This week in optometry: May 8-May 12

Article

Catch up on what happened in optometry during the week of May 8-May 12.

Catch up with what Optometry Times®' shared this week:

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Optometry news

2023 American Society of Cataract and Refractive Surgery (ASCRS) annual meeting

The annual American Society of Cataract and Refractive Surgery (ASCRS) annual meeting was held this past weekend in San Diego, California. Our colleagues Sydney Crago, Editor of Modern Retina®, and Sheryl Stevenson, Group Editorial Director for the Eye Care Brands, were on the ground

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Wellness-driven optometrists represent a new generation of eye care professionals

Carrie Roitstein, OD

What will optometry look like in the next year? In the next 5 years? In the next decade?

Over the years, optometric care has proudly grown from primarily providing vision correction to solving and preventing problems in all aspects of eye health. As health care continues to evolve, it challenges us to think more proactively vs reactively. Patients have become more interested in making informed decisions about health outcomes and preventive treatment plans. We must continue to make the connection between vision and health while incorporating measures for patient education and disease prevention.

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Glaukos announces FDA acceptance of NDA submission for iDose TR

David Hutton, Managing Editor, Ophthalmology Times

Glaukos Corp. announced it has received the “Day 74” notification from the FDA acknowledging its previously submitted New Drug Application (NDA) for iDose TR (travoprost intraocular implant) is sufficiently complete to permit a substantive review.

According to the company, the Prescription Drug User Fee Act (PDUFA) goal date for the completion of the FDA’s review of the iDose TR NDA is set for December 22, 2023. This date reflects a standard 10-month review period and is consistent with management’s expectations for the 505(b)(2) filing.

Thomas Burns, Glaukos chairman and CEO, noted the intraocular implant could shift the paradigm for patient treatment.

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Eyenovia Announces FDA approval of Mydcombi, first ophthalmic spray for mydriasis

David Hutton, Managing Editor, Ophthalmology Times

Eyenovia Inc. announced the FDA approved Mydcombi (tropicamide and phenylephrine hydrochloride ophthalmic spray) 1%/2.5% for inducing mydriasis for diagnostic procedures and in conditions where short-term pupil dilation is desired.

According to the company, this represents the first approved, fixed-dose combination of tropicamide and phenylephrine in the United States and also the first product using Eyenovia’s proprietary Optejet device to be approved by any regulatory authority.

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Nerve growth factor: From discovery to development for human use

Flavio Mantelli, MD, PhD

The cornea is the most densely innervated tissue of the body with an estimated 7000 nociceptors/mm2, making it 400 times more sensitive than skin.1 Sensory innervation of the cornea is derived from the first branch of the trigeminal nerve. In addition to serving as an afferent arm of the blink and tear reflex, sensory corneal nerves also provide trophic support to the corneal epithelium while facilitating and maintaining ocular surface homeostasis.2,3 This is achieved in part by secretion of neuropeptides and neurotrophins from sensory corneal nerves and corneal epithelia, respectively,4 interplay between which is key in maintaining corneal homeostasis.1,3

One such pertinent neurotrophin is nerve growth factor (NGF), which plays a role in proliferation, differentiation, and survival of sympathetic and sensory neurons.5 In the cornea, sensory nerves help regulate ocular homeostasis.6 NGF signaling occurs through its cognate receptors, high-affinity receptor tropomyosin related kinase A (TrkA) and low-affinity pan-neurotrophin 75 receptor (p75NTR).7 TrkA is expressed not just on corneal nerves but also on several cell types throughout the eye, including but not limited to the corneal epithelium, stromal keratocytes, endothelium, retinal ganglion cells, retinal bipolar and glial cells, and the optic nerve.4,8 This pro-survival effect of NGF-TrkA binding is responsible for maintaining integrity of the ocular surface, which is critical for clarity of the corneal optical medium and, hence, vision.9

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New and emerging myopia management: Low dose atropine

Ashley Wallace-Tucker, OD, FAAO, FSLS, Dipl ABO

Atropine has been used off-label for decades as a safe and effective monotherapy option, or as a counterpart in combination therapy along with orthokeratology or soft multi-focal contact lenses.

In addition to not being commercially available, one of the major barriers to successful implementation into everyday practice is that it is not currently FDA approved. Parents and practitioners alike often shy away from this pharmaceutical option due to the lack of extensive evidence on safety and efficacy.

Guiding our path now are the findings from clinical trials like Low-Concentration Atropine for Myopia Progression (LAMP) and Atropine for the Treatment of childhood Myopia (ATOM1/ATOM2). Despite a wealth of information coming from these studies, there is currently no solid or conclusive evidence on the ideal concentration of atropine.

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Measure twice, cut once: Repeat testing provides clarity

Benjamin P. Casella, OD, FAAO

Every time I have a physical examination, I am reminded of the importance of reliable and repeat testing. In fact, the physical exam I had a few months ago was no different. Let me preface this by saying that I truly like and trust my primary care physician; he is knowledgeable, patient, and kind, with a wonderful chairside manner. His staff, however, leaves me wanting.

...How am I going to segue this anecdote into the arena of glaucoma? Let’s begin with when I ordered a spectral domain optical coherence tomography (SD-OCT) study on a patient who was taking hydroxychloroquine for systemic lupus erythematosus.

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