Glaucoma News
Possible Link Between Glaucoma Medication and
Lower Death Risk
ANN ARBOR, Mich., March 2010 — A new study suggests that glaucoma medications may be associated with a reduced mortality risk.
Researchers from the University of Michigan examined 21,506 individuals over age 40, with an average age of 60 years. More than half of the participants had suspected glaucoma, and the rest had one or more types of glaucoma. All participants were enrolled in a managed care network.
Participants were surveyed over a four-year period, from January 2003 to December 2007. About 28 percent took one or more glaucoma medications, and about 9 percent had glaucoma surgery. By the end of the study, 237 participants or about 1 percent had died.
The researchers found that those using any type of glaucoma medication had a 74 percent reduced risk of death. Demographic characteristics and other medical conditions associated with mortality were taken into account.
According to the researchers, further studies are needed to determine the protective effect of glaucoma medications and other factors, such as access to care and providers' prescribing patterns.
The study was reported in the February issue of Archives of Ophthalmology.
Higher Risk of Glaucoma for Diabetics
SAN FRANCISCO, February 2010 — The American Academy of Ophthalmology is reminding Americans that diabetics are at higher risk than others for glaucoma and need to have their eyes examined to prevent the vision loss that results from the disease when untreated.
About 3 million Americans have glaucoma, but only about half know that they do, because at first the symptoms are unnoticeable or even non-existent.
Neovascular glaucoma is a variation that appears most often in diabetics. It can be treated with drainage implants, lasers and VEFG inhibitor medications, but treatment is most effective when it begins early.
The Academy will commit $1 to its diabetic eye health education efforts for each person who pledges to have an annual diabetic eye exam. All you have to do is visit the EyeSmart EyeCommitted website and take the pledge.
Researchers Identify Barriers to Glaucoma Care
SAN FRANCISCO, December 2009 — A new study examines why glaucoma patients miss follow-up appointments with their eye doctors. The team found barriers other than financial problems and insurance issues, which are assumed by many eye care professionals.
The researchers surveyed San Francisco General Hospital (SFGH) glaucoma patients from August 2008 to January 2009. Seventy-five percent of participants cited long clinic wait times as a significant barrier to follow-up care. Difficulty with scheduling appointments was another key issue.
Language barriers were problematic for 37 percent of Latino and 32 percent of Asian participants, even though SFGH provides interpreting services.
According to the researchers, poor glaucoma follow-up is a widespread problem, particularly among groups that are medically under-served. They recommend improving wait times, streamlining the appointment scheduling process and resolving interpreter issues.
The findings were presented at the 2009 American Academy of Ophthalmology - Pan-American Association of Ophthalmology joint meeting in October.
Researchers Study Glaucoma Factors in People of African Descent
SAN DIEGO, November 2009 — A new study seeks to shed light on what causes high rates of glaucoma among people of African descent. The study, called African Descent and Glaucoma Evaluation Study, or ADAGES, will examine 686 participants of African descent and 436 participants of European descent with no glaucoma, suspected glaucoma and glaucoma.
Currently the researchers have identified baseline differences, such as the individuals of African descent having thinner corneas, a higher percentage of diabetes mellitus and high blood pressure, and a lower percentage of heart disease.
The study may identify which factors influence the different rate of progression and onset of glaucoma between the two groups. These findings could help doctors predict and accurately diagnose glaucoma in high-risk patients.
The announcement of the study was in the September issue of Archives of Ophthalmology.
Jogging May Help Lower Intraocular Pressure, Says Study
THESSALONIKI, Greece, October 2009 — Scientists tested 145 people with and without glaucoma to see if jogging or bicycling had an effect on their eyes' intraocular pressure (IOP). A high IOP is a result of glaucoma and can be very harmful to the optic nerve, causing major vision loss over time.
Concerns have been raised in the past about glaucoma patients jogging or pursuing other physical exercise — especially those who were taking glaucoma medications.
But the researchers, from the Aristotle University of Thessaloniki, found a statistically significant decrease in IOP during jogging and bicycling, even among those in a glaucoma medication regimen.
The study report appeared online in BMC Ophthalmology in August.
Glaucoma Surgeries Rise; Medicare Reimbursements Fall
ALEXANDRIA, Va., July 2009 — While the number of glaucoma surgeries is increasing, Medicare payments for the procedures are decreasing. This is according to a study by Jordana Schmier and others of Alexandria-based Exponent Inc. that analyzed Medicare claims and payments for glaucoma surgery between 1997 and 2006.
The surgeries included laser trabeculoplasty, filtering surgery, shunt surgery and procedures to reduce the production of eye fluid. [Please read more about these procedures in our glaucoma surgery article.]
The researchers noted a decrease in procedures and payments from 1997 to 2001 but an increase in procedures after that. Payments increased for some types of procedures but decreased for trabeculoplasties.
"Medicare payments remain an important component of the cost of glaucoma in the United States, and the overall trend toward lower-cost surgical procedures (i.e., fewer trabeculectomies) despite the increased use of newer technologies (i.e., more glaucoma drainage devices) observed in this analysis may have a substantial impact on national glaucoma expenses," the researchers concluded. Their report appeared in Archives of Ophthalmology.
Alcon Research Ltd. funded this research. Alcon, Inc. is a manufacturer of glaucoma medications and other pharmaceuticals and medical devices for the eyes.
Anecortave Acetate No Longer in Development
for Intraocular Pressure Reduction
HUENENBERG, Switzerland, July 2009 — Early clinical studies were promising. But after a phase 2 clinical trial involving more than 200 glaucoma patients, Alcon, Inc. has decided to discontinue development of anecortave acetate for reduction of intraocular pressure (IOP) associated with glaucoma.
Although the injection treatment did reduce IOP for an extended period of time, the amount of IOP reduction was not enough to address the problem of patient compliance with eye drop therapy.
The company had hoped that anecortave acetate injections could be as infrequent as every three months, relieving glaucoma patients of the necessity of using eye drops every day to prevent vision loss from high IOP.
"While the results show the possibility of alternative, longer term delivery for glaucoma patients, we are disappointed that anecortave acetate did not prove to have sufficient IOP reduction efficacy to be a successful treatment," said Sabri Markabi, MD, Alcon's senior vice president of research and development and chief medical officer.
Pregnant Women Should Use Right Glaucoma Medication
TAIWAN, June 2009 — A new study found that taking certain glaucoma eye drops other than beta-blockers during pregnancy can increase the risk for low birth weight infants.
After adjusting for characteristics of the infant, mother and father, researchers found no significant difference in infant birth weight between the control group and mothers who took beta-blockers that decrease fluid production in the eye.
But significantly higher risks of having low birth weight infants were noted when mothers used other types of anti-glaucoma eye drops.
Based on these results reported in the June issue of the British Journal of Ophthalmology, researchers concluded that topical beta-blockers are the best drug choice for treating pregnant women who have glaucoma.
Are Glaucoma Med Contact Lenses in Our Future?
CAMBRIDGE, Mass., June 2009 — Can contact lenses deliver glaucoma medications to the eyes?
It's an idea that has been around for a while, with no effective product in sight. But now a Cambridge, Mass., company called Cambridge Eyenovations is patenting their lens's method of delivering high doses of drugs for up to 100 days in a gradual, controlled fashion, according to a May 21 report in Technology Review (a Massachusetts Institute of Technology publication).
People with glaucoma would be prime beneficiaries of the new technology, since they must use glaucoma eye drops several times a day to control their eyes' intraocular pressure. Many glaucoma patients do not follow their eye drop schedules very carefully, and vision loss can result.
Other medications could be delivered via a contact lens as well, such as antibiotics and dry eye treatments.
Cambridge Eyenovations is reportedly planning to test the lens in animals.
Studies Confirm Safety of Punctal Plug Delivery
Method for Glaucoma Medication
ATLANTA, April 2009 — The idea of delivering glaucoma medication to the eye with a punctal plug has passed two important tests: an initial pilot study and a phase II clinical trial, during both of which the device reduced intraocular pressure (IOP) without serious side effects. (See November 2008 item, with slide show.)
In the phase II clinical trial conducted in the United States, 61 people with bilateral glaucoma were fitted with punctal plugs containing the glaucoma medicine Latanoprost (QLT, Inc.). The researchers tested three different concentrations of the medication in the plugs, which were in place in patients' tear ducts for three months.
As investigator Richard A. Lewis, MD, noted at the 2008 annual meeting of the American Academy of Ophthalmology, for safety reasons the dosage was significantly less than patients normally would receive during a three-month period. That may be why IOP reduction was only 4 to 5.5 mm, vs. a 6 mm reduction during the smaller pilot study that had occurred in Mexico.
Dr. Lewis added that the device needs more work to improve the drug's performance and increase tolerance of the punctal plugs. Results were reported in the April issue of Ophthalmology Times.
Can Alzheimer's Disease Actually Cause Glaucoma?
BEERNEM, Belgium, March 2009 — Studies have shown that people with Alzheimer's disease may be significantly more likely to develop glaucoma than other people. But researchers disagree as to the clinical and genetic relationship between the two diseases.
It may be that they share risk factors. Or perhaps one disease causes or contributes to the development of the other.
An article by Belgian researchers in this month's British Journal of Ophthalmology hypothesizes a causal relationship. This is based on low cerebrospinal fluid pressure (CSFP) in Alzheimer's patients. A recent study found that mean CSFP was 33 percent lower in study participants with primary open-angle glaucoma than in those without glaucoma.
Low CSFP in tissue behind the eye means an abnormally high pressure difference with the tissue inside the eye, pinching and deforming the nerve fibers and blood vessels passing through both. This helps cause glaucoma-related optic nerve damage.
Glaucoma Could Impair Reading Skills in Older Adults
BALTIMORE, January 2009 — A recent study demonstrates that glaucoma eye disease could slow down verbal and general reading skills in older adults.
During the study, 1,154 people of an average age of 79.7 were asked to read text aloud. Subjects with glaucoma (4.4 percent) were more likely to have impairment, meaning they were unable to read more than 90 words per minute. Impairment was even more evident in people who had glaucoma in both eyes.
"Glaucoma affects 2 percent of U.S. adults older than 40 years, and as many as 10 percent have suspected glaucoma," researchers at Wilmer Eye Institute, Johns Hopkins University said in published study results. "Determining who should be treated requires that we understand when and how glaucoma produces disability."
Study results were published in the January issue of Archives of Ophthalmology. 
Please click here for more glaucoma news from 2008.
[Page updated March 16, 2010]
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