Macular Edema in NIU: New Rx, New Delivery Method

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This month, News in Review highlights selected papers from the original papers sessions at AAO 2018. Each was chosen by the session chair because it presents important news or illustrates a trend in the field. Only 4 subspecialties are included here; papers sessions will also be held in 5 other fields. For more information, see the Meeting Program, which you’ll find in your meeting bag, or the Mobile Meeting Guide.

Suprachoroidal injections of a proprietary suspension of triamcino­lone acetonide might present clinicians with a new treatment for the macular edema that can persist in patients with noninfectious uveitis (NIU) even after their inflammation is under control, ac­cording to the results of a phase 3 trial.

In the study, 46.9% of the patients who received a total of 2 suprachoroi­dal injections of the investigational new drug, CLS-TA (Clearside Biomedical) administered 12 weeks apart, gained at least 15 letters in best-corrected visual acuity at 24 weeks. That compared to 15.6% in the control subjects, who received sham injections, said Rahul N. Khurana, MD, with Northern Cali­fornia Retina Vitreous Associates in Mountain View, California.

Addressing an unmet need. This potential therapeutic approach would address a large unmet need in the treatment of patients with NIU, Dr. Khurana said.

“Uveitic macular edema is really challenging. It’s the leading cause of vision loss in patients with uveitis,” he said. “It occurs in about 40% of patients with uveitis, and it can be very difficult to manage even when you control the inflammation itself.”

Novel method of drug delivery. “Most of our medicines for diseases of the posterior segment have centered on delivering medications in the intra­vitreal space. This is one of the first clinical trials, if not the first, to look at the suprachoroidal space,” Dr. Khurana said. “So it’s really exciting to see a su­prachoroidal treatment actually work.”

Measuring impact on vision. “This study was also unique in the sense that most uveitis studies evaluate a potential treatment’s effectiveness at treating inflammation by measuring vitreous haze. But in this study we actually looked at improvements in vision,” he said.

If CLS-TA ultimately wins market­ing approval from the U.S. Food and Drug Administration, it has the poten­tial to become a new paradigm for the treatment of visual impairment caused by uveitic macular edema, Dr. Khurana concluded.

—Linda Roach

Relevant financial disclosures—Dr. Khurana: Allergan: C; Clearside Biomedical: S; Genentech: C; Regeneron: C,S.

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