Eyeworld

continued on page 2 Innovating advanced treatments to increase compliance and improve outcomes for glaucoma patients: diagnostics, novel therapies, and surgical options (ROCK) inhibitors and adenosine receptor agonists. These target the trabecular meshwork, and the ROCK inhibitor under develop- ment (Rhopressa, Aerie Pharma- ceuticals) increases fluid outflow through the trabecular meshwork, reduces episcleral venous pres- sure, and functions as a norepi- nephrine transporter inhibition. A second ROCK inhibitor combines Rhopressa with latanoprost, and may be commercially available as early as 2018. Trabodenoson decade that for every 1 mm Hg drop in IOP, the risk of disease progression drops by 10%. 3 Potentially complicating our prescribing habits even further is our underlying belief that brand name glaucoma medications are being substituted with generic pharmaceuticals about half of the time, 1 often by the pharma- cist and without our knowledge. These substitutions also may affect patient compliance. There are new classes of medical treatments on the hori- zon, including the Rho-kinase Overall, the respondents noted fewer than 30% of their patients who are prescribed prostaglandin analog-based therapies for the reduction of intraocular pressure (IOP) are compliant with their prescribed treatment. 1 As a result, we (as clinicians) have little confidence with this traditional therapy that has little to do with the class of medication's efficacy. In today's real-life clinical settings, medical/topical therapy is likely to remain the first-line choice for the majority of glauco- ma specialists, as it is non-inva- sive and proven efficacious. Un- fortunately, one patient may be able to tolerate three medications, but another may only be able to tolerate one, leaving us to choose between combination therapies or surgical interventions early on. Even worse, there are patients who will have loss of visual field despite adequate IOP control. 2 As clinicians, we acknowledge that IOP control is the key to limiting vision loss—it has been generally well accepted for more than a T he ASCRS Clinical Survey is a membership survey designed to assess clini- cal opinions and practice patterns; in 2014 there were 1,501 unique respondents that helped provide us with 267 data points surrounding the most compelling and controversial issues facing our membership. For instance, in 2014, U.S. respon- dents said they see more than 400 glaucoma patients yearly, almost twice as much as the non- U.S. respondents. 1 (See Figure 1.) by Richard A. Lewis, MD Customizing treatment strategies Richard A. Lewis, MD Aerie Pharmaceuticals, Alcon Laboratories Inc., Allergan, AqueSys Inc., AVS, Carl Zeiss Meditec Inc., Envisia Therapeutics, Glaukos Corporation, Ivantis Inc., Oculeve Inc., PolyActiva, and ViSci. Nathan Radcliffe, MD, has received a retainer, ad hoc fees or other consulting income from, is a member of the speakers bureaus of: Alcon Laboratories Inc., Allergan, Carl Zeiss Meditec Inc., Endo Optiks Inc., Glaukos Corporation, Iridex, Reichert Inc. He has received a retainer, ad hoc fees or other consulting income from Transcend Medical Inc. Douglas J. Rhee, MD, has received a retainer, ad hoc fees or other consulting income from: Aerie Pharmaceuticals, Alcon Laboratories Inc., Allergan, Glaukos Corporation, Ivantis Inc., Merck & Co. Inc., and Santen Inc. Staff members: Laura Johnson has no oph - thalmic-related financial interests. Beth Marsh has received a retainer, ad hoc fees or other consulting income from: Akorn, Oculeve, and Shire Pharmaceuticals. Accreditation Statement This activity has been planned and implemented in accordance with the Essential Areas and pol - icies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Society of Cataract & Refractive Surgery (ASCRS) and EyeWorld. ASCRS is accredited by the ACCME to provide continuing medical education for physicians. Educational Objectives Ophthalmologists who participate in this activity will: • Describe the issue of treatment compliance in the management of glaucoma and its impact on patient outcomes; • Identify the latest diagnostics to assist in the diagnosis and detection of progression of glaucoma disease; • Assess the impact of novel pharmaceutical options—including new combination drugs and drug delivery systems—on treatment compliance among patients with glaucoma and their corresponding effect on treatment outcomes; and • Identify the latest scientific information on MIGS, both in regard to study results and evolving surgical techniques, to maximize the outcomes in a practice. Designation Statement The American Society of Cataract & Refractive Surgery designates this enduring materials edu- cational activity for a maximum of 1.0 AMA PRA Category 1 Credits. ™ Physicians should claim only credit commensurate with the extent of their participation in the activity. Claiming Credit To claim credit, participants must visit bit.ly/1OvkXht to review content and download the post-activity test. All participants must pass the post-activity test with a score of 75% or higher to earn credit. Alternatively, the post-test form included in this supplement may be faxed to the number indicated for credit to be awarded, and a certificate will be mailed within 2 weeks. When viewing online or downloading the mate - rial, standard Internet access is required. Adobe Acrobat Reader is needed to view the materials. CME credit is valid through May 31, 2016. CME credit will not be awarded after that date. Notice of Off-Label Use Presentations This activity may include presentations on drugs or devices or uses of drugs or devices that may not have been approved by the Food and Drug Administration (FDA) or have been approved by the FDA for specific uses only. ADA/Special Accommodations ASCRS and EyeWorld fully comply with the legal requirements of the Americans with Disabilities Act (ADA) and the rules and regulations thereof. Any participant in this educational program who requires special accommodations or services should contact Laura Johnson at ljohnson@ ascrs.org or 703-591-2220. Financial Interest Disclosures Brian A. Francis, MD, has received a retainer, ad hoc fees or other consulting income from Allergan, Endo Optiks Inc., Merck Sharp & Dohme Corporation, and NeoMedix. He is a member of the speakers bureau of Merck Sharp & Dohme Corporation and has received research funding from Allergan and NeoMedix. Richard A. Lewis, MD, has received a retainer, ad hoc fees or other consulting income from: Supported by unrestricted educational grants from Aerie, Alcon Laboratories, Allergan, Carl Zeiss Meditec, and Glaukos Supplement to EyeWorld November 2015 " Fewer than 30% of our patients … are compliant with their prescribed treatment. " –Richard A. Lewis, MD Click to read and claim CME credit

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