Lowering intraocular pressure (IOP) is the only proven therapeutic approach to preserving visual function in patients with glaucoma. Pharmacological therapies are currently the most common form of initial intervention for lowering IOP. We will review three recently developed glaucoma drugs.
1. Once-daily latanoprostene bunod 0.024% is an effective and well tolerated treatment option for the reduction of IOP in adults with open-angle glaucoma or ocular hypertension. It is thought to lower IOP by increasing aqueous humor outflow through the uveoscleral pathway (mediated by latanoprost acid) and increasing the facility of aqueous humor outflow through the trabecular meshwork pathway (mediated by NO).
2. Rho kinase inhibitors are effective alone or when combined with other known ocular hypotensive medications. They also offer the possibility of neuroprotective activity, a favorable impact on ocular blood flow, and even an antifibrotic effect that may prove useful in conventional glaucoma surgery.
3. A bimatoprost sustained-release (bimatoprost SR) implant reduced IOP by approximately 30% over 12 weeks in a second phase 3 study. The majority of patients with open-angle glaucoma or ocular hypertension in the 528-subject trial were able to remain treatment-free for at least 1 year after the last implant was inserted. Use of bimatoprost SR for glaucoma treatment may reduce the incidence of adverse events typically associated with topical prostaglandins by targeting bimatoprost delivery to the key site of action of and reducing exposure to off-target tissues.