The Latest Dope
NEWLY IDENTIFIED PROTEIN may become key factor in developing new dry eye treatments. Discovered and named by Gordon Laurie at the University of Virginia, lacritin “may be involved in stimulating new tear production and, if so, could form the basis of a revolutionary treatment for dry-eye syndrome”, according to project lead Robert McKown at James Madison University. Click here for related news article.
THE LIFE IMPACT OF DRY EYE: A recent study (Mertzanus et al: The Relative Burden of Dry Eye in Patients’ Lives: Comparisons to a U.S. Normative Sample, IOVS 2005; 46:46-50) looks at the life impact of dry eye disease, and suggests more research be done in this area. Of course, we patients already know that, and even a brief visit to our online community forum Dry Eye TALK makes clear the potential for dramatic life impact from this painful condition. We applaud all efforts to scientifically quantify it. Click here for abstract.
MEDICAL JOURNALS WANT CLINICAL TRIAL DATA PUBLIC (hear, hear!): Editors of leading medical journals are calling for clinical trials to be entered in a free, central, publicly available registry and have declared their intent to make such registration a condition for consideration for publication, in an attempt to (among other benefits) reduce selective reporting. Click here for joint editorial from leading editors.
BACK AT LAST, BY POPULAR DEMAND (as the saying goes): After a several-year hiatus, popular lubricant eyedrops Dwelle, Dakrina and NutraTear are on the market, this time from patient-run venture The Dry Eye Company (Apollo Beach, Florida). Samples are available for physicians and consumers. Quantities are limited. Physicians click here for more information or to order samples, consumers click here for product information or to order free samples.
ARE YOUR WIPERS WORKING? This study (Korb et al, Lid wiper epitheliopathy and dry eye symptoms, Eye Contact Lens. 2005 Jan;31(1):2-8) is not exactly hot off the press (5 months old) but this being our first issue, we wanted to cover it because many of our readers are symptomatic dry eye patients who have normal Schirmer or TBUT scores. The study found wiper staining in 76% of symptomatic patients with otherwise normal clinical findings. Click here for abstract.
WHAT REALLY AFFECTS SURFACE PRESSURE? A fascinating study (Tragoulias et al, Surface Pressure Measurements of Human Tears and Individual Tear Film Components Indicate That Proteins Are Major Contributors to the Surface Pressure, Cornea: 24(2):189-200, 2005) investigates the role of tear proteins in determining surface tension of tears – thence tear film stability – and finds them to be major contributors, shedding doubt on common assumptions about the uniqueness of lipids and mucins in this function. Click here for abstract.
GENTEAL GEL SORELY MISSED: Genteal Gel (Novartis Ophthalmics) continues its conspicuous absence from pharmacy shelves. The Dry Eye Zone has been receiving complaints from US patients for months about regional shortages, with some now desperate patients even going to the length of trying to get it shipped in from Australia. According to Novartis, the product is not being discontinued, and as we went to press their latest word was that its “backorder” status was expected to be resolved by the end of the summer. Oh, and yes, the pun was intended. For more information, call 1-888-669-6682.
BLINKING ON THE JOB: A study published in Occupational and Environmental Medicine (P. Wolkoff et al, Eye complaints in the office environment: precorneal tear film integrity influenced by eye blinking efficiency, 2005;62:4-12) investigates work-related eye complaints involving the tear film, from the standpoint of indoor air science, occupational health, and ophthalmology. Click here for abstract.
RESTASIS PLUS: Many doctors have moved on from “Do I prescribe Restasis” to “My favourite drop to supplement Restasis is...” In addition to discussions such as in May’s Ophthalmology Management (subscription only), and a study suggesting Alcon’s Systane does a better job in combined therapy with Restasis than Allergan’s own OTC tears, we at The Dry Eye Zone have been hearing from many patients of a wide range of Restasis mates being advised, including several Rx eyedrops such as Acular.
EYELID TATTOOS & LASIK - A CRYING SHAME FOR THIS PATIENT: A case study in Ophthalmic Plastic and Reconstructive Surgery (T Kojima et al, Tear film and ocular surface abnormalities after eyelid tattooing, 2005 Jan; 21(1):69-71) discusses serious ocular surface woes of a patient with LASIK performed many years after eyelid tatooing. Click here for abstract.
DRY EYE AND LASIK – NOW WE’RE TALKING: After years of ASCRS surveys consistently showing dry eye as the number one complication of LASIK, this sore subject is finally seeping out of the peer-reviewed journals into popular medical news-reporting (did I say throwaways?) on a regular basis (count ‘em, 11 feature articles in EyeWorld’s May issue). This is consistent with the increased focus on dry eye observeable throughout eyecare circles in the last couple of years, particularly with the emergence of Restasis and Systane. With more than 30% of members of Dry Eye TALK reporting LASIK as the (or a) cause of their chronic dry eye, we worry that despite this welcome loquacity prospective customers (sorry, I mean patients) are not necessarily getting the right message.
EDITORIAL HUMOUR ALIVE AND KICKING (across the border, anyway): We are indebted for our chuckle of the month to the editors of the American Journal of Ophthalmology, who in their May issue called our attention to a study in the Canadian Medical Association Journal titled “Incidence and risk factors for nodding off at scientific sessions”. Click here for a riot (the study, that is).
What’s in the pipeline?
NOVARTIS/REBAMIPIDE (in-licensed by Novartis from developer Otsuka): Clinical trials ongoing. Rebamipide is a drug designed to “enhance tear secretion and increase the levels of mucin covering the conjunctiva and cornea”. It is currently in Phase III clinical trials with participants receiving higher or lower dose or placebo. Click here for initial screening checklist and list of study centers. See Dry Eye TALK for commentaries from participating members.
INSPIRE/DIQUASOFOL: Phase I and Phase II clinical trials completed. On June 1st Inspire Pharmaceuticals submitted an amendment to its New Drug Application focusing this time on analysis of ocular surface staining. Diquasofol is a drug designed to stimulate secretion of all three tear components (mucin, fluid and lipid). Click here for news report about the amendment. Click here for Inspire Pharmaceutical’s information page about the clinical trials.
NASCENT/ NP50301: Nascent Pharmaceuticals Inc. recently announced it has completed enrollment of a 90-patient Phase IIb clinical trial of NP50301, their topical ophthalmic therapeutic eye drop for treating dry eye in postmenopausal women.
NEI/CYCLOSPORINE IMPLANT: NEI is recruiting patients for Phase I clinical trials of a subconjunctival cyclosporine implant for patients with GVHD (graft-vs-host-disease, which causes eye dryness and inflammation). It consists of a half-inch silicone implant with sustained-release cyclosporine, and is implanted in the conjunctiva for a year. Click here for details.
PORT PUNCTUM OCCLUDER/ALCON & LANDEC: Clinical trials are complete, and product is awaiting approval. A brief report in Ocular Surgery News (June 15th) was just about the first we’d ever heard about this, and we didn’t find much info except a 4-year-old Review of Ophthalmology article which explains that it contains “temperature-activated Intelimer polymers which can be customized to change their physical characteristics abruptly when heated or cooled through a pre-set temperature switch. The PORT system involves liquifying a gel with gentle warming and injecting the fluid into the punctal openings where the lower temperature of adjacent tissue causes it to gel. You can remove the plug with gentle warming of the adjacent lid area.” Many patients we know will be attracted to the idea of a removeable plug... the perennial question for the sometime intracanalicular silicone plug-ee being “So is it still there or isn’t it, darn it?”.
NEI/DIGITAL PHOTOGRAPHY: And on the diagnostics side of the equation... A National Eye Institute sponsored study seeks to assess digital photography and compare it with the standard slit-lamp examination as a method of evaluating findings from ocular surface staining. Currently recruiting patients. Click here for details.