4-Meds in One Glaucoma Eyedrop May Decrease Preservatives, Lower Cost, Improve Compliance

MedicalResearch.com Interview with:

Nathan Radcliffe, MD Senior Faculty, Ophthalmology Glaucoma and Cataract surgeon Mount Sinai Health System

Dr. Radcliffe

Nathan Radcliffe, MD
Senior Faculty, Ophthalmology Glaucoma and Cataract surgeon
Mount Sinai Health System

MedicalResearch.com: What is the background for this study?

Response: Glaucoma is a leading cause of blindness and the mainstay of therapy is to lower the intraocular pressure (IOP) with topical eye drops.

Up to 40% of patients may require more than one eye drop to control the disease, and yet taking more than one eye drop bottle can result in higher costs, more eye irritation, worse therapeutic compliance, and possibly worse outcomes.  Compounded therapies (not FDA approved, but made at the physician’s request by a compounding pharmacy) can be created to contain multiple glaucoma therapies in one bottle.

We sought to determine if a compounded solution containing three or four drops in one bottle could control glaucoma as well as three or four separate bottles (standard of care) in patients requiring three or four eye drop bottles to control glaucoma.

We performed a multi-center, randomized, observer-masked, parallel-group study comparing a compounded therapy containing latanoprost 0.05%, dorzolamide hydrochloride 2%, timolol maleate 0.5%, brimonidine tartrate 0.2% with 0.01% BAK to standard three or four bottle regaimins.  We measured IOP and corneal staining (a sign of preservative toxicity), as well as other safety measures at week one, month one, two and three.

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NSAID Eyedrop + Eye Patch Better at Reducing Pain After Intravitreal Injection

MedicalResearch.com Interview with:

Ronald Gentile, MD Professor of Ophthalmology Icahn School of Medicine at Mount Sinai New York

Dr. Gentile

Ronald Gentile, MD
Professor of Ophthalmology
Icahn School of Medicine at Mount Sinai
New York

MedicalResearch.com: What is the background for this study?

Response: Intravitreal injections have revolutionized the treatment of some of the most common retinal diseases that cause blindness. These diseases include wet age related macular degeneration and diabetic retinopathy. Intravitreal injections are the most common eye procedure in the world. Pain after an intravitreal injection negatively impacts the patient’s experience. We set out a to find a way to improve the patient’s experience by improving the pain they feel after the intravitreal injection.

MedicalResearch.com: What are the main findings? 

Response: The main finding was that the NSAID we used, Nepafanac 0.3% suspension, and pressure patching resulted in lower pain scores when compared to the tear drop placebo at both 6 and 24 hours after the intravitreal injection. The NSAID had a greater effect on lowering the pain score and was found statistically significance. Even though the eyepatch was associated with lower pain scores than placebo, the difference did not reach statistical significance. 

MedicalResearch.com: What should readers take away from your report?

Response: Readers should understand that patients not only have a fear going blind, they also fear the pain of the treatment. Physicians should place more emphasis on the patients experience and try to decrease or eliminate any pain a patient may have from the intravitreal injections. It would be expected that this should help patient compliance, especially for those patient who need regular intravitreal injections. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should focus on the patients experience and find ways to eliminate any pain a patient may have before, during, and after the intravitreal injections. 

MedicalResearch.com: Is there anything else you would like to add?

Response: Yes. Patient satisfaction and the patient experience is something that all ophthalmologists and all doctors need to put on the top of their priority list. Physicians have the greatest ability and insight into this. Having the greatest medicines in the world cant help if a patients fear of pain prevents them from being compliant.

I have no disclosures.

Citation: AAO 2018 abstract

Pain Control Following Intravitreal Injection Using Topical Nepefanac 0.3% or Pressure Patching: A Prospective, Randomized, Placebo Controlled Trial

Nov 2, 2018 @ 6:24 pm 

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Medications Commonly Used During Pregnancy Not Associated With Higher Autism Rates

MedicalResearch.com Interview with:

Magdalena Janecka PhD Department of Psychiatry Icahn School of Medicine at Mount Sinai

Dr. Janecka

Magdalena Janecka PhD
Department of Psychiatry
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study?

Response: Our paper explored the association between maternal use of medication during pregnancy and the rates of autism in a large cohort from Israel. This followed on from a number of earlier studies reporting that the use of certain medications – for example antidepressants – during pregnancy is associated with higher rates of autism in children. However, rather than test the effects of any particular drug, or a set of drugs aggregated based on maternal condition, our large dataset allowed us to group all medications prescribed to pregnant women based on their drug target, and in the subsequent analyses focus on over 50 groups that included drugs with neurotransmitter-relevant targets – for example agonists and antagonists of their receptors.

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What Can Be Done About Sundamaged Skin?

MedicalResearch.com Interview with:

Dr. Janet Prystowsky, MD Dr. Prystowsky is a leading board-certified dermatologist in New York City.  In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.

Dr. Prystowsky

Dr. Janet Prystowsky, MD
Dr. Prystowsky is a leading board-certified dermatologist in
New York City.  

In addition to her private practice, Dr. Prystowsky is a senior attending physician at Mount Sinai Roosevelt/St. Luke’s Medical Center.
http://www.janetprystowskymd.com/

MedicalResearch.com: When does sun damage to the skin start?  Is there such a thing as a ‘safe tan’?  Who is most susceptible to photoaging?  What parts of the body are more likely to show signs of sun damage? 

Response: Sun damage will increase a person’s risk of premature aging and skin cancer.  Although tanning does function to help protect your skin from excessive ultraviolet radiation tanning is still a form of sun damage.  Also, people with very fair skin may not tan at all; only burn.  They are the most susceptible to sun damage. Certain medical conditions (e.g., Lupus), medications, cosmetics, and food can make your more reactive (photosensitive) to sunlight.

"Sunburn" by Kelly Sue DeConnick is licensed under CC BY-SA 2.0Sunburns are caused by UV damage from sun rays, almost entirely due to UVB rays. UVA rays are weaker for burning but can contribute to blistering sunburns as well. For example, If you get lime peel rubbed on your skin while you are in the sun, you could get a bad burn.  UVA can also cause significant skin damage that can result in premature wrinkling, brown spots, and skin cancer. That’s why you’ll see dermatologists pushing for broad-spectrum sunscreens as opposed to sunscreens that just protect against UVB rays.  Continue reading