EyeWorld Weekly Update, May 18, 2018

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May 18, 2018
Volume 24 , Number 17

Patent application filed for cannabinoid-based glaucoma treatment

InMed Pharmaceuticals (Vancouver, British Columbia) has filed a Patent Cooperation Treaty application for INM-085, its cannabinoid-based topical therapy for glaucoma. The application includes protection of its technology in about 150 countries, including the U.S., according to a company press release. The filing helps to provide intellectual and commercial protection for the therapy. The company is completing preclinical studies for INM-085 and pursing an initial discussion with potential partners. The therapy under development is a stimulus-responsive, nanoparticle-laden vehicle for the controlled delivery of ophthalmic drugs into the eye's aqueous humor, the first application of which would be INM-085 to help reduce IOP associated with glaucoma. The therapy is intended as a once daily eye drop used right before bed.

New Drug Application submitted for netarsudil/latanoprost glaucoma treatment

A New Drug Application has been submitted to the U.S. Food and Drug Administration for Roclatan (netarsudil/latanoprost ophthalmic solution, Aerie Pharmaceuticals, Durham, North Carolina), a once-daily eye drop to lower IOP in patients with glaucoma or ocular hypertension, the company reported in a press release. The agent is a fixed-dose combination of the company's agent Rhopressa (netarsudil) and latanoprost. Rhopressa is currently available in the U.S.

First-in-human trial results reported for MINIject for glaucoma

Six-month first-in-human trial results were reported for the MINIject device, a microinvasive glaucoma surgery device designed to treat glaucoma, according to a press release from iSTAR Medical (Wavre, Belgium). Use of MINIject led to an average 39% lowering of IOP to a mean of 14.2 mm Hg at 6 months; 87.5% of patients were able to stop topical medication usage and remained medication-free at 6 months. No serious ocular adverse events occurred, according to iSTAR. The prospective, open, international, multicenter trial implanted MINIject in 25 patients with mild to moderate primary open angle glaucoma that was uncontrolled with topical hypotensive medication. Safety and performance will continue to be measured for up to 2 years. The MINIject helps reduce IOP by enhancing aqueous humor outflow from the anterior chamber to the supraciliary space and uses STAR material, a medical-grade silicone with a microporous and multichannel geometry.

Valeant to be renamed Bausch Health Companies

Valeant Pharmaceuticals International (Laval, Quebec) will be renamed Bausch Health Companies beginning in July, according to a company news release. At that point, the company will roll out a new corporate brand identity, including new imagery and a new website.

Register for the ASCRS webinar on Wednesday, May 30

Register now for the upcoming webinar, "Know Your Tools/Toy Box: Preop Diagnostics in Cataract Surgery," which will take place on Wednesday, May 30 at 9:00 p.m. EDT. Sponsored by the ASCRS Young Eye Surgeons Committee, attendees will learn from expert surgeons about basic preoperative diagnostic tools needed for cataract surgery. This will include how to evaluate varying corneal topographers and biometers. In addition, case studies will show examples of preoperative diagnostic evaluation in patients with compromised corneas and post-refractive eyes. Case presentations will also discuss preoperative diagnosis of astigmatism to aid in the use of toric IOLs. Join moderators Zaina Al-Mohtaseb, MD, and Samuel Lee, MD, and panelists Mitchell Weikert, MD, and Kevin Miller, MD, for an interactive, case-based discussion. This webinar is free for ASCRS members. Nonmembers can attend for $75, or become a member of ASCRS today.

RESEARCH BRIEFS

  • There was a lower risk for clinically significant macular edema (CSME) after cataract surgery in patients treated with a combination of topical bromfenac 0.09% and dexamethasone 0.1%, reported Laura Wielders, MD, and coresearchers. The randomized controlled trial took place at 12 European study centers and compared the efficacy of a topical nonsteroidal anti-inflammatory drug, topical corticosteroid, and a combination of both drugs to prevent cystoid macular edema. Patients (n=914) were randomized to receive topical bromfenac 0.09% two times a day for 2 weeks or dexamethasone 0.1% four times a day with one drop less per day every following week, or a combination. The difference in central subfield mean macular thickness at 6 weeks postoperatively was the main outcome. At 6 weeks, the mean central subfield macular thickness was 288.3 microns, 296 microns, and 284.5 microns in the bromfenac group, dexamethasone group, and combination treatment group, respectively (overall P=.006). Within 12 weeks postoperatively, the incidence of CSME was 3.6%, 5.1%, and 1.5%, respectively (overall P=.043). The study is published in the Journal of Cataract & Refractive Surgery.
  • A thinning of the cornea and changes in posterior cornea curvature occurred after 8 hours of scleral lens wear in 26 study subjects with keratoconus, according to Maria Serramito and coresearchers. Their study focused on corneal thickness, anterior chamber depth, and posterior corneal curvature and aberrations after scleral lens wear with and without intrastromal corneal ring segments (ICRS). Subjects were divided into an ICRS group and a group without ICRS. Study variables included corneal thickness in different quadrants, posterior corneal curvature, and posterior corneal aberrations. There was a statistically significant corneal thinning (P<0.05) in the inferior region of the keratoconus group and in the superior region of the ICRS group, but no change in anterior chamber depth occurred. There was a steepening in the temporal quadrant and a flattening that mainly affected the superior nasal quadrant. The only changes for posterior corneal aberrations were Z4 for 8 mm and Z8 for 4 mm in the keratoconus group. The study appears in Contact Lens & Anterior Eye.
  • Severe visual impairment was seen in 119 children with congenital Zika syndrome, reported Liliana Ventura, MD, and coresearchers. Their study compared the 119 children with Zika syndrome to a control group of infants (n=85). The groups were matched for age, sex, and socioeconomic status. Binocular Teller Acuity Card testing was abnormal in 107 of the infants with Zika syndrome and four controls (89.9% versus 5% [P<0.001]). Abnormal monocular Teller Acuity Card results were more frequent in eyes with funduscopic alterations, but 104 of 123 normally structured eyes also presented abnormal Teller Acuity Card results. Among the Zika syndrome infants, 87 of 107 presented with reduced binocular contrast sensitivity compared with eight of 80 controls. Visual development milestones were met less frequently in the infants with Zika syndrome. "A protocol for assessment of the ocular findings, visual acuity, and visual development milestones testing against age-matched controls is suggested," the researchers concluded. The study is published in the Journal of the American Association for Pediatric Ophthalmology and Strabismus.
  • Fall prevention interventions may be an adequate starting point to prevent falls in patients with glaucoma, according to Avodeji Sotimehin, and coresearchers, in their prospective cohort study. Researchers had patients with suspected or diagnosed glaucoma complete monthly calendars to report their falls. A 30-item questionnaire helped to determine fall location, circumstances, and injury. Among 142 patients, 330 falls occurred, most of which where in or around the home (71%). The likelihood of falling did not vary significantly with visual field damage (P>0.2). Tripping (43.6%), slipping (31.3%), uneven flooring (23.5%), and poor vision (15.9%) were the most commonly cited fall circumstances. Circumstances related to the falls did not change by visual field damage severity except for poor vision, which was cited more often by those with more advanced visual field damage. There was an injury in 43% of falls. Those with more severe glaucoma were more likely to have a fall that resulted in a fracture (9.4%) or ER visit (18.8%), but those associations did not persist in multivariable models. The study is published in the American Journal of Ophthalmology.

This issue of EyeWorld Weekly Update was edited by Amy Goldenberg and Vanessa Caceres.

EyeWorld Weekly Update (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery and the American Society of Ophthalmic Administrators, is published every Friday, distributed by email, and posted live on Friday.

Medical Editors: Eric Donnenfeld, MD, chief medical editor; Rosa Braga-Mele, MD, cataract editor; Clara Chan, MD, cornea editor; Nathan Radcliffe, MD, glaucoma editor; and Vance Thompson, MD, refractive editor.

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