Purchase this article with an account.
A.L. Robin, T. Landry, M.V. W. Bergamini, A.F. Clark; A Single Anterior Juxtascleral Anecortave Acetate Injection Lowers Intraocular Pressure Greater Than 3 Months in Patients With Open Angle Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1541.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Both compliance and adjunctive therapy are important problems in glaucoma therapy. No current intraocular pressure (IOP) lowering medication can be routinely given at intervals greater than 24 hours per dose. All current glaucoma therapies are given either topically or orally and do not routinely yield an additional 25% decrease in IOP lowering when added to a prostaglandin analogue. Anecortave acetate (AA) is a cortisene and an analog of cortisol acetate. Among the modifications to the steroid are the removal of the 11–hydroxyl OH group, introduction of the C9–11 double bond and an addition of a 21–acetate group. As a result of these modifications, AA lacks the typical anti–inflammatory and immunosuppressive properties of glucocorticoids. We investigated the extent and duration of IOP lowering following a single sub–Tenon’s injection (anterior juxtascleral depot [AJD]) of 24 mg of AA.
An investigator IND and IRB approval was obtained. All patients gave informed consent. An inferior AJD was given under topical anesthesia and we followed patients at weeks 1, 2, & 4; and monthly thereafter. Prior glaucoma medications were not changed throughout study.
Six subjects with glaucoma and IOP ≥ 23 mmHg on topical medications (POAG , PDS , PXF ) mean age 59 +/–8 years. Mean C/D ratio 0.8+/–0.2. Prior glaucoma medications included prostaglandins, beta blockers and/or alpha agonists (four on 1, one on 3, and one on 4). Mean pretreatment IOP was 31.3+/–11.3 mmHg on topical medications. Five of six patients had a >25% IOP decrease at 3 months with a mean IOP of 16.4+/–6 mm Hg and a mean 10.8+/–7.0 mmHg ( 38.5%+/–21%) IOP decrease. No clinically significant adverse events occurred.
This represents a potentially new avenue of treating glaucoma patients obviating problems with eye drops and many issues with compliance. Clinically meaningful additional medium–term IOP reduction is possible with a single AJD of AA, much more than presently obtained with any currently available adjunctive medications. Larger scale, longer–term studies are needed to determine the dose response and duration of action.
This PDF is available to Subscribers Only