Scientists have revealed that vCJD could be transmitted to patients by the surgical instruments used in eye surgery.
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A team from the Prion Unit at Imperial College School of Medicine, London, reported in the Lancet medical journal today on a new highly sensitive test to detect the particles that cause the disease. The test examines the retina and optic nerve, areas that exhibit high levels of prion proteins (PrPSc) in vCJD-infected patients.
Scientists believe that these are the disease-causing particles, but importantly they are not destroyed at the temperatures used to sterilise eye surgeons’ tools.
Fears emerging in January over the transmission of vCJD during surgery led the Department of Health to call for the surgical instruments used in tonsil removal operations to be used once then thrown away. The scientists who have developed the new test believe however that there could be a greater risk of transmission in eye operations.
Under lead researcher Professor John Collinge, the team analysed tissue samples from four patients who have died from vCJD. It is still unknown what concentration of PrPSc is required before the risk of vCJD transmission is tangible, but the scientists were able to identity areas with increased concentration.
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By GlobalDataPrPSc was present in tissue from the tonsils, spleen and lymph-nodes at concentrations of up to 15% of those found in the brain. It was also present in the retina and the optic nerve tissue at 2% and 2.5% the concentration of that found in the brain, respectively.
The study concluded: “Ophthalmic surgical instruments used in procedures involving optic nerve and the posterior segment of the eye, in particular the retina, might represent a potential risk for iatrogenic (accidental) transmission of vCJD.”
Professor Collinge commented that it is still unknown exactly how great the risk is of transmitting vCJD via surgical instruments. “The Department of Health will need to balance all the potential risks and decide what the appropriate response to all this is,” he said.
He added: “Obviously it is not practical, or desirable to use disposable instruments for every operation.”
The team has said that its findings will be referred to the government’s advisory group: the Spongiform Encephalopathy Advisory Committee.
