At PIE magazine, we love talking shop with the world’s top ophthalmologists. Lucky for us, we were recently treated to an opportunity that perfectly fit that description. PIE magazine CEO Matt Young spoke with Professor Laurent Kodjikian, M.D., Ph.D., professor of ophthalmology at France’s Université de Lyon and former president of the French Society of Ophthalmology.
Prof. Kodjikian has also had a long history in academic writing, with around 300 peer-reviewed publications. This includes 24 on Ozurdex (Allergan, Dublin, Ireland), a medication that was central to our interview. Prof. Kodjikian and Matt also discussed other AMD and DME medications, as well as the significant role diabetes plays in vision impairment and the body in general.
Ozurdex and DME
One of the main topics Matt and Prof. Kodjikian discussed was the role of Ozurdex in treating diabetic macular edema (DME). To put it bluntly, Prof. Kodjikian is a big proponent of Ozurdex — and for good reason.
First, a bit of background. Ozurdex is a dexamethasone intravitreal implant designed to treat three different conditions: DME, macular edema (ME), and noninfectious uveitis. It’s an extended release implant that dissolves naturally within the eye over time, reducing the need for visits to the ophthalmologist. Dexamethasone, a corticosteroid, reduces swelling associated with conditions like DME.
Prof. Kodjikian noted that Ozurdex is more effective in treating DME than anti-VEGF agents, partially because of the injection regimen. Specifically, Ozurdex requires three times fewer injections than anti-VEGF drugs, which leads to greater patient compliance and more consistent treatment.
The professor also pointed out that DME patients are often younger and more active than patients with AMD, so they need a different treatment scheme. Additionally, Ozurdex can help the whole body and not just the eye, which is important because diabetes is a systemic condition that affects far more than the eyes alone.
And What About Diabetes?
Diabetes makes the world less colorful for sufferers.
On the subject of diabetes, Prof. Kodjikian had some dire statistics that bear repeating. For example, he pointed to the explosive growth of diabetes: We can expect diabetes rates worldwide to double between now and 2040.
It’s well known that diabetes has significant deleterious effects on vision, and is one of the leading causes of blindness. If caught and treated early, DME can be managed, but left unchecked it can be devastating to vision.
As mentioned earlier, diabetes is a chronic, pernicious condition that affects nearly all aspects of health. For example, Prof. Kodjikian said that diabetes reduces a person’s life expectancy by an average of eight years — which in many countries is more than 10% of a person’s expected lifespan.
The more diabetes itself can be managed, the smaller its effect will be on vision — both in individuals and as a society. After all, the costs of vision loss and blindness are astronomical in terms of both economic cost and quality of life.
Allergan to the Rescue?
Because Ozurdex is an Allergan product, the discussion turned to other Allergan products, including Abicipar. This new agent Abicipar was designed to treat neovascular (wet) age-related macular degeneration (nAMD) but unfortunately did not clear the FDA’s hurdle due to an apparent risk of intraocular inflammation.
However, Prof. Kodjikian didn’t see the risks from Abicipar to be so terrible. “I’m very disappointed to not have Abicipar,” he said, “because I’m thinking about our patients … and I would like to have Abicipar available for them.”
In the meantime, Allergan still produces extremely valuable treatments like Restasis for dry eye, and Xen for glaucoma, which many ophthalmologists rely on.
The French Society of Ophthalmology (Société Française d’Ophthalmologie (SFO))
Prof. Kodjikian was the former president of the SFO, and remains editor-in-chief of its website, which is a treasure trove of ophthalmic information. You can check it out here, though French language ability is a must. If your French isn’t up to snuff, Google translate or similar tools may be your best bet.
Hats off to Prof. Kodjikian for sharing his knowledge and impressive breadth of experience, and we look forward to the next chance we have to chat with him.
