brimonidine + brinzolamide (SJP0135 / Ailamide / SJP 0135)

Topical Carbonic Anhydrase Inhibitors in Macular Edema: A Systematic Review.

Sadr Ata A, Maleki Alireza A, Asadollahi Mohammadreza M, Maleki Shahaboddin S et al.

In order to systematically evaluate the efficacy and safety of topical carbonic anhydrase inhibitors (CAIs) in the treatment of macular edema across different retinal disorders, a systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched from inception to June 13, 2026, without language or publication date restrictions. Clinical studies evaluating topical dorzolamide or brinzolamide for macular edema of any etiology were included. Data regarding study characteristics, treatment protocols, visual and anatomical outcomes, and follow-up were extracted independently by two reviewers. Twenty-eight studies met the inclusion criteria, comprising randomized controlled trials, quasi-experimental studies, cohort studies, case series, and one analytical cross-sectional study. Overall, the included studies were of moderate-to-high methodological quality. Retinitis pigmentosa-associated cystoid macular edema was the most frequently investigated condition (13 studies), followed by X-linked retinoschisis (10 studies), diabetic macular edema (four studies), and one macular edema following vitrectomy and epiretinal membrane removal. Topical dorzolamide was the most commonly evaluated agent, whereas topical brinzolamide was investigated less frequently. Across retinal disorders, topical CAIs consistently reduced central macular thickness and improved retinal morphology as assessed by optical coherence tomography. Functional outcomes were more variable, with improvements in best-corrected visual acuity observed primarily in selected patients with retinitis pigmentosa and diabetic macular edema, whereas visual gains were generally modest in X-linked retinoschisis. Long-term studies reported recurrence of macular edema despite continued treatment, particularly in retinitis pigmentosa. Topical CAIs were well tolerated, with no serious ocular or systemic adverse events reported. Topical CAIs provide consistent anatomical improvement in macular edema, particularly in inherited retinal disorders, while functional benefits are less predictable. This discrepancy between anatomical and functional outcomes may be attributed to prolonged photoreceptor loss, retinal pigment epithelium dysfunction, and irreversible disruption of the ellipsoid zone. Their favorable safety profile and non-invasive administration support their use as a therapeutic option, especially for retinitis pigmentosa-associated cystoid macular edema and selected cases of X-linked retinoschisis and diabetic macular edema. However, the current evidence is limited by predominantly observational studies and clinical heterogeneity. Well-designed multicenter randomized controlled trials are needed to establish their optimal role in the management of macular edema.

Therapeutic efficacy and systemic pharmacokinetics of a dual-drug hydrogel contact lens for sustained glaucoma therapy.

Varshitha Vangol V, Sankararajan Umadevi U

Conventional topical therapy for glaucoma is limited by poor ocular bioavailability, rapid precorneal drug loss, frequent dosing and systemic absorption through the nasolacrimal pathway, which may reduce therapeutic efficacy and increase the risk of adverse effects. Drug-eluting hydrogel contact lenses have emerged as a promising strategy to overcome these limitations by enabling sustained ocular drug delivery. This study aimed to evaluate the therapeutic efficacy, ocular biocompatibility and systemic pharmacokinetic profile of an optimized dual-drug-loaded HEMA-based hydrogel contact lens delivering timolol maleate (TM) and brimonidine tartrate (BT) for sustained glaucoma management. Optimized hydrogel contact lenses composed of 2-hydroxyethyl methacrylate (HEMA), N, N-dimethylacrylamide (DMA), N-vinylpyrrolidone (NVP) and ethylene glycol dimethacrylate (EGDMA) were fabricated by UV photopolymerization and loaded with TM and BT (4 mg/mL each). Ocular biocompatibility was assessed using the modified Draize irritation test. Therapeutic efficacy was evaluated in a steroid-induced ocular hypertension New Zealand White rabbit model by monitoring intraocular pressure (IOP) for 24 h. Systemic drug exposure was determined by validated high-performance liquid chromatography (HPLC) analysis of plasma samples, while ocular safety was further confirmed through histopathological examination. The optimized hydrogel lens exhibited excellent ocular biocompatibility, with a maximum Draize score of 0.33 ± 0.12 that resolved completely within 48 h and no histopathological evidence of ocular tissue damage. In hypertensive rabbits, the dual-drug hydrogel lens maintained normotensive IOP (16.1 ± 0.8 mmHg) for 24 h, representing a 43.5% reduction from baseline and significantly outperforming conventional eye drops beyond 4 h (p < 0.01). Plasma concentrations of both TM and BT remained below the limit of quantification (<2.0 ng/mL) throughout the study, whereas conventional eye drops produced measurable systemic exposure (TM: 18.4 ± 2.1 ng/mL; BT: 8.2 ± 1.2 ng/mL), demonstrating effective minimization of systemic drug absorption. The optimized dual-drug-loaded hydrogel contact lens provided sustained intraocular pressure reduction, excellent ocular biocompatibility and negligible systemic drug exposure compared with conventional topical therapy. These findings highlight its potential as a sustained ocular drug-delivery platform capable of improving therapeutic efficacy, reducing systemic adverse effects and enhancing long-term treatment adherence in glaucoma management. Further long-term preclinical investigations and clinical studies are warranted to support clinical translation.

Management of brimonidine-associated uveitis and conjunctivitis.

Amrani Yasmina Y, Ameli Shervine S, Verhulst Karen K, Dugauquier Artemise A

Post-acne Erythema: A Systematic Review of Randomized Controlled Trials on the Comparative Efficacy and Safety of Interventions Across Clinical, Instrumental, and Patient-Reported Outcomes.

Alhussain Ahmed A, Majrashi Mohammad M, Omar AlMubarak Khalid K, Faleh Alqahtani Rayan R et al.

Post-acne erythema (PAE) is a persistent acne sequela without an established standard treatment. This systematic review evaluated the comparative efficacy and safety of interventions tested in randomized trials. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception through August 1, 2026. Randomized parallel-group and split-face trials reporting erythema outcomes were eligible. Risk of bias was assessed with the Cochrane Risk of Bias 2 (RoB 2) tool. Heterogeneity precluded meta-analysis, and available findings were synthesized narratively. Nine trials involving 301 participants contributed 11 pairwise comparisons. Against untreated or blank controls, favorable effects were reported for picosecond alexandrite laser, narrow-spectrum vascular intense pulsed light (IPL), and non-cross-linked hyaluronic acid mesotherapy. A 577-nm semiconductor laser showed interim instrumental benefit, but blinded assessors found no final between-side difference. In active-treatment and add-on comparisons, narrow-spectrum IPL was favored over broad-spectrum IPL, neodymium-doped yttrium aluminum garnet (Nd) laser added to low-dose isotretinoin was favored over isotretinoin alone, and 577-nm pro-yellow laser was favored over topical brimonidine. Botulinum toxin type A was favored over broadband light at the earliest assessment only. Fractional laser and pulsed dye laser did not differ significantly, while delicate pulsed light and Q-switched 1064-nm Nd laser showed no sustained difference at the final assessment. Adverse events were mild and transient, although pigmentation and blistering occurred with one broad-spectrum IPL protocol. Five trials had some concerns, and four had high overall risk of bias. Trials suggested potential benefits, but small samples, heterogeneity, short follow-up, and reporting limitations precluded identification of a preferred treatment. Larger, prospectively registered trials using blinded assessment and standardized outcomes are needed.