News

Knowledge about the circadian pattern of IOP and the 24-hour efficacy of glaucoma medications is increasing, which is expected to improve medical management of glaucoma in the future, reported Sunita Radhakrishnan, MD.

New generation of surgical procedures for glaucoma are being performed with good facility and encouraging safety and efficacy results. Only time will tell whether these techniques will maintain their initial promise and how they impact the treatment for glaucoma.

Intraocular pressure (IOP) is only the starting point for glaucoma treatment. Successful treatment begins with establishing an IOP goal, but there are multiple considerations that affect treatment choices. Robert Stamper, MD, explored the considerations that go into drug selection. None of the factors that should influence drug selection are new, he said, but it is easy to forget that the patient with glaucoma likely has other medical problems and is taking other medications.

Future healthcare reform is not a luxury. Rather, it is a necessity, especially when the performance and costs of healthcare in the United States are considered.

Patients needing glaucoma surgery may also be candidates for a combined procedure with cataract removal and IOL implantation. For a variety of reasons, cataract surgery may present challenges in eyes with glaucoma. Alan S. Crandall, MD, provided cases to demonstrate the complexities encountered when performing cataract surgery in glaucoma patients and strategies for achieving successful outcomes.

Glaucoma care in the United States has changed very little over the past 20 years. Kuldev Singh, MD, outlined the state of glaucoma in 2014. Only 25% to 50% of Americans with glaucoma are aware that they have glaucoma, and there are many more who are aware and not under regular care. Then, there are patients who are under regular care, but they may not be compliant with prescribed therapy. The bottom line is there is much room for improvement in the diagnosis and treatment of this glaucomatous disease.

Negotiating the twists and turns that will be inherent to the Patient Protection and Affordable Care Act (PPACA)-commonly known as the Affordable Care Act (ACA) or “Obamacare”–could be tricky, said Terri Pickering, MD. In order to succeed, ophthalmologists must be aware of and ready for the inevitable changes.

IOP is the only proven modifiable risk factor for progression of normal-tension glaucoma (NTG). However, Shan Lin, MD, says there is some compelling evidence that a number of other variables play a role. Dr. Lin reviewed information from studies investigating cerebrospinal fluid (CSF) pressure, myopia, sleep apnea, low blood pressure (BP), oxidant minerals (calcium and iron), and oral contraceptive (OC) use, and found that these factors may contribute to NTG progression.

For many years, researchers have suspected and tried to prove a link between glaucoma and dementia, said Yvonne Ou, MD. Definitive answers, however, have been hard to come by. Glaucoma and dementia have several factors in common: both are neurodegenerative, chronic, and progressive diseases that are age-related and cause irreversible neuronal cell loss. They are both becoming a major public health concern as the U.S. population ages.

Physicians are taking pictures of eye problems with their personal smartphone, and smartphones are expected to have a tremendous impact in expanding telemedicine, reports Robert T. Chang, MD. However, while smartphone cameras may function well for pictures of the external eye, they lack the proper magnification and lighting to provide the necessary detail when capturing intraocular images. New adapters are addressing those limitations to enable smartphone fundus photography and acquisition of other high quality anterior segment images.

Identifying and managing the risk factors of glaucoma is key to its effective management. Andrew G. Iwach, MD, says ophthalmologists are not treating means or averages,but individuals, and this requires a customized approach for every eye and every patient.

Adding a dry eye center is not only beneficial to patients, but can also increase revenue to practices.

Blowing through a half-billion dollars is probably a lot harder than it seems

Controlling staff members’ attitudes may not seem important, but it is to patients who attend your practice. Make sure the overall atmosphere and experience for them is highly important or they will go elsewhere.

Patients with elevated tear osmolarity who underwent punctal occlusion showed rapid improvement in tear osmolarity and other features of dry eye disease.

Further distancing itself from Valeant Pharmaceuticals International’s unsolicited acquisition proposal, Allergan has filed an investor presentation with the Securities and Exchange Commission (SEC) and has posted the presentation to its website detailing its initial concerns about the sustainability of Valeant’s business model.

Allergan has received a strong outpour of support from its physician customers, their nurses, and office staff members, as well as from patient advocacy groups and medical associations following the company’s rejection of Valeant Pharmaceuticals International’s unsolicited acquisition proposal.

Value-based medicine analyses have indicated that glaucoma therapy has great patient benefits because it preserves their vision-which positively impacts their quality-of-life (QOL)-and it is cost effective with a high return on investment, according to Gary Brown, MD.

The FDA has granted AbbVie’s adalimumab (Humira) orphan drug designation for the treatment of non-infectious intermediate, posterior, or pan-uveitis, or chronic non-infectious anterior uveitis.

Ophthotech Corp. has entered into an ex-U.S. licensing and commercialization agreement with Novartis Pharmaceuticals that will focus on the treatment of wet age-related macular degeneration (AMD).

Analyses of data from a large, prospective, comparative case series show that laser cataract surgery (LCS) significantly reduces use of ultrasound energy. Furthermore, outcomes from the most recent group of LCS cases shows that after laser lens fragmentation, cataract removal can be achieved in almost all eyes using aspiration only, said Burkhard Dick, MD, PhD.

Ohr Pharmaceutical has entered into a definitive agreement with SKS Ocular and its affiliate SKS Ocular 1 (SKS Ocular) to acquire SKS Ocular's ophthalmology assets.

Following a meeting with the FDA last week, Shire has announced that it intends to submit a New Drug Application (NDA) for its dry eye disease treatment, lifitegrast, in the first quarter of 2015, as it completes remaining chemistry and manufacturing work.

Amakem Therapeutics announced that first patients have commenced treatment in a phase II dose-ranging study of its lead drug candidate-AMA0076-for the treatment of glaucoma.

BioLight Israeli Life Sciences Investments’ ViSci, its wholly owned subsidiary, has been informed that the FDA has granted a patent number covering the proprietary formulation of its glaucoma treatment, latanoprost, by the U.S. Patent and Trademark Office.

Advances in endoscopy, a decades-old technology, offers major advantages to patients with pituitary tumors by improved visualization, rehabilitation, and shorter hospitalization.

Small Incision Lenticule Extraction (SMILE) performed using a femtosecond laser (VisuMax 500 kHz, Carl Zeiss Meditec) is being investigated as a treatment for spherical myopia in a U.S. clinical trial. Positive results were achieved in preliminary analyses of data from 315 eyes.

A new patient interface improved the usability and performance of a femtosecond laser system in a multicenter study.

Two-year follow-up data is positive for eyes enrolled in the first study of the Schlemm canal scaffold (Hydrus, Ivantis).

After watching a muddy high school soccer game, Dr. Rob Kitei and his two daughters were inspired to create a product that could be applied to players’ cleats to prevent mud accumulation. Following acquisition by global brand Mission Athletecare in September 2012, it will be nationally sold this summer.