Oct. 21, 2020
There has been talk in optometric circles for some time about the research being done to develop eye drops to correct presbyopia. During this month’s Academy at Home 2020 meeting, research findings were presented that update the progress made in bringing such eye drops to market, according to reporting by Review of Optometry.
During Academy, Kathryn Richdale, OD, PhD, of the University of Houston College of Optometry, presented the Phase I/II results of the topical eye drop Dioptin (UNR844, Novartis). The eye drop is a lipoic acid-based, topically instilled prodrug that penetrates the cornea. Enzymes metabolized by the crystalline lens help reduce disulfide bonds between proteins and restore elasticity. According to Dr. Richdale, increasing lens protein disulfide content may cause presbyopia through a loss of lens elasticity. The ophthalmic solution showed a five-letter improvement in distance-corrected near visual acuity (DCVNA) vs. placebo, with treatment benefit observed up to seven months in observational follow-up.
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However, work remains to be done, as the objectives of the trial were not met. The prospective, randomized, double-masked, multicenter Phase IIa study analyzed male and female subjects aged 45 to 65 years old who had DCNVA in each eye and binocularly <70 ETDRS letters (20/40) at 40cm and who needed a minimum add of +1.00D or greater to achieve binocular DCNVA of at least 85 ETDRS letters (20/20). Subjects were randomized 1:1 to receive 1.5% Dioptin (n=40) or placebo drops (n=38) in each eye, twice a day for three months. “There was no significant difference in mean change in DCNVA between Dioptin and placebo, (difference of 1.6 letters), so the primary objective was not met,” the study’s findings state.
More research is needed to better understand what it will take to make a reliably efficacious eye drop to correct presbyopia, but Dr. Richdale noted the continuing “unmet need for pharmacological treatments in presbyopia.”