Thursday, October 28, 2010

Minor drug updates - RGN259 and RX-10045

1) RGN259 is enrolling for a Phase II trial this quarter and the trial will take place through 2011, according to a recent news report.

2) Rexolvyx has a new partner, Celtic Therapeutics, who have an option to acquire and license RX-10045, according to a press release.

Abstract: Interferometry in evaluating tear film thickness

Am J Ophthalmol. 2010 Oct 21. [Epub ahead of print]
Interferometry in the Evaluation of Precorneal Tear Film Thickness in Dry Eye.
Hosaka E, Kawamorita T, Ogasawara Y, Nakayama N, Uozato H, Shimizu K, Dogru M, Tsubota K, Goto E.
Department of Ophthalmology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.

PURPOSE: To compare tear film thickness between normal subjects and aqueous tear deficiency dry eye patients by tear interferometry.

DESIGN: Prospective case-control study.

METHODS: Central precorneal tear film thickness was measured noninvasively using an interference thin-film thickness measurement device (Quore MSPA1100; Mamiya-OP). Tear film thickness of 14 eyes from 14 normal subjects and of 28 eyes from 28 aqueous tear deficiency dry eye patients were compared along with noninvasively measured tear meniscus height, DR-1 (Kowa) dry eye severity grading, fluorescein and rose bengal staining scores, tear film break-up time, and Schirmer test results. Among dry eye patients, 13 eyes underwent punctal occlusion, and tear film thickness was compared before and after the surgery.

RESULTS: Tear film was significantly thinner in dry eye patients (2.0 ± 1.5 μm) than normal subjects (6.0 ± 2.4 μm; P < .0001). Tear film thickness showed good correlation with other dry eye examinations. After punctal occlusion, tear film thickness increased significantly from 1.7 ± 1.5 μm to 4.9 ± 2.8 μm (P = .001) with the improvement of tear meniscus height, fluorescein and rose bengal staining scores, tear film break-up time, and Schirmer test values.

CONCLUSIONS: Interferometric tear film thickness measurement revealed impaired precorneal tear film formation in aqueous tear deficiency dry eyes and was useful for showing the reconstruction of tear film after punctal occlusion surgery. Interferometry of precorneal tear film may be helpful for the evaluation of aqueous tear deficiency in conjunction with other dry eye examinations.

Abstract: from Spain

I'm just posting this one so Spanish readers (or others in the neighborhood) can take note of the authors in case they are looking for names of doctors or researchers that might take an interest in dry eye.

Ocul Surf. 2010 Oct;8(4):185-92.
The tear film and the optical quality of the eye.
Montés-Micó R, Cerviño A, Ferrer-Blasco T, García-Lázaro S, Madrid-Costa D.
From the Optometry Research Group, Department of Optics, University of Valencia. Spain.

ABSTRACT The stability of the tear film plays an important role in the optical quality of the eye. Various methods have been developed to quantify the contribution of the tear film to optical quality, including the double-pass optical method, Hartmann-Shack wavefront sensing, videokeratoscopy, retroillumination analysis, and interferometry. In addition to assessing the effect of tear film irregularities, these methods can aid in the diagnosis of dry-eye related conditions and the monitoring of therapy. This review describes the methodologies used to assess the relationship between the tear film and optical quality of the eye and summarizes the most important findings obtained with these methods with regard to the healthy human eye, the dry eye, and the effect of artificial tear instillation.

Abstract: SmartPlugs, DumbPlugs and DarnedPlugs

Almost as often as I see a new study on this brand of plugs, I hear of YET ANOTHER patient who is probably facing reconstructive eyelid surgery after having a so-called SmartPlug inexplicably go AWOL in her eyelid.

Stay away from this product - that's all I can say.

A high success rate means nothing when the consequences of being one of the minority failures is so terribly serious.

Some form of simple failure is acceptable for most medical treatments. Catastrophic failure is ABSOLUTELY UNACCEPTABLE for any dry eye treatment.

Nan Fang Yi Ke Da Xue Xue Bao. 2010 Oct 20;30(10):2370-2372.
[Application of Smart Plug lacrimal plug in the treatmengt of dry eye.]
[Article in Chinese]
Guo L, Wu XY, Yuan F, Li B.
Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan 250012, China.

OBJECTIVE: To evaluate the clinical efficacy of Smart Plug lacrimal plug in the treatment of dry eye.

METHODS: Twenty-nine patients with dry eyes (58 eyes) were treated with Smart Plug lacrimal plug. All the patients were follow up for 6-10 months (average 7.8 months). Schirmer I test (SIT), tear break-up time (TBUT) and corneal fluorescein staining were used for evaluation of the clinical efficacy.

RESULTS: The SIT was 3.35∓2.60 mm and 6.35∓4.15 mm, TBUT was 3.14∓1.22 s and 5.46∓1.26 s, and corneal fluorescein staining was 2.15∓0.09 and 0.05∓0.01 before and after the treatment, respectively (P<0.05). The subjective symptoms were improved in most of the patients.

CONCLUSION: Smart Plug lacrimal plug is effective in the treatment of dry eye due to aqueous tear deficiency, and can be one of the choice of dry eye treatment

Wednesday, October 27, 2010

New eyewear: Ziena Oasis

Isn't this a stunning frame?

Would you believe it is also the best non-goggle Rx-able moisture chamber you can buy?

An aesthetically pleasing moisture chamber has always been a contradiction in terms. Most of us have compromised in some way or another with goggles that rate either somewhat or very high on the dorkiness scale. For prescription glasses wearers, the options are narrower (and usually uglier).

Those who can afford to slide up the scale from goggles have had to get either custom moisture chambers built for their glasses, or Micro-Environment Glasses, both of which are very good, but neither of which you would ever consider if you didn't have dry eye.

So the Ziena has arrived to fill an important niche. And you would hardly believe from the picture that it does fill it - but it does.

The frame has a silicone eyecup which attaches with several tiny little magnets. No foam. The silicone is very, very delicate and as it approaches the face curls under slightly. It forms a nice (not airtight) seal most of the way around. It's extremely comfortable. For those of you familiar with MEGs, it's kind of the reverse design in that there is a gap at the top rather than the bottom. Seemed counterintuitive to me and I really wondered how it would perform. But it was great. And once I had these things on my face I didn't want to take them off, outdoors or indoors.

The Ziena is easily the best pair of glasses I have ever had for driving. In a weeklong test, they did not fog - period. Amongst all the 7Eye and Wiley glasses I have ever used (and they are many) all of them have fogged at least occasionally when driving.

The lenses are larger than most 7Eye or Wiley glasses I've had, so my vision was better. And while the silicone eyecup is semi-opaque, it's clear/whitish and light comes through so you don't get any of the tunnel-vision effect most moisture chambers produce. These glasses are real design coup.

So, to boil it down to essentials:


1. Beautiful.

2. Effective for dry eye protection.

3. Good vision.


1. Price and ongoing expense. With no prescription, you're looking at a minimum of $290, and you're probably going to have to replace that silicone shield ($35) every month or two. It's new, so I really won't know for awhile how long they'll last. I'm not even really sure how to clean it.

2. Hinge placement (see note below)


For those of you whose dry eyewear budgets are in the double rather than triple digits, don't worry, there's an excellent new product due out soon - probably before the end of the year - that I tested awhile back and really liked! So stay tuned - it'll be in the blog and newsletter when it comes.


There are three framestyles: Glossy black, light tortoise, and brown fade. The one pictured above is light tortoise.

Lens options are much as for other 7Eye products:
- Sharpview if you want the basic darker lens for outdoor use
- Photochromic 24:7 lenses for indoor/outdoor (best if you want to use this at the office)
- ColorAmp Polarized
- ColorAmp grey or copper

If you need RX, you can either get a local dealer to produce it for you, get it direct from 7Eye, or purchase the frame on my site and take it to a local optician to get whatever lenses you want in it (including clear lenses).


They are not yet available on the 7Eye website. So:

Local: Call 7Eye or go on their website to get local dealer phone numbers. Not too many dealers have them yet though.

Dry Eye Shop: Click here to buy or just to look at the different frame/lens combinations. I have several of these in stock including frame-only for those who need Rx (I don't sell Rx - you would need to take it to your optician). Anything not showing in stock has to be special-ordered so please allow an extra 5 days for delivery.


NOTE re: Hinge placement:
This will probably not affect anyone except people like me whose skin is freakishly sensitive to metals (I can't wear necklaces or watches even for one day). The hinge on the Ziena is much further up on the earpiece than 7EYE's other products in order to accommodate the eyecup, so a teensy bit of the metal comes pretty close to my cheek. It's only a little, but after about a week of frequent wear my cheeks broke out. Again, I think very few people would be affected by this. I am so bummed about it because if it weren't for that, I would be wearing this full-time - yes, even at the computer at my home office!