Recent updates on medical management of Glaucoma.

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide. It is estimated to affect more than 110 million people globally by the year 2040. The disease is characterised by progressive loss of the retinal ganglion cells resulting in characteristic visual field defects. Modulating intraocular pressure is the widely accepted and practiced strategy in managing glaucoma. While most of the available drugs either suppressed aqueous formation or shunted it across the uveo-scleral pathways, rho kinase inhibitors have been introduced targeting the trabecular meshwork. Latanoprostene Bunod and its combination with Latanoprost, and Omidenepeg Isopropyl are new additions soon to be available in India. Durysta, a sustained release Bimatoprost implant is already approved in United States and other implants involving Travoprost are in pipeline. Neuroprotection is the ultimate goal in glaucoma management and recent trials with neurotrophic factors, glutamate antagonists, stem cells and antioxidant therapy have been encouraging. Coenzyme Q10 with vitamin E combination (Coqun) eye drops have demonstrated efficacy as an adjunct antiglaucoma therapy. While Brain Derived Neurotrophic factor have demonstrated efficacy in animal studies, experimental study with Nerve Growth Factor eye drops have shown promising results in humans. Stem cell research has a great potential in neuroprotection but still is in infancy. Concerns such as mode of delivery, graft survival and potential side effects remain to be known before stem cell therapy comes to the fore of clinical management of glaucoma. The present provides an overview of the recent developments in the wide arena of medical management of glaucoma.