EW Weekly, July 24, 2020

Medicare Administrative Contractor establishes physician fee schedule code for intracanalicular inserts
Ocular Therapeutix announced that Novitas Solutions, one of seven Medicare Administrative Contractors (MACs), established a physician fee schedule for procedure code 0356T for drug-eluting intracanalicular inserts, including the company’s DEXTENZA, a dexamethasone ophthalmic insert. This means, according to the company’s press release, that the physician can be reimbursed for the drug as well as seek professional fee reimbursement in the 10 states covered by Novitas Solutions.

Six-month data from gene therapy trial for X-linked retinitis pigmentosa
Janssen, a pharmaceutical company of Johnson & Johnson, announced 6-month data from its ongoing Phase1/2 trial of a gene therapy for X-linked retinitis pigmentosa. The trial has three phases: dose-escalation, dose-confirmation, and dose-expansion. According to a press release from the company, the dose-escalation phase included 10 adults who received a low, intermediate, and high dose of the gene therapy, which is delivered into cells via a viral vector. The company stated that the low- and intermediate-dose cohorts showed significant improvement in retinal sensitivity from baseline. The 6-month results also show significant differences in central visual field progression rate in treated and untreated eyes in the low and intermediate groups. In terms of safety, the most common adverse events were related to the surgical procedure, according to the press release, and inflammation was seen in two of the three patients in the high-dose cohort with visual function measures not improved.

Study: Risk of ophthalmic corticosteroids in pregnancy
Given the relatively unclear risk of topical ophthalmic corticosteroids during pregnancy, researchers undertook a retrospective, cohort, database study to determine whether there was an association with adverse neonatal outcomes. Researchers used the JMDC Claims Database (Japan’s largest epidemiological database), pulling out data on pregnant women with allergic conjunctivitis who were treated with or without topical ophthalmic corticosteroids in their first trimester between 2005 and 2018. Adverse neonatal outcomes such as congenital anomalies, preterm birth, and low birthweight were compared. The study included data on 6,847 pregnant women, 898 of whom received topical corticosteroids. The researchers ultimately found that topical corticosteroids were not significantly associated with an increased risk of congenital anomalies, preterm birth, or low birthweight. This research is published in the American Journal of Ophthalmology.

ASCRS joins the Medical Society Consortium on Climate & Health
ASCRS, along with the American Academy of Ophthalmology, joined the Medical Society Consortium on Climate & Health. According to a press release from ASCRS, the consortium sees addressing climate change as the greatest public health opportunity of the 21st century; conversely, not addressing climate change could reverse global health progress. This news comes alongside the publishing of a survey of more than 1,300 cataract surgeons and nurses that found 93% think cataract surgery waste is excessive and should be reduced. “The problem of operating room waste is not an easy one to fix, but one we can all agree is an ideal area in which to target carbon reduction strategies,” David F. Chang, MD, lead author of the survey, said in a press statement. “Because cataract surgery is one of the most commonly performed operations, we have an opportunity to collaborate with industry and regulatory agencies to make an impact.” The survey is published in the Journal of Cataract and Refractive Surgery and further information and perspectives are available in the August issue of EyeWorld.

Research highlights
  • A new study showed that if the optic nerve of one eye is damaged, the optic nerve of the second eye can step in to share the metabolic load. Researchers from Vanderbilt University Medical Center used positron emission tomography imaging to show the movement of metabolites from a healthy optic nerve to one that was stressed, according to a press release. The researchers report that the healthy tissue that is contributing metabolic energy can become stressed itself and more susceptible to damage. The study authors propose this could explain how neurodegeneration can spread to other healthy areas of the brain. The research is published in the Proceedings of the National Academy of Sciences.
  • A low-carb diet was associated with lower risk of a primary open angle glaucoma (POAG) subtype, according to research published online earlier this year and in print this month in the journal Eye. More than 185,000 patients were followed biennially from three U.S. cohorts (1976–2016, 1986–2016, and 1991–2017). The researchers’ data suggests that higher fat and protein consumption from vegetable sources (instead of carbohydrate sources) was associated with a lower risk of POAG with initial paracentral visual field loss.
  • Optical quality in patients with dry eye disease was improved after intranasal neurostimulation to stimulate tear production, a recent study found. The cross-sectional review of 33 eyes (21 patients) found a decrease in objective scattering index 0.30±0.68 from baseline after the intranasal treatment, as well as a 2.12±9.2 improvement in modulation transfer function (this factor wasn’t statistically significant). This research is published in the journal Clinical Ophthalmology.

Product news
  • Bausch + Lomb introduced PINNACLE 360 25-gauge Scleral Fixation Forceps, developed to aid in placement of scleral-sutured posterior chamber IOLs.
  • Norlase received the CE mark for LEAF, a fiberless green laser that received FDA approval in October 2019.
  • The Vera180 Synthetic Absorbable Lacrimal Plug (Lacrivera) received the CE mark.

This issue of EyeWorld Weekly was edited by Stacy Jablonski and Vanessa Caceres.

EyeWorld Weekly (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery (ASCRS), 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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