New classes of glaucoma medical treatment

Jin A Choi

doi:10.5124/jkma.2019.62.9.497

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Choi: New classes of glaucoma medical treatment

Pharmacotherapeutics

J Korean Med Assoc 2019;62(9):497-504.

Published online: 17 July 2019

DOI: https://doi.org/10.5124/jkma.2019.62.9.497

New classes of glaucoma medical treatment

Jin A Choi, MD

Department of Ophthalmology and Visual Science, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Corresponding author: Jin A Choi E-mail: jinah616@catholic.ac.kr

Received 26 June 2019 Accepted 29 July 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Glaucoma is a progressive degenerative disease of the optic nerve head, characterized by a specific pattern of axonal loss and visual field deterioration. This review aims at introducing the different novel pharmacologic agents for its treatment, as well as their mechanisms. Most glaucoma patients require lifelong care and individualized treatment. Intraocular pressure (IOP), which is regulated by aqueous humor production, outflow via the trabecular meshwork (parasympathomimetics only) and uveoscleral outflow pathways, is currently the only treatable target for glaucoma treatment. Conventional glaucoma medications are categorized as β blockers, α agonists, carbonic anhydrase inhibitors, parasympathomimetics, and prostaglandin analogues. The development of basic research-derived novel classes of pharmacologic agents features novel action mechanisms, which are different from those of conventional medications. New classes of recently approved or clinical trial-tested medications include Rho-kinase inhibitors, nitric oxide donors, adenosine agonists, and prostaglandin analogs targeting E-type prostanoid receptors, etc. Their integration and future development will facilitate the expansion and customization of therapeutic options.

Keywords: Glaucoma, Ocular hypertension, Intraocular pressure, Drug development

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