No

  • How to cite:  Hmadcha K .What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report [Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001664
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Dear Dr. Hmadcha, I am well-pleased to have your esteemed comments and formal review posted on this forum. Thank you! Dr. Bill Misner PhD - Emeritus
Responded by Dr. Bill Misner on 09 Apr 2012 04:11:00 PM

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    Too many references for a case report. Suggest to reduce to half.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I am a pulmonologist and therefore have no experience in this area.

  • How to cite:  Abdul Rahaman J .Effects of topical N-Acetylcarnosine on cataract: A case report[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001657
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Dear Dr. Jamalul Azizi Abdul Rahaman, Thank you for you esteemed review. I agree there are too many references for a "Case Report." Since I as author was also the subject, it was my intention to report observations by showing that previous similar observations had been recorded by others. Also, these same research papers (5-23) discuss possible antioxidant paths by which NAC-eyedrops may reduce the visual-inhibiting effects of age-onset cataracts prior to surgical correction. I hope you do not object to this reply stating some of the reasons for having too many references for a case report. Warm regards with appreciation, Dr. Bill Misner PhD - Emeritus
Responded by Dr. Bill Misner on 07 Apr 2012 04:56:07 PM
N-Acetylcarnosine
Posted by Dr. Samad E Golzari on 05 Apr 2012 08:34:30 PM GMT

1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? Partly
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:
    1. In the introduction section, definition of cataracts seems quite unnecessary.
    2. Half the population ages 65-74, and 70% over 75 present cataract-inhibited visions. Reference is required for this report. The sentence also lacks a verb.
    3. In the discussion section, definition of cataract surgery seems quite unnecessary.
    4. The introduction part lacks proposing any probable mechanism by which the medication would be effective.
    5. As the efficacy of this medication has not been proven yet, was the patients aware of this issue that this intervention was not necessary beneficial for him? Were any informed written consents obtained from the patient? If yes, they should be mentioned in the study.
    6. Another question in my mind is : "is this the routine in your health system that the patients visited by optometrists do not require to be reexamined with an ophthalmologist? If yes, I think it would be a better idea to be placed in the article.
    7. "follow-up eye examinations" seems to have been performed just once so it should be corrected.
    8. " self-administered" this term seems quite confusing, what do you mean by that? The patient himself applied the drop every time? If yes, no need to be presented. The patient by his own will chose the medication? If yes, no need to be present in either case. I would suggest this term to be eliminated.
    9. " topical N-Acetylcarnosine eye-drops protocol", is there any approved protocol? If not, this term should not be used.
    10. In the acknowledgment part, there should be a sentence about the second visit by the alternative doctor which seems unnecessary and has been performed because of the present study. Who paid for the second visit? The author or the patient.
    11. References 21-24, 17-18, 12,5 could be replaced or deleted.
  • Competing interests:
    no
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Anesthesia, pain management

  • How to cite:  Golzari S E.N-Acetylcarnosine[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001654
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Dear Dr. Golzari, Thank you for this critical, but positively-precise review of this case report. May I address some of the brilliant points you raised? Half the population ages 65-74, and 70% over 75 present cataract-inhibited visions. Reference is required for this report was listed in the next sentence as (1, 2). In our language, this sentence contains the verb, present, which means "demonstrates or shows." In the discussion section, defining the curative cataract surgery is unnecessary, because that is the end-step action taken when mild cataracts progress to problematic sight-inhibition. The introduction part lacks proposing any probable mechanism by which the medication would be effective. You are absolutely correct, however, I am uneasy about discussing a hypothetical mechanism in a case report, when experts in Opthomology and Optometry do not conclude what the actual mechanism is. However, references 5-23 were listed because indeed these papers discussed the mechanisms and procedures commonly chosen to treat and resolve cataract-inhibited vision.Currently, in the USA, it is the routine in our health system that patients examined by Optometrists are not required to be reexamined by an Ophthalmologist, unless the cataract-inhibited vision is severe. Kindly note, I self-administered 1-eyedrop to both eyes 4-times each day while laying supine with eyes closed for 5-minutes in order to permit absorption of the 1%-N-Acetylcarnosine eyedrops. This was stated in both methods and in disclosure that as author and subject of this case report, I funded the project's before and after Optometrist's examination, eyeglasses, and 8-each 2-ml units containing 1%-N-Acetylcarnosine eyedrops. I have no remunerative relationsip with an Optometrists or eye medication products. One last comment, I am very thankful for your review, an esteemed review, which shows you read this paper and added concise comments I as author warmly accept. With kindest regards and sincere appreciation, Bill Dr. Bill Misner PhD - Emeritus AAMA Board Certified Alternative Medicine Practitioner WebMedCentral - Advisory Board
Responded by Dr. Bill Misner on 05 Apr 2012 11:17:23 PM

1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    Although this is only a case and no firm conclusion can be reached from the results of any single case study, this report is very prospective and an interesting issue.

     

    So, novel studies are needed as clinical investigation.

     

     

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Yes

  • How to cite:  Aribas B .What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report [Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001652
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Dr. Bilgin Kadri Aribas, Thank you for your esteemed comments and helpful review posted. Warm regards! Dr. Bill Misner PhD - Emeritus
Responded by Dr. Bill Misner on 05 Apr 2012 11:21:37 PM

1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? No
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? No
5 Are structure and length satisfactory? No
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? No
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? No
  • Other Comments:

    The work appears clear from the optmetrist point of view.  But what are the other conditions of the eye which can only confirmed by an ophthalmologist.  What is the improvement in each eye.  The discussion deals heavly with the surgical treatment of cataract but in this report the focus is on medical management of cataract and also not alternative management.  What about the complaince and correct methodology of applying the eye drops.  And finally one small doubt -- who are "Doctors of Optometry" ?  Are they optometricians.

  • Competing interests:
    no
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Worked as Government medical officer where cataract surgery camps were conducted, supervised a optometrician in the government hospital.

  • How to cite:  Satish N S.what are the other conditions of the eye of this elderly subject ?[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001651
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Dear Dr. Satish, Thank you for your review. Optometrists (Ophthalmic Opticians outside of the United States) are licensed medical professionals trained to prescribe and fit lenses to improve vision, and to diagnose and treat various eye diseases. Optometrists were recruited to perform eye examinations on myself (a 72-y male subject in this case report). This was done in order to offer objective findings over this 90-day period of which 4 x day one eye-drops N-Aceytlcarnosine was placed in each eye in supine position then the subject waited 5-minutes while the eye-drops were completely absorbed. As a case report for only 90-days, the results expected were no change in the Optometrist's eyeglass prescription. As the subject, I, also as the author, began to notice changes in my vision and I confirmed what I noticed with the Optometrist's final eyeglass exams. All that this case report can conclude is that change to a lessor strength prescription eyeglass did occur as confirmed by two separate Optometrist's examinations. We need more research with additional subjects who suffer mild cataract onset. Warm regards, Dr. Bill Misner PhD
Responded by Dr. Bill Misner on 05 Apr 2012 04:11:50 PM

1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? No
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    The subject is partly outside the field of alternative medicine, the drug in object does not appear to be strictly considered as an alternative/non conventional treatment.

    The paper is not original since the topic has been addressed in many studies before. It has value as a case report corroborating the evidence of a positive effect of the drug.

    I suggest to include a brief description of the mechanism by which the drug would exert its effect: antioxidant, etc...

    Too many references for a case report, most of them by the same author: should be cut by 50% at least. 

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Practitioner of alternative/complementary medicine.

  • How to cite:  Luchetti M .Topical N-Acetylcarnosine for cataract in the elderly[Review of the article 'What are the Effects of Topical N-Acetylcarnosine [eye drops] on Cataract-Inhibited Vision in an Elderly Subject? - A Case Report ' by Misner B].WebmedCentral 2012;3(4):WMCRW001644
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Dear Dr. Luchetti, Thank you for your esteemed review of this manuscript. Research with N-acetylcarnosine demonstrates that it is effective not only in preventing cataracts but also in treating them. NAC has been shown to improve vision by partially reversing the development of the cataract, thus increasing the transmissivity of the lens to light. The structural difference between NAC and carnosine is that one hydrogen atom in carnosine replaces an acetyl group (CH3CO-), and this substitution occurs at a nitrogen atom. An important chemical difference between carnosine and N-acetylcarnosine is that carnosine is relatively insoluble in lipids (fats and fatty compounds), whereas N-acetylcarnosine is relatively soluble in lipids (as well as in water). This indicates that N-acetylcarnosine may pass through the lipid membranes of the corneal and lens cells more easily than carnosine, and may thereby gain access more readily to the cells' interior, which is primarily aqueous. There, the N-acetylcarnosine is gradually broken down to carnosine (and, perhaps, to histidine), which then exerts its beneficial effects. Now, my comment as the author is that a case report is not the place to discuss the mechanism when the intent is to discuss only the "effects" so well supported by two separate Optometrists' eye exams, which resulted in lowering the strength of the original prescription eyeglasses within a 90-day examinations time period. Respectfully yours, Dr. Bill Misner PhD - Emeritus
Responded by Dr. Bill Misner on 04 Apr 2012 08:27:14 PM