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ISSUE
07 | 03 | 21
cataract • anterior segment • kudos • enlightenment
HIGHLIGHTS
C A K E M A G A ZIN E ’ S D A ILY CO N GR E S S N E W S O N T H E A N T E R IO R S E G M E N T
New Drugs
is the buzzword, 04 MIGS but how are the
and Treatments on the Horizon
Malaysians accepting it?
for
on Sri Lanka 06 Spotlight ... Wanted: More ophthalmologists!
09
In normal tension glaucoma, it all boils down to eyeball pressure.
Russia with love ... 11 From This multifaceted country brought insightful glaucoma research updates to WGC!
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N
ew drugs and treatment paradigms are emerging in the continued search for better outcomes for glaucoma patients. These include advances in topical medications and drug delivery, as well as the potential for neuroregeneration and non-IOP lowering therapies. On Day 3 of the World Glaucoma e-Congress (WGC 2021), these important innovations were covered in a session co-chaired by Drs. Tina Wong (Singapore) and Arthur Sit (USA).
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New topical medications
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Unmet needs exist for drugs that are safer, with more potent IOP-lowering effect, or a novel mechanism of action, said Prof. Makoto Aihara, from the University of Tokyo (Japan). During his presentation, he covered three drugs that may demonstrate this potential: EP2 agonists, ROCK inhibitors and new drug combinations.
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The new EP2 agonist, Omidenepag isopropyl (OMDI; EYEBELIS, Santen, Tokyo, Japan), is administered in a once daily drop. “This is a drug first approved in Japan, Korea and Taiwan,” shared Prof. Aihara, adding that it has a novel mechanism of action that differs from FP receptor agonists. “OMDI increases aqueous humor outflow via both uveoscleral and trabecular pathways,” he continued. In the RENGE study, stable IOP was achieved over 52 weeks, with enhanced efficacy in combination with timolol. “In the low IOP
groups, OMDI can reduce baseline IOP by 19.5% (-3.66 mmHg); in the high baseline groups OMDI can reduce IOP by 23.4% (-5.64 mmHg); and in the high baseline group with OMDI and timolol, the IOP reduction was 36.1% (-8.36 mmHg),” he shared. Importantly, OMDI has no cosmetic side effects like DUES and has the benefit to recover PAPS after switching from FP agonists without changing IOP. He said that this novel drug can help maintain not only quality of life, but also quality of vision. Next, he covered two kinds of ROCK inhibitors: ripasudil 0.4% (Glanatec, Kowa Pharmaceutical, Japan) and netarsudil 0.02% (Rhopressa, Santen). “ROCK inhibitors directly improve trabecular outflow,” he shared, adding that netarsudil also has a function to reduce aqueous production. “ROCK inhibitors may be useful for the treatment of various ocular diseases,” said Dr. Aihara. He continued: “In the future, we will have various types of combined drugs … these could be useful to keep patients adherent.”
Advances and challenges in drug delivery “It’s an exciting time with SLT and laser trabeculotomy, MIGS and now drug delivery, rounding out our toolbox with the hope of dealing with issues of compliance,” began Dr. Paul Singh, from the Eye Centers of Racine and Kenosha (Wisconsin, USA).
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