Week in review: COVID again, FDA approvals, VEGF alternative

A weekly roundup of ophthalmic news from around the web.

As the pandemic continues, the list of potential COVID-19 manifestations continues to grow. A new case study from Morocco details a 24-year-old patient who presented with acute onset of diplopia and strabismus 3 days after showing general symptoms. Ophthalmic and neurological exams led physicians to suspect painless incomplete third cranial nerve palsy. While oculocerebral magnetic resonance angiography did not reveal anything noteworthy, blood tests suggested mild normocytic regenerative anemia. Following Moroccan guidelines, the patient received chloroquine and azithromycin and appeared to recover after 6 days of treatment. American Journal of Case Reports, Medpage Today

It’s been a busy week of approvals for the FDA. First up: A cyclosporine topical ophthalmic emulsion 0.1% for severe vernal keratoconjunctivitis in patients aged 4 to 18 years. The decision was based on a 12-month pivotal trial in which patients were randomized to receive the drug 2 or 4 times daily. The treatment is already available in 10 countries across Asia, Europe and North America (Canada). Santen Pharmaceuticals

The agency also cleared the first short-term ocular corticosteroid for dry eye disease. Kala Pharmaceuticals’s loteprednol etabonate ophthalmic suspension 0.25% (EYSUVIS) is indicated to relieve dry eye signs and symptoms for up to 2 weeks. The company touts enhanced delivery of the drug to the ocular surface, thanks to their mucus-penetrating technology. According to the press release, the treatment has proven to be safe and effective in 4 clinical trials. The most common adverse reaction is pain at the instillation site, which affected 5% of patients. Kala Pharmaceuticals

Topline results appear encouraging for Abbvie’s investigational presbyopia drug. In a pair of phase 3 trials, AGN-190584 (pilocarpine 1.25%) led to significant near vision gains in mesopic conditions without compromising distance vision. The company proposes that the once-daily drops provide dynamic pupil modulation and mild contractions of the ciliary muscle. “These GEMINI findings support the possibility of another treatment option for people living with presbyopia," said George Waring IV, MD, medical director at the Waring Vision Institute. These studies will be used to support a new NDA submission to the FDA early next year. Abbvie

Scripps Research scientists have unveiled a new strategy for treating retinal diseases—without directly targeting VEGF. Mouse experiments reveal that the protein CITED2 can significantly reduce neovascularization while allowing healthy retinal capillaries to regrow, something that is not always achievable with anti-VEGF therapy. Combining aflibercept with CITED2 fragments, however, appears to provide better results than either treatment alone while continuing to save and restore capillaries. “We were thrilled to see how well this worked in the animal model,” says Rebecca Berlow, PhD, co-senior author of the study. “There really is a need for another way to treat patients who do not respond well to anti-VEGF treatments.” Scripps Research Institute, PNAS