Ophthalmology Overview: First Nasal Spray for Dry Eye Disease, Surgical Outcomes in Pediatric Patients, and More

Highlighting the latest ophthalmology-related news reported across MJH Life Sciences^™.

FDA Approves First Nasal Spray for Treatment of Dry Eye Disease

This week, the FDA approved the first nasal spray indicated for the treatment of dry eye disease (DED) in the United States, according to Ophthalmology Times^®.

Varenicline solution nasal spray 0.03 mg, sold as Tyrvaya and developed by Oyster Point Pharma, is a highly selective cholingergic agonist designed to activate the trigeminal parasympathetic pathway. Notably, its novel nasal delivery was indicated to potentially improve self-administration of DED therapy for patients who have difficulty administering topical eye drops independently.

Based on evidence of the ONSET-1, ONSET-2, and MYSTIC clinical trials, the nasal spray was associated with statistically significant improvements in tear film production and further improvements from baseline in eye dryness. The most common adverse events were sneezing, cough, throat irritation, and nose irritation.

Innovations in Ophthalmologic Surgery Care for Pediatric Populations

In an article by Ophthalmology Times^®, 4 key innovations in the surgical care of pediatric ophthalmology patients were noted at the Women in Ophthalmology 2021 Summer Symposium:

• Prenatal surgical planning to address congenital hereditary disease
• Endothelial keratoplasty
• Endocyclophotocoagulation (ECP) to treat refractory glaucoma
• Ultrasound biomicroscopy (UBM) as a tool for guiding complex cataract surgery.

In pediatric patients with refractory glaucoma, the use of ECP vs transscleral ciliary ablation was indicated to provide a minimally invasive and safer technique. Notably, less than 1% of eyes experiencing phthisis in the absence of retinal detachment were reportedly treated with ECP compared with over 30% in eyes treated transsclerally.

Furthermore, evaluating pediatric patients with cataract via UBM was said to better enable surgery planning and avoid intraoperative surprises. Speaking on a particular case study of a 1-month child with bilateral cataract who had to have their surgery postponed for 3 months due to required treatment for comorbid heart failure, UBM imaging conducted prior to the scheduled surgery uncovered a significant decrease in crystalline lens thickness that helped guide appropriate surgical techniques.

Assessing Treatment Options for Presbyopia

Despite risk of age-related blurry near vision, known as presbyopia, increasing naturally among a growing older adult population, there are no approved drug therapies, with all available interventions, such as contacts, lens exchange, and monovision, reportedly having issues.

As reported by Ophthalmology Times^®, demand for interventions, especially those beyond corrective reading glasses, has been noted, with over two-thirds of patients indicating their preference for eye drops. Development of eye drops for the treatment of presbyopia has generated several investigational therapies, in which the closest to achieving commercial availability is Allergan’s AGN-190584.

AGN-190584 was shown in the GEMINI I trial to meet its primary and key secondary end points without compromising distance vision. The drop achieved a 3-line or greater improvement in the mesopic distance corrected near vision, with onset in 15 minutes.