b'The first compared visual field pro-gression, additional glaucoma medi-cations or a recommendation for sur-gery or laser due to inadequate intra-ocularpressurecontrolintheinter-ventionandcontrolarmsoverthe 12 months following randomization. While the study found no significant differences in the two groups, Muir suspects the findings might have been different,ifthefollow-uphadbeen longer.Glaucomaisareallyslowly progressingdisease,shesaid. Fortunately, it takes about five yearsU.S. Air Force Airman 1st Class Kyle Rudisaile, 18th Logistics Readiness Squadron vehicle to really see a change, so we did notmaintainer, left, receives eye drops for dilation from Maj. Todd Christiansen, 18th Operational Medical Readiness Squadron human performance flight commander, on Kadena Air Base, seeadifferenceintheinterventionJapan, last year. Theyearly eye exams look for disorders such asglaucoma.and control arm in terms of how manyU.S. Air Force photo by Staff Sgt. Rhett Isbellveterans had to go on to have surgery or more intensive medicine. But not that many indrops. In March 2020 the FDA approved Durysta, either arm had to have these interventions.2 the first biodegradable, intracameral implant for the A separate study using a decision analytic model toloweringofintraocularpressureinpatientswith simulate the lifelong costs and quality-adjusted lifeopen-angle glaucoma or ocular hypertension. The years QALYs, found that, compared to standard ofimplant is inserted into the anterior chamber and care, the intervention dominated resulting in lowerprovides a sustained release of bimatoprost for sev-lifelong costs ($23,339.28 versus $23,504.02) anderal months.higher QALYs (11.62 versus 11.58). Muri and herBecause glaucoma is a lifelong disease and the ben-colleagues concluded: From a VA payer perspectiveefits of the implant are limited to a relatively short over a lifetime, the glaucoma medication-enhancingtime (each eye can be treated only once), the implant behavioral intervention dominated standard of carehas not been widely adopted by the VA. Muir, how-intermsofgeneratingcostsavingsandgreaterever, finds the concept of sustained-release medica-QALYs.tions for glaucoma exciting. While the therapy has 3Muir said her next goal is to get support to expandsome limitations in its current form, there is a need the interventionwhich was tested in a single eyefor sustained release medications and it is exciting clinicto other VAs, because the stakes of nonad- that there is now one FDA approved, she said.herence have the potential to affect all areas of life.1. Muir KW, Rosdahl JA, Hein AM, Woolson S, Olsen MK, Kirshner Most people in their 70s or 80s arent just dealingM, Sexton M, Bosworth HB. Improved Glaucoma Medication Adher-with glaucomait is not the only thing they have toence in a Randomized Controlled Trial. Ophthalmol Glaucoma. 2022 deal with, she said. But if you lose vision, caringJan-Feb;5(1):40-46. doi: 10.1016/j.ogla.2021.04.006. Epub 2021 Apr for everything else in your life becomes difficult. If20. PMID: 33892170.you have diabetes, seeing your glucometer becomes2. Buehne KL, Rosdahl JA, Hein AM, Woolson S, Olsen M, Kirshner M, Sexton M, Bosworth HB, Muir KW. How Medication Adherence difficult; your risk of falls goes up significantly, so itAffects Disease Management in Veterans with Glaucoma: Lessons is certainly all connected. Treating glaucoma shouldLearned from a Clinical Trial. Ophthalmic Res. 2023 Jan 5. doi: be a priority because of its potential effectnot just10.1159/000528857. Epub ahead of print. PMID: 36603568.on sight but on virtually every area of life. 3. Hung A, Williams AM, Newman-Casey PA, Muir KW, Gatwood J. As Muirs research focusing on improving medi- Cost-Utility Analysis of a Medication Adherence-Enhancing Educa-tional Intervention for Glaucoma. Ophthalmol Glaucoma. 2023 Jan cation adherence other research is aimed at circum- 25:S2589-4196(23)00032-7. doi: 10.1016/j.ogla.2023.01.006. Epub venting the issue by eliminating the need for dailyahead of print. PMID: 36707031.40'