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Abstract #46534 Published in IGR 13-3
Pharmacotherapy of glaucoma
Pelcic G; Vitezic D; Mrsic-PELCIC JFarmaceutski Glasnik 2011; 67: 311-327
Glaucoma is the second leading cause of blindness worldwide. This disease is characterized with a slow progressive degeneration of the retinal ganglion cells and the optic nerve axons, leading to irreversible blindness if left undiagnosed and untreated. The primary goal in the management of glaucoma is to prevent the possible risk factors like elevated intraocular pressure (IOP) as the most important risk factor in developing and progression of glaucoma. The first-line treatment of glaucoma is topical selective or non-selective (beta)-receptor antagonists or prostaglandin analogs. Second-line drugs of choice are represented by (alpha)-agonists and topical carbonic anhydrasc inhibitors. Cholinergic agonists are third-line treatment option. When a single therapy is not sufficient to lower or control the elevated IOP, a combination therapy is indicated. Future directions for the development of a novel therapy glaucoma may target glutamate inhibition, NMDA receptor blockade, exogenously applied neurotrophins, open channel blockers, antioxidants, protease inhibitors and gene therapy. Although local application of anti-glaucoma drugs reduces the risk of systemic side effects, their long-term use can lead to systemic and /or local side effects. Patients with various diseases and conditions like cataract, asthma, bradycardia, systemic allergy on sulphonamide drugs or local allergy to specific drugs should be treated with different therapeutic approaches (laser trabeculoplasty or surgery). Although potential, future therapeutic options are promising, poor compliance with physicians and irregular controls are still among the key reasons for visual loss in patients with glaucoma. Therefore, continuous education and communication with patients in order to preserve vision and quality of life is necessary. LA: Croatian
G. Pelcic. Klinika za Oftalmologiju, Klinicki Bolnicki Centar Rijeka, Croatia.
Classification:
11.1 General management, indication (Part of: 11 Medical treatment)