Glaucoma Research Progress
Researchers around the world are conducting numerous trials to study glaucoma with the goal of improving the diagnosis, management and treatment of glaucoma.
Treatment Strategies for Glaucoma
Glaucoma is primarily treated by lowering intraocular pressure, which can be achieved with laser surgery, medications, traditional surgery or a combination of these methods. Treatment strategies may vary depending on the type of glaucoma and the individual patient.
Laser Therapy
Target the trabecular meshwork thereby lowering IOP, or perform peripheral laser iridotomy to prevent pupillary block, or ablate the ciliary process to reduce aqueous humor.
Traditional Surgical Therapy
Create an opening and remove a portion of the trabecular meshwork, or insert a small tube shunt to drain excess fluid to lower IOP, or minimally invasive glaucoma surgery (MIGS).
Drug Therapy
Glaucoma is usually treated with medications that help the eye's fluid drain better or reduce the amount of fluid produced, and must be taken daily to keep the eye pressure at a safe level.
Drug Treatment Strategies for Glaucoma
In recent years, pharmacotherapy for glaucoma has played an increasingly important role as an early basic treatment strategy. The main types of drugs for glaucoma treatment are prostaglandin analogues, beta blockers, alpha agonists, Rho kinase inhibitors, and carbonic anhydrase inhibitors.
Prostaglandin Analogues
These increase the outflow of intraocular aqueous humor, thereby lowering intraocular pressure. Such drugs include Latanoprost (Xalatan), Travoprost (Travatan Z), Tafluprost (Zioptan), Bimatoprost (Lumigan), and Latanoprost (Vyzulta).
Beta Blockers
These medications reduce intraocular fluid production, thereby lowering intraocular pressure, and include Timolol (Betimol, Istalol, Timoptic) and Betaxolol (Betoptic).
Alpha Agonists
These reduce the production of aqueous humor and increase the outflow of fluid from the eye. Examples include Iopidine and Brimonidine (Alphagan P, Qoliana).
Rho Kinase Inhibitors
These drugs lower eye pressure by inhibiting the rho kinases that cause an increase in body fluid, including Netarsudil (Rhopressa).
Carbonic Anhydrase Inhibitors
These drugs reduce the production of fluid in the eye, examples include Dorzolamide (Trusopt) and Brinzolamide (Azopt).
Drug therapy remains an important part of glaucoma treatment, and many researchers and pharmaceutical companies are conducting trials to evaluate these drug candidates.
- Storgaard L et al. concluded that 105 different drug targets have been identified, but these represent only a small fraction of the possible drug targets in glaucoma, as there are more than 2,700 possible targets associated with glaucoma.
- Storgaard L et al. summarized that 88 new compounds have been identified to date, 22 of which are of particular interest and may be approved for glaucoma treatment.
Fig. 1 Investigational and future drug candidates for glaucoma treatment. ( Storgaard L, et al.,
2021)
Future Research in Glaucoma Therapy
One area of interest is the development of new forms of glaucoma drug delivery to improve drug therapy, such as extended-release drugs, which release drugs uniformly over a longer period of time to make treatment more convenient and effective.
Also researchers are still actively studying new types of drugs for glaucoma, looking for drugs that have fewer side effects, are more responsive to the eye, and are more effective at lowering eye pressure.
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Reference
- Storgaard L, et al. Glaucoma Clinical Research: Trends in Treatment Strategies and Drug Development. Frontiers in Medicine, 2021, 8:1492.
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