Update on the Medical Treatment of Primary Open-Angle Glaucoma

Anjum Cheema, Robert T. Chang, Anurag Shrivastava, Kuldev Singh

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Glaucoma comprises a group of progressive, neurodegenerative disorders characterized by retinal ganglion cell death and nerve fiber layer atrophy. Several randomized controlled trials have consistently demonstrated the efficacy of intraocular pressure lowering to slow or halt the measurable progression of the disease. Medical therapy, in places where it is easily accessible, is often the primary method to lower intraocular pressure. We review the medical options currently available and possible future options currently in development. The 5 contemporary classes of topical agents in use include prostaglandin analogs, beta blockers, carbonic anhydrase inhibitors, alpha agonists, and cholinergics. In addition, several fixed combination agents are commercially available. Agents from each of these classes have unique mechanisms of action, adverse effects, and other characteristics that impact how they are used in clinical practice. Despite the plethora of medical options available, there are limitations to topical ophthalmic therapy such as the high rate of noncompliance and local and systemic adverse effects. Alternate and sustained drug delivery models, such as injectable agents and punctal plug delivery systems, may in the future alleviate some such concerns and lead to increased efficacy of treatment while minimizing adverse effects.

Original languageEnglish (US)
Pages (from-to)51-58
Number of pages8
JournalAsia-Pacific Journal of Ophthalmology
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Intraocular Pressure
Carbonic Anhydrase Inhibitors
Synthetic Prostaglandins
Cholinergic Agonists
Retinal Ganglion Cells
Nerve Fibers
Neurodegenerative Diseases
Glaucoma
Atrophy
Disease Progression
Cell Death
Randomized Controlled Trials
Injections
Therapeutics
Pharmaceutical Preparations
Primary Open Angle Glaucoma
Punctal Plugs

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Update on the Medical Treatment of Primary Open-Angle Glaucoma. / Cheema, Anjum; Chang, Robert T.; Shrivastava, Anurag; Singh, Kuldev.

In: Asia-Pacific Journal of Ophthalmology, Vol. 5, No. 1, 01.01.2016, p. 51-58.

Research output: Contribution to journalReview article

Cheema, Anjum ; Chang, Robert T. ; Shrivastava, Anurag ; Singh, Kuldev. / Update on the Medical Treatment of Primary Open-Angle Glaucoma. In: Asia-Pacific Journal of Ophthalmology. 2016 ; Vol. 5, No. 1. pp. 51-58.
@article{d8b33414bee94586a26040fc4cf31efc,
title = "Update on the Medical Treatment of Primary Open-Angle Glaucoma",
abstract = "Glaucoma comprises a group of progressive, neurodegenerative disorders characterized by retinal ganglion cell death and nerve fiber layer atrophy. Several randomized controlled trials have consistently demonstrated the efficacy of intraocular pressure lowering to slow or halt the measurable progression of the disease. Medical therapy, in places where it is easily accessible, is often the primary method to lower intraocular pressure. We review the medical options currently available and possible future options currently in development. The 5 contemporary classes of topical agents in use include prostaglandin analogs, beta blockers, carbonic anhydrase inhibitors, alpha agonists, and cholinergics. In addition, several fixed combination agents are commercially available. Agents from each of these classes have unique mechanisms of action, adverse effects, and other characteristics that impact how they are used in clinical practice. Despite the plethora of medical options available, there are limitations to topical ophthalmic therapy such as the high rate of noncompliance and local and systemic adverse effects. Alternate and sustained drug delivery models, such as injectable agents and punctal plug delivery systems, may in the future alleviate some such concerns and lead to increased efficacy of treatment while minimizing adverse effects.",
author = "Anjum Cheema and Chang, {Robert T.} and Anurag Shrivastava and Kuldev Singh",
year = "2016",
month = "1",
day = "1",
doi = "10.1097/APO.0000000000000181",
language = "English (US)",
volume = "5",
pages = "51--58",
journal = "Asia-Pacific Journal of Ophthalmology",
issn = "2162-0989",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Update on the Medical Treatment of Primary Open-Angle Glaucoma

AU - Cheema, Anjum

AU - Chang, Robert T.

AU - Shrivastava, Anurag

AU - Singh, Kuldev

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Glaucoma comprises a group of progressive, neurodegenerative disorders characterized by retinal ganglion cell death and nerve fiber layer atrophy. Several randomized controlled trials have consistently demonstrated the efficacy of intraocular pressure lowering to slow or halt the measurable progression of the disease. Medical therapy, in places where it is easily accessible, is often the primary method to lower intraocular pressure. We review the medical options currently available and possible future options currently in development. The 5 contemporary classes of topical agents in use include prostaglandin analogs, beta blockers, carbonic anhydrase inhibitors, alpha agonists, and cholinergics. In addition, several fixed combination agents are commercially available. Agents from each of these classes have unique mechanisms of action, adverse effects, and other characteristics that impact how they are used in clinical practice. Despite the plethora of medical options available, there are limitations to topical ophthalmic therapy such as the high rate of noncompliance and local and systemic adverse effects. Alternate and sustained drug delivery models, such as injectable agents and punctal plug delivery systems, may in the future alleviate some such concerns and lead to increased efficacy of treatment while minimizing adverse effects.

AB - Glaucoma comprises a group of progressive, neurodegenerative disorders characterized by retinal ganglion cell death and nerve fiber layer atrophy. Several randomized controlled trials have consistently demonstrated the efficacy of intraocular pressure lowering to slow or halt the measurable progression of the disease. Medical therapy, in places where it is easily accessible, is often the primary method to lower intraocular pressure. We review the medical options currently available and possible future options currently in development. The 5 contemporary classes of topical agents in use include prostaglandin analogs, beta blockers, carbonic anhydrase inhibitors, alpha agonists, and cholinergics. In addition, several fixed combination agents are commercially available. Agents from each of these classes have unique mechanisms of action, adverse effects, and other characteristics that impact how they are used in clinical practice. Despite the plethora of medical options available, there are limitations to topical ophthalmic therapy such as the high rate of noncompliance and local and systemic adverse effects. Alternate and sustained drug delivery models, such as injectable agents and punctal plug delivery systems, may in the future alleviate some such concerns and lead to increased efficacy of treatment while minimizing adverse effects.

UR - http://www.scopus.com/inward/record.url?scp=84988841513&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988841513&partnerID=8YFLogxK

U2 - 10.1097/APO.0000000000000181

DO - 10.1097/APO.0000000000000181

M3 - Review article

C2 - 26886120

AN - SCOPUS:84988841513

VL - 5

SP - 51

EP - 58

JO - Asia-Pacific Journal of Ophthalmology

JF - Asia-Pacific Journal of Ophthalmology

SN - 2162-0989

IS - 1

ER -