New and Upcoming Development in Glaucoma Treatment (Eyes on Eyecare)

New and Upcoming Developments in Glaucoma Treatment

As a glaucoma specialist, Dr. Amy Mehta struggles with the daily emotional task of diagnosing patients with an irreversible form of vision loss, inevitably at times feeling a heavy burden of explaining the grave nature of this sight-threatening disease. Having no curative treatment to reverse the optic neuropathy in glaucoma is the crux of managing patients with this condition. In this article, she discusses new and upcoming developments in glaucoma treatment, including an advance by UF startup and UF Innovate | Accelerate at Sid Martin Biotech company TearClear.

Glaucoma is the second most common cause of blindness overall and the leading cause of irreversible blindness worldwide. As life expectancy grows, the incidence and prevalence of those diagnosed with glaucoma will continue to grow. Currently, in the United States, 1.9% of the population has been diagnosed with glaucoma, and in patients aged > 80, the prevalence is 7.7%. In addition to the varying glaucomatous etiologies and stages, there is a significant need for more individualized treatment modalities in the management of glaucoma.

While benzalkonium chloride (BAK) is necessary for preservation of sterility in topical ophthalmic solutions in a multidose vial (most glaucoma topical medications), it is one of the key perpetrators of ocular surface disease, particularly dry eye disease. It can cause several signs and symptoms, including conjunctival hyperemia and inflammation, tear film instability, burning, tearing, foreign body sensation, and pain.

Whereas a majority of glaucoma patients are on at least one topical glaucoma medication, ocular surface disease from chronic BAK preservative is inevitable and found in up to 40% of glaucoma patients. This in turn leads to intolerance of certain topical glaucoma medications and non-adherence to medications needed to curb disease progression.

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On the horizon is a preservative-free multidose vial of Latanoprost, formulated by TearClear (Boston, MA). As of 24 August 2021, TearClear filed an investigational new drug (IND) application for TC-002 latanoprost ophthalmic solution 0.005%. The goal is to create a safe and effective formulation of latanoprost in a multidose vial that will capture the preservative before it leaves the bottle and reaches the ocular surface. This would allow BAK to remain in the bottle, preserving the eye drop’s sterility but not allowing it to get the ocular surface.

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