Advancements in new drugs, new microinvasive glaucoma surgery (MIGS) devices, and a new diagnostic tool made 2017 a banner year for glaucoma innovation.
On the pharmaceutical front, the FDA last month gave a green light to latanoprostene bunod ophthalmic solution 0.024% (Vyzulta, formerly Vesneo; Bausch + Lomb/Nicox).
“It’s always exciting to have another alternative available to us,” said Andrew Iwach, MD, executive director, Glaucoma Center of San Francisco.
Latanoprostene bunod works by a dual mechanism of action. It is metabolized in the eye to latanoprost acid and butanediol mononitrate.
An F2-alpha prostaglandin analog, latanoprost acid increases outflow of aqueous fluid primarily through the uveoscleral pathway. Butanediol mononitrate releases nitric oxide, which is reported to induce relaxation of cells in the trabecular meshwork and Schlemm’s canal, increasing outflow through them.
In the phase II VOYAGER study, IOP fell below 18 mm Hg in 68.7% of patients taking latanoprostene bunod 0.024% compared with 47.5% of patients taking latanoprost 0.005%.
It remains to be seen which patients will benefit most from latanoprostene bunod, said Joel S. Schuman, MD, chairman, Department of Ophthalmology, NYU Langone Medical Center, New York.