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HOT TOPIC

Study Ties FECD to Higher Rates of Heart Conditions and Tobacco Exposure

A study recently published in Ophthalmology Science explored the relationship between Fuchs endothelial corneal dystrophy (FECD) and systemic comorbidities, lifestyle factors, and dietary patterns, offering insights and guidance for clinicians who manage this incurable condition. The study was conducted at Massachusetts Eye and Ear Infirmary and compared 50 patients with FECD with 50 age- and sex-matched controls. The results revealed that patients with FECD exhibited significantly higher rates of cardiovascular-related conditions, including hyperlipidemia (75% vs 50%) and atrial fibrillation (26% vs 8%), with trends toward significance in congestive heart failure, hypertension, and coronary artery disease.

Of note, patients with FECD seemingly had a greater cumulative tobacco exposure (11.2 pack years vs 6.1 pack years), which suggests a relationship between smoking and disease severity. It is believed that smoking can exacerbate FECD by increasing the oxidative stress of the cornea, eventually leading to endothelial cell apoptosis, corneal guttata formation, and other negative changes.

My Two Cents

This connection makes sense logically, and I will immediately begin emphasizing it to my students. Speaking of whom, it seems few are able to pick up on any endothelial issues with the slit lamp. If you have students in your clinic, be sure to show them as many irregular endothelia as possible! Endothelial issues and guttata are missed at an almost criminal rate by our peers.

OUTSIDE THE LANE

Marine-Derived Sugar Compound Shown to Inhibit Cancer Growth

In a groundbreaking study published in The FASEB Journal, it was revealed that a specific sugar compound named EPS3.9, derived from deep sea bacteria, exhibits potent anti-cancer properties by inducing pyroptosis, a type of inflammatory programmed cell death.

EPS3.9 is a long-chain exopolysaccharide composed of mannose and glucose and is isolated from the Spongiibacter nanhaibus CSC3.9 bacterial strain. In the study, experiments were performed on mouse models with liver cancer, in which this marine-derived sugar demonstrated remarkable efficacy in halting tumor growth by targeting five membrane phospholipid molecules, thereby triggering pyroptosis in human leukemia cells. Pyroptosis leads to the cancer cells swelling, bursting, and releasing inflammatory signals, which differs from typical apoptosis in that pyroptosis not only directly destroys tumor cells, but also activates the immune system, effectively turning the tumor itself into a beacon for additional immune response. This unique dual action of both direct tumor destruction and immune system engagement makes EPS3.9 an up-and-coming candidate for cancer therapies. (Read more here.)

My Two Cents

It seems most of the cool studies I’ve read about recently are being conducted in China, and this one is no different. Kudos to Chaomin Sun, PhD, of the Chinese Academy of Sciences. EPS3.9 is quite some time away from being useful clinically; however, this is how many great things are discovered in health care. Let’s hope the future development of such an amazing compound can bring its potential to fruition.

CAN YOU RELATE

Last weekend, I attended speaker training for Alcon’s new prescription dry eye medication, acoltremon ophthalmic solution 0.003% (Tryptyr). Anytime we have a new pharmaceutical treatment in the dry eye space, it’s cause for celebration.

There is no silver bullet in the treatment of dry eye (or most eye conditions, for that matter); however, Tryptyr is yet another bullet in our chamber—and I’m pretty excited about it for a multitude of reasons. It works via an entirely different mechanism of action and is higher up the inflammatory cascade. Essentially, the TRPM8 receptors are found on the corneal surface, and they detect small micro-temperature changes that occur between our blinks. When the temperature drops, it triggers the eye to make more basal tears. Tryptyr stimulates those nerves—pretty ingenious.

Alcon

I’m also really excited about the fact that some patients see results in as little as 1 day, which is unheard of in the treatment of dry eye with chronic medications. And it seems to have excellent insurance coverage for a newly launched medication. From my understanding, each patient’s first month is free, with many patients paying only $30 afterwards. (Obviously, that can vary wildly, so don’t take my word on anything related to insurance.)

I don’t mean to sound like an infomercial about this new product, but I believe it is a significant milestone in the treatment of dry eye. Unfortunately, other medications’ recent attempts at securing FDA approval have not been successful, so to see this one seemingly breeze through the process in just one attempt is encouraging and should give us all confidence in its effectiveness!