Behind the mechanism of action of brimonidine tartrate ophthalmic solution

At the Tear Film and Ocular Surface: Basic Science and Clinical Relevance meeting in Venice, Italy, Melissa Toyos, MD, presented her insights on ocular vascular constrictors, specifically focusing on brimonidine tartrate ophthalmic solution (Lumify; Bausch + Lomb). This presentation sheds light on the safety and efficacy of this innovative product, offering eye care providers essential information for patient care.

Toyos emphasized the widespread availability of over-the-counter vasoconstrictors, noting that while they provide quick relief from redness, their safety varies significantly. The key takeaway from her research, which involved a comprehensive analysis of 50 million units over four years, was the specific mechanism of action of Lumify. Unlike traditional redness relievers that act on alpha one adrenergic receptors—which constrict arteries and can compromise ocular nutrition—brimonidine selectively targets alpha two receptors. This distinction is crucial, as it minimizes potential side effects and reduces the risk of rebound redness, a common problem with conventional products.

One of the standout findings from Toyos’s study is that the occurrence of rebound redness with Lumify was extremely low, with only nine reported cases among the large sample size. This significantly lowers the risk of dependence that can occur with other redness relievers, which often lead to a cycle of overuse and increasing dissatisfaction. The study reported an almost negligible rate of ineffectiveness, underscoring Lumify’s safety profile.

Toyos also addressed the impact of brimonidine on the ocular surface. While the study primarily focused on self-reported adverse events, she noted the favorable vehicle composition of Lumify, which includes glycerin, making it comfortable for patients. The small active ingredient concentration further enhances its tolerability, setting it apart from other options.

In summary, Toyos encouraged eye care providers to embrace Lumify as a scientifically-backed option for managing ocular redness. She praised Bausch + Lomb’s commitment to research and safety, reinforcing that eye care professionals can confidently recommend Lumify to their patients without the fear of dependency or adverse effects associated with traditional vasoconstrictors. This innovative approach offers a promising solution for patients seeking relief from redness while maintaining the health of their ocular surface.