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  • Emerging Therapies for Dry Eye Target Underlying Causes

    Dry eye disease affects up to 30 percent of the world’s population and greatly diminishes quality of life. Outcomes are best when the underlying process is resolved so that the ocular surface can heal. But dry eye can stem from a web of biological and environmental factors, ranging from inflammation to systemic drug use to windy climates.

    New therapies may make it easier to home in on the underlying causes of disease, Bennie H. Jeng, MD, reported at the “Hot Topics of the Ocular Surface” session.

    “Dry eye treatments have evolved significantly over the last decade or so as we’ve better understood the pathology and developed new options to diagnose and treat patients,” Dr. Jeng said.

    In the past few years, a number of therapeutic options for dry eye have entered the clinic or approached commercialization, including:

    • TrueTear, an intranasal tear neurostimulator (Allergan)
    • Lifitegrast/Xiidra, a novel small-molecule integrin antagonist that decreases inflammation (Shire)
    • MIM-D3, a TrkA receptor agonist that acts on neurotransmitters (Mimetogen)
    • Dextenza a sustained-release dexamethasone-loaded punctal plug (Ocular Therapeutix)
    • EBI-005, an interleukin-1 receptor inhibitor administered as a topical drop (Eleven Biotherapeutics)
    • iLid TearCare system, a software-controlled, wearable eyelid technology that directs heat to the meibomian glands to promote natural meibum expression (Sight Sciences)
    • Rebamipide, a mucin stabilizer marketed in Japan and other Asian countries for treatment of gastric mucosal disorder and gastritis, now being studied for its effect on the tear film
    • Crosslinked hyaluronic acid (HA) eyedrops, which promote wound healing and treat punctate epitheliopathy
    • PCA, 5-oxo-2-pyrrolidinecarboxylic acid (PCA) with or without HA, as artificial tears
    • Amniotic membrane extracts
    • Diquafosol, a uridine nucleotide analog and agonist of the P2Y2 receptor
    • Thymosin-β4, a naturally occurring protein that promotes corneal surface healing
    • Acupuncture, less than 3 times a week for at least 1 month on the BL1, ST2, TE23, and Ex-HN5 acupoints. — Anni Griswold

    Financial disclosures. CoDa Therapeutics: C; EyeGate Pharmaceuticals.: O; Jade Therapeutics: C; Kedrion: C; Santen: C.

    Disclosure key. C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.

    Next story from AAO 2018—Late-Breaking Trial Results in Retina: Yutiq, 2RT, Prima: A Retina Subspecialty Day session reported that Yutiq keeps uveitis calm at 24 months; the 2RT laser slows intermediate AMD 4-fold in patients without without reticular pseudodrusen; and Prima participants meet the endpoint.