The American Academy of Ophthalmology (AAO) 2024 meeting featured discussions on a range of topics, from the aging ophthalmologist workforce to advancements in treating presbyopia and wet age-related macular degeneration (AMD).
Addressing the Aging Clinician
Alfredo Sadun, MD, chief of Ophthalmology at the Doheny Eye Institute of UCLA, led a discussion on the increasing number of aging clinicians in ophthalmology. With 40% of the academy over 60, the session addressed the challenges of maintaining competency and the legal issues surrounding mandatory testing. Dr. Sadun highlighted the variability in aging rates and the potential for ageism in requiring older physicians to undergo testing not required of their younger colleagues. He presented a case of a respected physician who failed a cognitive test, sparking legal concerns and ethical considerations.
CSF-1 for Presbyopia
Jennifer Loh, MD, presented a paper on CSF-1, the lowest effective concentration of pilocarpine approved in the United States, for the treatment of presbyopia. The study evaluated the mean reduction in pupil size and improvement in near visual acuity over 15 days. Results showed a 30% mean reduction in pupil size at all measured time points, corresponding with an improvement in near visual acuity of greater than 3 lines without a loss of distance visual acuity. "For a presbyopic drop to function well, it needs to improve near vision without affecting distance vision and with minimal side effects," Dr. Loh noted.
Modern Anesthesia in Cataract Surgery
Brent Kramer, MD, discussed the use of the MKO Melt (ImprimisRx) for modern anesthesia in cataract surgery. The MKO Melt, containing Versed (midazolam), ketamine, and ondansetron, offers a needle-free, opioid-free alternative to traditional anesthesia. Dr. Kramer emphasized the improved patient experience, as patients experience less anxiety and a more relaxed state leading up to surgery. He also highlighted the benefits for the surgical team, as nurses can focus on building rapport with patients rather than administering IVs. "Cataract surgery is the most-performed surgery in America, and if ophthalmologists were able to perform it without opioids, that's less fentanyl being made, less fentanyl being diverted and just a better world."
Advancements in Wet AMD Treatment
Researchers at the Wilmer Eye Institute, Johns Hopkins Medicine, presented findings on why some patients with wet AMD fail to respond to anti-VEGF therapies. The study revealed that anti-VEGF treatments may increase ANGPTL4, counteracting their effectiveness by promoting abnormal blood vessel growth. The researchers also found that the experimental drug 32-134D reduces HIF-1, VEGF, and ANGPTL4 levels, enhancing the efficacy of anti-VEGF therapies in mice. These findings suggest a potential strategy for improving outcomes in wet AMD patients.
FELIQS' lead asset, FLQ-101, received Fast Track designation from the FDA for the prevention of retinopathy of prematurity. The company plans to initiate a Phase 1b/2 study, tROPhy-1, in the US and Japan in the first quarter of 2025.
