Time to Say CU KC?

Glaucoma treatment may be moving away from the humble eyedrop in favor of sustained-release drugs and minimally invasive technologies, but the treatment of keratoconus could be moving towards it.

IVMED-80 is a copper-based topical treatment for keratoconus that is currently under investigation by iVeena Delivery Systems, Inc, (founded by Bala Ambati, Professor of Ophthalmology,  University of Utah, Salt Lake City, UT, USA). IVMED-80’s mechanism of action is believed to center on enhancing the activity of lysyl oxidase (LOX) – the enzyme responsible for corneal collagen crosslinking, and also known to be associated with keratoconus (1).

The essential cofactor for the enzyme? Copper. “And that led us to our hypothesis that if we supplement with copper, we could enhance LOX activity and corneal stiffening,” says Sarah Molokhia, Vice President of Research and Development at iVeena.

Applying IVMED-80 to human corneal stromal cells, the team found that LOX activity increased 10-fold in cells from keratoconic corneas, compared with a four-fold increase in normal stromal cells. They also found that human cadaver corneas treated with IVMED-80 showed improvements in radial strain. Moving to in vivo studies in New Zealand white rabbits, the team found that after four weeks of treatment, there was a flattening in corneal topography and corneal stiffness was increased (2). “We also found that our one month data was comparable with human data of UV-mediated crosslinking at six months,” says Molokhia.

The team is currently preparing for publication of their pre-clinical results, and plan to move into human trials by the end of 2018. Could patients soon be saying good-bye – or ‘C u’ – to keratoconus?