The effects of topical bromfenac 0.09% ophthalmic solution (Xibrom, ISTA Pharmaceuticals) on cystoid macular edema were evaluated in 17 eyes with associated retinal disease. After 6 to 28 weeks of treatment, the majority of eyes showed a positive response based on decreases in OCT-measured subfield thickening, cystic spaces, or both.
He evaluated the effects of bromfenac in 17 patients with CME associated with branch and central retinal vein occlusion, macular epiretinal membrane, diabetic retinopathy, and age-related macular degeneration (AMD). Optical coherence tomography (OCT) was performed at baseline. Patients used bromfenac twice daily for 6 to 28 weeks. A positive response, defined as a decrease in OCT-measured subfield thickening, cystic spaces, or both, compared with baseline, was observed in 13 of the 17 patients.
"These findings suggest bromfenac has promise either as monotherapy or as an adjunct to standard or investigational treatments, such as anti-VEGF agents, intravitreal steroids, and/or laser, for the management of retinal diseases associated with CME. However, they also have implications for the evaluation of patient responses in clinical trials of other treatments where OCT retinal thickness is measured as an endpoint," said Dr. Gross, a private practitioner in Columbia, SC.
Dr. Gross said that he was interested in evaluating the effect of bromfenac on CME associated with retinal disease based on the potency and penetration characteristics of the drug. Bioavailability studies have shown that bromfenac penetrates the cornea rapidly and achieves significant, sustained levels in the choroid and retina, he said.
"In a preclinical study using radiolabeled medication, significant concentrations of bromfenac were achieved and maintained in the retina and choroid for 24 hours after topical administration of a single drop, whereas levels of a comparator topical NSAID, at three times the commercially available strength, were undetectable beyond 6 hours in the retina and 12 hours in the choroid," Dr. Gross said.
Dr.Gross said bromfenac seemed to have its greatest effect in a subset of five eyes that had recently undergone cataract surgery.