CLINICAL CORNER

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ACCESSING THE RISK OF BLINDNESS. The incidence of blindness due to open-angle glaucoma (OAG) decreased from 1965 to 2009, according to a study conducted by the Mayo Clinic in Rochester, MN. Mehrdad Malihi, MD, and his colleagues examined the longitudinal trends in the probability of blindness due to OAG using medical records from residents of Olmsted County, MN (aged ≥40 years) who were diagnosed with OAG between 1965 and 2000. Blindness was defined as visual acuity ≤20/200 or visual field constriction to ≤20°. The researchers found that there was a significant decrease in the probability of glaucoma-related blindness in at least one eye from 25.8% for subjects diagnosed 1965″“1980 to 13.5% for subjects diagnosed 1981″“2000 (P=0.01). In the same period, there was a significant decrease in the incidence of blindness within 10 years of the diagnosis, from 8.7 to 5.5 per 100,000, respectively (P=0.02). There was an increased risk of progression to blindness among those diagnosed at an older age (P<0.001).

MENOPAUSE AND GLAUCOMA. Women who take estrogen-only hormone-replacement therapy to relieve menopausal symptoms might also be reducing their risk for a common form of glaucoma, according to Joshua Stein, MD, an assistant professor of ophthalmology at the University of Michigan. According to his research, estrogen might work by lowering the pressure or by protecting certain cells in the eye. Although the researchers found an association between the use of estrogen-only therapy and a reduced risk for this form of glaucoma, they did not prove a cause-and-effect link. Instead, the findings may prompt drug companies to begin looking at estrogen as a glaucoma treatment.

FIRST IN CLASS GLAUCOMA STUDY BEGINS. Aerie Pharmaceuticals, Inc., a clinical-stage pharmaceutical company focused on the discovery, development, and commercialization of first-in-class glaucoma therapies, has announced dosing of the first patients enrolled in the Company’s Phase 2b study of PG324, a novel, fixed-combination of Aerie’s AR-13324 and latanoprost, a prostaglandin analogue that is the most widely prescribed glaucoma drug. The 28-day Phase 2b clinical trial is expected to enroll approximately 300 patients with glaucoma or ocular hypertension and will compare two concentrations of PG324 to latanoprost and to AR-13324, all dosed once daily. If approved, Aerie believes that PG324 would be the first glaucoma product to lower IOP through potentially four mechanisms of action: increasing fluid outflow through the trabecular pathway or primary drain, increasing fluid outflow through the uveoscleral pathway or secondary drain, reducing fluid production in the eye, and potentially also lowering episcleral venous pressure. Topline results of this trial are expected to be released later this year.

TEARLAB EMBARKS ON DED STUDY. In collaboration with the UK’s National Health Service (NHS), four ophthalmologists are beginning a large 1,000 patient multi-center study to assess the overall prevalence of Dry Eye Disease (DED). Patients who suffer from a wide variety of eye complications presenting daily in NHS clinics will be the primary target group of this study. Tear osmolarity testing will be incorporated as a diagnostic measure to detect the presence of DED. The study will be conducted under ethical controls, adopted by the National Institute of Health Research in the UK and will allow UK ophthalmologists to view DED in their own patient base.

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