2023’s Significant Moments

HOT TOPIC

Revisiting 2023’s Headlines and Trends

It’s hard to believe, but this is the last edition of the newsletter for the year. Below is a recap of some of the hottest topics we’ve covered, and others worth mentioning.

Back in June, Florida’s anti-optometry bill SB 230 threatened to ban ODs from using the titles “doctor” and “physician” and would have subjected them to felony prosecution if they did. Despite strong bipartisan support from both the Florida Senate (37-0) and the House (111-3), when sent to Governor Ron Desantis’ desk, the presidential candidate vetoed the bill, thanks to the tireless advocacy efforts of the Florida Optometric Association and of ODs from around the country.

On a related note, congratulations to Iowa, New Hampshire, South Dakota, and Washington, whose optometrists all won scope enhancements! The battle rages on elsewhere, with a few states experiencing legislative setbacks, including Alabama, South Dakota, and California. Here’s hoping that 2024 and 2025 prove more fruitful and that legislators in those states realize just how vital optometry is—especially in light of a recent report that the ophthalmology workforce is expected to decline 12% by 2035.

This year, we received some new FDA approvals to help in the constant battle against dry eye disease. Perfluorohexyloctane ophthalmic solution (Miebo, Bausch + Lomb) is the first prescription eye drop for dry eye disease that directly targets evaporation. I have been using this drop in my patients, and have had a wonderful experience. Additionally, lotilaner ophthalmic solution 0.25% (Xdemvy, Tarsus Pharmaceuticals) has been an absolute game-changer in my clinic. Xdemvy is the first FDA-approved treatment for Demodex blepharitis. Its twice daily dosing for 6 weeks has shown outstanding results in both FDA trials and in my clinical experience.

Radiofrequency (RF) and intense pulsed light (IPL) therapy continue to become more accepted as treatment options on the dry eye treatment menu (most notably for those with ocular rosacea). It seems as if at least once per month, I’m hearing from a company about RF as the new IPL in the treatment of dry eye. My hope is that in 2024, we start to see some clinical trials backing up the use of RF to prove its superiority over other methods of meibum melting, etc. Not only that, but it seems as if new IPL and RF machines are coming out each month. The OG, OptiLight (Lumenis), is still the only FDA-approved machine out there; however, it has been receiving stiff competition from other companies in its effort to maintain market dominance.

A few new treatment options even emerged for glaucoma! A new(ish) player in the eye care world, Théa Pharma, released the first FDA-approved, commercially available, preservative-free formulation of latanoprost (Iyuzeh). Additionally, the FDA in December approved Glaukos Corporation’s NDA for a single administration per eye of its travoprost intracameral implant 75 mcg (iDose TR). This implant is a long-duration prostaglandin analog indicated for the reduction of IOP in patients with ocular hypertension or open-angle glaucoma.

In September,
a team effort by Ocuphire Pharma and Viatris succeeded in getting their phentolamine ophthalmic solution 0.75% (Ryzumvi) approved by the FDA for the treatment of pharmacologically induced mydriasis

produced by adrenergic agonists or parasympatholytic agents (or a combination thereof). The drop, formerly known as Nyxol, is a preservative-free drop that blocks the alpha-1 receptor within the eye’s iris dilator muscle without affecting the ciliary muscle.

Adding a bit of competition to the apparently stalled out presbyopia drop market,
the FDA in October approved Orasis Pharmaceuticals’ pilocarpine HCl ophthalmic solution 0.4% (Qlosi) for the treatment of presbyopia in adults.

Also, congrats to Orasis on having (in my opinion) the best-named pharmaceutical of 2023 (maybe ever). The name Qlosi, is pronounced “close-see.” And it’s a presbyopia drop. Get it?

This past year could be viewed as the year of geographic atrophy (GA).

The FDA in February approved Apellis Pharmaceuticals’ pegcetacoplan injection (Syfovre) for the treatment of GA secondary to age-related macular degeneration. In August, the FDA approved avacincaptad pegol intravitreal solution 2 mg (Izervay, Iveric Bio) for the same indication. Two game-changers!

Regeneron also had a strong 2023, with its aflibercept injection (Eylea) approved for the treatment of retinopathy of prematurity in preterm infants. The company also received approval for aflibercept 8 mg (https://investor.regeneron.com/news-releases/news-release-details/eylea-hd-aflibercept-injection-8-mg-approved-fda-treatment-wetEylea HD) for the treatment of wet age-related macular degeneration, diabetic macular edema, and diabetic retinopathy. Although there are other retina approvals of note, October’s FDA approval of Genentech’s faricimab-svoa (Vabysmo) for treating macular edema following retinal view occlusion proved especially noteworthy to me.

Regeneron also had a strong 2023, with its aflibercept injection (Eylea) approved for the treatment of retinopathy of prematurity in preterm infants. The company also received approval for aflibercept 8 mg (Eylea HD) for the treatment of wet age-related macular degeneration, diabetic macular edema, and diabetic retinopathy. Although there are other retina approvals of note, October’s FDA approval of Genentech’s faricimab-svoa (Vabysmo) for treating macular edema following retinal view occlusion proved especially noteworthy to me.

One of the current buzzwords in optometry seems to be myopia management. Blessed with such industry dynamos such as Justin Kwan, OD, FAAO, preaching the gospel of myopia control, many optometrists have discovered this past year that taking a more active role in this area is not only financially beneficial to their practice, but it’s also the new standard of care. I strongly expect myopia management to continue to grow and become more commonplace among nearly all practices.

Speaking of optometric dynamos, Adam Ramsey, OD, and Darryl Glover, OD, might just be two of the most important members of our profession at the moment. These two have made it their mission to bring optometry’s diversity, equity, and inclusion issues to the forefront of everyday conversations. Drs. Ramsey and Glover founded Black EyeCare Perspective to “cultivate and foster lifelong relationships between Black eyecare professionals and the eyecare industry.”

My final note on 2023 is that it felt like the year that many of us decided to return to in-person conferences! From my perspective, a lot of the big, established conferences seemed to be packed to the gills, but most interestingly, quite a few of the newer conferences found their footing and are in the process of changing the in-person education game. A personal favorite of mine was MOD Live 2023 in Nashville. This high-energy, no-fluff conference encouraged participation during the segments, and rather than having just one or two lecturers speak for 1 to 2 hours at a time, it was panel-driven. A group of doctors took the stage, and each only had a few minutes to share their absolute best clinical pearls. Then, a natural Q&A took place. Here’s to hoping for continued evolution in the continuing education realm!

CAN YOU RELATE

That’s a wrap for year 1 of Significant Findings! Thanks so much for reading and for sharing your thoughts and suggestions. We’ll be back with a regular edition in January. Happy holidays to you and yours!