New Trends in the Medical Management of Glaucoma
Abstract
Glaucoma management is continuously evolving to safer more effective and less invasive modalities. Topical anti-glaucoma medications are still the first line therapy in glaucoma management.1 Recently there has been a lot of research into novel drugs, delivery systems and medications with better preservatives. A few years ago, available therapeutic options mainly increased uveo-scleral outflow or decreased aqueous humor production in order to lower intraocular pressure. There were no medications that targeted the diseased trabecular meshwork (TM) directly. Pilocarpine, a miotic glaucoma drug that works to increase aqueous humor outflow does not directly target the TM. Rather it induces contraction of the ciliary muscle in order to expand the TM and decrease outflow resistance.
References
Boland MV, Ervin AM, Friedman DS, et al. Comparative effectiveness of treatments for open angle glaucoma: a systematic review for the US
Preventive Services Task Force.Ann Intern Med.2013; 158: 271-279
Lu LJ, Tsai JC, Liu J. Novel Pharmacologic Candidates for Treatment of Primary Open-Angle Glaucoma. Yale J Biol Med 2017;90(1):111–118.
Sit AJ, Kazemi A, McLaren JW, et al. The effects of netarsudil ophthalmic solution on aqueous humor dynamics in humans. Invest Ophthalmol
Vis Sci. 2017; 58:2112.
Kaneko-Kawano T, Takasu F, Naoki H,Sakumura Y, Ishii S, Ueba T, Eiyama A, Okada A, Kawano Y, Suzuki K: Dynamic regulation of myosin light chain phosphorylation by Rhokinase. PLoS One. 2012;7:e39269. DOI:10.1371/journal. pone.0039269
Nucci C, Martucci A, Giannini C, Morrone LA, Bagetta G, Mancino R. Neuroprotective agents in the management of glaucoma. Eye [Internet].
May 23 [cited 2019 Aug 29];32(5):938–45. Available from: http://www.nature.com/articles/s41433-018-0050-2
