Eyeworld Daily News

EW SHOW DAILY 30 Tuesday, May 10, 2016 Meeting Reporter by Liz Hillman EyeWorld Staff Writer level—those with a college degree or higher—seemed to show a greater prevalence of DED as well, and those who lived in the southern geograph- ic region of the U.S. showed a higher prevalence of DED. As Marguerite McDonald, MD, Lynbrook, New York, said in her presentation about abnormal osmolarity, the effects of DED can be "devastating" on surgical outcomes if not addressed prior to surgery. What's more, it can have a signifi- cant impact on a patient's quality of life. As such, there is much work being done in the diagnosis of DED and treatment of the disease. Some of these techniques were presented in a paper session focused on the cornea and DED. Edward Holland, MD, Cincin- nati, presented the results of a phase 3 randomized double-masked placebo controlled trial (OPUS 3), which found that the dry eye treat- ment solution lifitegrast (Shire, Lex- ington, Massachusetts), resulted in significant improvement of dry eye symptoms compared to placebo. Dr. Holland said the study, designed to replicate the symptom improvement shown in the OPUS 2 trial, showed "virtually identical symptom im- provement" between the 2 trials. The trial also evaluated safety and tolerability of the drug, finding some issues could include irrita- tion, reaction at the site at which it was administered, or dysgeusia, an altered sense of taste. Dr. Holland pointed out that only 1 subject— the 1 who developed dysgeusia— dropped out of the study. "In dry eye disease subjects with moderate to severe baseline symp- tomatology and a history of recent artificial tear use, lifitegrast signifi- cantly improved patient-reported symptoms," Dr. Holland presented, noting that the improvement versus the placebo was seen as early as day 14. Also presented were 2 studies evaluating the safety and efficacy of Oculeve Tearbud (Allergan, Dublin), an intranasal neurostimulating de- vice that activates the production of natural tears for patients with DED. John Berdahl, MD, Sioux Falls, South Dakota, presenting on behalf of Richard Lewis, MD, Sacramen- to, California, and Patricia Sierra, MD, Sacramento, California, said the device increased Schirmer scores well over the placebo and the sham group, the latter of which consisted of a device being placed in the nasal cavity without electrical stimulation. Dr. Berdahl also said that the researchers found the safety profile favorable with 2 adverse events, neither serious nor related to the device, out of 16 patients. Arturo Chayet, MD, Tijuana, Mexico, presented on his study in- volving the use of Oculeve Tearbud and 40 DED patients. In the end, he said he found this treatment reduced DED symptoms relative to baseline. In a survey of participants, most said they would not only use the device again, but that it improved their quality of life and that they would recommend it. Dr. Chayet reported 2 non-serious adverse events, which included mild nasal discomfort and migraines in a patient with a history of headaches. While there is much being done in the drug and device world to alleviate and treat DED, David Alevi, MD, East Meadow, New York, presented on a simple behavioral change that could prove beneficial for patients: how one sleeps. He presented the results from a study of 125 subjects that found "patients who did not sleep on their back were more likely to have increased lissamine staining and a higher ocular surface disease index." "Patients with severe meibo- mian gland disease or dry eyes may be aided by sleeping on their backs as this may help with other symp- toms," Dr. Alevi said. Other paper presentations included the relationship between dry eye and myopia, outcomes of a thermal pulsation treatment for pa- tients with Sjögren's disease, and the results of a safety and efficacy phase 2 study evaluating a punctal plug delivery system for dexamethasone to treat inflammatory dry eye. EW Editors' note: Dr. Schaumberg and Dr. Holland have financial interests with Shire. Dr. McDonald has financial interests with TearLab (San Diego). Dr. Berdahl, Dr. Lewis, and Dr. Chayet have financial interests with Allergan. Drs. Sierra and Alevi have no financial interests related to their comments. What's new in dry eye diagnosis and treatment Dr. Schaumberg presents on the prevalence of dry eye disease within the U.S. A ccording to research based off of data from the 2013 U.S. Health and Wellness Survey, 6.8% of the U.S. population—about 16.4 million people—have what's catego- rized as dry eye disease (DED). Prior to this study, Debra Schaumberg, ScD, OD, Lexington, Massachusetts, said information about the prevalence of DED in the U.S. was "very dated." Further analysis based on the survey put the prevalence of DED as higher among Hispanics and those reported as "other" races, while no significant difference was seen among whites, blacks, and Asians. Educational

• Cover