Question: Hello Sir,My dad is 64 years old and bmi is 22..He has been suffering from type 2 diabetes and HTN for more than 20 years..He suffered from CVA(ischemic stroke) in 2015 and has recovered fully and his MRI report was also normal..He has been diagnosed with open angle glaucoma in both eyes and diabetic macular edema in the right eye with few microaneurysms..He was given the eye drop Tovaxo T containing the prostaglandin receptor agonist travoprost which enhances aqueous humor drainage via uveoscleral pathway and a beta blocker called timolol. Since Tovaxo T was not readily available I chose to buy Xovatra T by a better brand Cipla containing the same potency and composition..My questions are..
1.. Is there any difference in the efficacy of Tovaxo T by XXXXXXX Pharma and Xovatra T by Cipla (logically there should not be any difference as the composition is same).
2..During his latest examination his IOP was on the higher side and he has been prescribed another antiglaucoma eye drop Dorzox by Cipla containing a carbonic anhydrase inhibitor called dorzolamide 3 times a day..Is it safe to take this drug topically three times a day?
3..He is also taking Nevanac drops containing a NSAID nepafenac for reducing macular edema but his latest OCT report shows that macular edema in the right eye has increased..Shall he go for ranibizumab monoclonal anti VEGF1 antibody injection and how many times is it required and at what potency?Corticosteroid injections have been ruled out as he had a ischemic stroke.
In total he is taking 3 eye drops..Xovatra T,Nevanac and Dorzox currently.
4..Will taking N acetyl carnosine eye drops help as he has also been diagnosed with early cataract?NAC has been found in research to act as an antioxidant and does not get degraded due to its acetyl group and reduces protein crosslinking and clumping which causes cataract.
5..Will taking lutein,zeaxanthin and astaxanthin tablets help as pubmed has many papers in favour of their role as a protective antioxidant against blue light and free radicals and our eyes contain lutein and zeaxanthin and mesoxanthin too..I have attached all his reports too..There are two pdf files attached each one named after the date of eye examination..Thanks and regards ..Rahul Saha.