NEWS & OPINION 48 EWAP MARCH 2023 the drop and was found on examination 1 month later to have retinal tears and limited detachments in both eyes. A second patient noted a visual field defect 5 weeks after instillation of the drop and had a retinal detachment with subretinal fluid extending into the macula. 3 3. This is a case report of a 65-year-old patient who developed vitreomacular traction following instillation of one dose of pilocarpine 1.25%. 4 Summary of Task Force recommendations: An increased risk of retinal traction, tears, and detachment has been associated with miotics such as pilocarpine. Physicians should inform patients who desire treatment of presbyopia with miotics including pilocarpine of this potential adverse event. The duration of miotic registration studies and the included population parameters should be considered when applying risk/benefit assessments to specific patients. Before prescribing miotics, one should consider performing a dilated fundus examination as part of the individual risk assessment for retinal detachment. One may also consider other specific diagnostic testing, such as optical coherence tomography (OCT macula), based on clinical considerations. Patients should be educated regarding symptoms of retinal tears or detachment, including flashes, floaters, and visual field loss and should be advised to seek medical attention urgently should any of these symptoms The Next Generation NEW Pentacam® AXL Wave The first device to combine Scheimpflug Tomography with Axial Length + Total Wavefront + Refraction + Retroillumination The new Pentacam® AXL Wave is a reliable partner for your refractive and cataract practice, creating the best prerequisites for surgery, based on pre-op metrics, and providing post-op measurements for reliable monitoring, in just one device ! With high-end hardware and software for optimum treatment and satisfied patients, the new Pentacam® AXL Wave makes no compromises on quality. OCULUS Asia Ltd. Hong Kong pentacam.com/axl-wave • info@oculus.hk occur. EWAP References 1. Waring GO, et al. Safety and efficacy of AGN-190584 in individuals with presbyopia: the GEMINI 1 Phase 3 randomized clinical trial. JAMA Ophthalmol. 2022;140:363–371. 2. Eton EA, et al. Rhegmatogenous retinal detachment following initiation of pilocarpine hydrochloride ophthalmic solution 1.25% for treatment of presbyopia. Retin Cases Brief Rep. 2022. Online ahead of print. 3. Al-Khersan H, et al. Retinal detachments associated with topical pilocarpine use for presbyopia. Am J Ophthalmol. 2022;242:52–55. 4. Amarikwa L, et al. Vitreofoveal traction associated with pilocarpine for presbyopia. Ophthalmic Surg Lasers Imaging Retina. 2022;53:410–411. Disclaimer: This Consensus Statement is provided by ASCRS for informational and educational purposes only and is intended to offer practitioners recommended monitoring and treatment options for patients who desire treatment of presbyopia with miotics including pilocarpine. Practitioners should use their personal and professional judgment in interpreting these recommendations. This document is not intended to provide medical advice, create a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. Adherence to these recommendations will not ensure successful treatment in every situation. The information in this statement is provided “as is,” and ASCRS makes no warranties as to its accuracy or completeness. This Consensus Statement may need to be updated as future studies are conducted.
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