India is now a hub for ophthalmic drug trials for glaucoma which already impacts 11.2 million persons aged 40 years in the country. There are already five such human studies taking place in India, said Dr K Bhujang Shetty, chairman and managing director, Narayana Nethralaya.

Although cataract accounts for 62.60% of the total causes of blindness, glaucoma cases represent 05.80% of the population which is third reason for losing eyesight after refractive errors which is reported to be 19.70%. This is followed by posterior segment disorder: 04.70%, surgical complication: 01.20%, corneal blindness: 0.90%, posterior capsular opacification: 0.90% and other conditions: 04.19%, Dr Shetty told Pharmabiz.

Now glaucoma is the second leading cause of blindness worldwide with 12 million estimated to lose sight blind because of the disease. Barring Asia, primary open angle glaucoma (POAG) is far more common than primary angle-closure glaucoma (PACG) worldwide. In Asia, population-based studies from India have reported that a significant percentage suffer from angle-closure glaucoma. PACG is a more blinding disease than POAG. There is a need to alert people to have regular eye checks, including optic nerve checks along with new treatment modalities, he added.
 
There are glaucoma therapy options being assessed and India is key for these clinical trials. The first is a study to see how two different agents: Mitomycin C a commonly used drug and bevacizumab a newer agent influence the outcome of surgery for medically uncontrolled glaucoma. This is an interventional study where recruitment is underway for medically uncontrolled glaucoma at the Government Medical College and Hospital, Chandigarh, he said.
 
The second study at the L V Prasad Eye Institute, in Andhra Pradesh and the patient recruitment is yet to commence will compare a laser procedure for glaucoma with the current standard filtration operation, when either of it is combined with cataract operation.
 
The third study is a randomized controlled trial at the India Institute of Medical Sciences, New Delhi to assess the effects of short-term yoga-based lifestyle intervention for Glaucoma cases under standard medical treatment.
 
The fourth clinical trial to treat glaucoma with high intensity focused ultrasound will be held at Dr. RP Centre for Ophthalmic Sciences at AIIMS, New Delhi, Narayana Nethralaya in Karnataka and Sankara Nethralaya in Tamil Nadu. The patient recruitment for this is yet to start, said Dr. Shetty.
 
For the fifth study to assess the effectiveness and safety of Brimonidine tartrate in treatment of glaucoma, will have three centres conducting the clinical trial. These are M&J Western Region Institute of Ophthalmology’s Civil Hospital in Ahmedabad with Dr. Purvi Bhagat monitoring the study. Narayana Nethralaya for Karnataka and NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur where Dr. Rekha Khandelwal along with PBMA’s HV Desai Eye Hospital will conduct the study for the Maharashtra region.