Glaucoma management: relative value and place in therapy of available drug treatments

Sambhara, Deepak; Aref, Ahmad A.

doi:10.1177/2040622313511286

Cited by 74 publications

(61 citation statements)

References 74 publications

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“…Topical carbonic anhydrase inhibitors, therefore, reduce aqueous humor formation. 59 Brinzolamide and dorzolamide are currently approved for reducing IOP and provide an efficacy between 15% and 20% from the initial value. 45 Topical carbonic anhydrase inhibitors are sulfonamides and special attention should be paid to possible hypersensitivities, as allergic reactions can occur manifesting as urticaria, angioedema, or pruritus.…”

Section: Topical Therapiesmentioning

confidence: 99%

“…45 Prostaglandin analogues are usually well tolerated with almost no systemic side effects. 45,59 Common local side effects include conjunctival hyperemia, burning, stinging, eyelash changes, increased periocular skin pigmentation, and increased iris pigmentation. Therefore, unilateral use should be avoided.…”

Section: Topical Therapiesmentioning

confidence: 99%

“…Patients must be evaluated for their kidney and heart function before administration of these agents. 45,59 Impact of other systemic medications on the course of the disease. Systemic calcium channel blockers have been suggested by some authors as potential therapies for a subgroup of glaucoma patients, namely patients with NTG and a predisposition to vasospastic episodes.…”

Section: Systemic Therapiesmentioning

confidence: 99%

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Pharmacotherapy of Glaucoma

Schmidl

Schmetterer²,

Garhöfer³

et al. 2015

Journal of Ocular Pharmacology and Therapeutics

136

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Glaucoma is a group of diseases involving the optic nerve and associated structures, which is characterized by progressive visual field loss and typical changes of the optic nerve head (ONH). The only known treatment of the disease is reduction of intraocular pressure (IOP), which has been shown to reduce glaucoma progression in a variety of large-scale clinical trials. Nowadays, a relatively wide array of topical antiglaucoma drugs is available, including prostaglandin analogues, carbonic anhydrase inhibitors, beta-receptor antagonists, adrenergic agonists, and parasympathomimetics. In clinical routine, this allows for individualized treatment taking risk factors, efficacy, and safety into account. A major challenge is related to adherence to therapy. Sustained release devices may help minimize this problem but are not yet available for clinical routine use. Another hope arises from non-IOP-related treatment concepts. In recent years, much knowledge has been gained regarding the molecular mechanisms that underlie the disease process in glaucoma. This also strengthens the hope that glaucoma therapy beyond IOP lowering will become available. Implementing this concept with clinical trials remains, however, a challenge.

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Section: Topical Therapiesmentioning

confidence: 99%

Section: Topical Therapiesmentioning

confidence: 99%

Section: Systemic Therapiesmentioning

confidence: 99%

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Pharmacotherapy of Glaucoma

Schmidl

Schmetterer²,

Garhöfer³

et al. 2015

Journal of Ocular Pharmacology and Therapeutics

136

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“…4 This study endeavoured to analyse the temporal trends in the prescription of medication for effective management of POAG during the study period.…”

Section: Introductionmentioning

confidence: 99%

Prescribing trends of anti glaucoma medication usage in treatment naive patients of primary open angle glaucoma in a tertiary care hospital in Eastern India

Maitra¹,

Bhattacharyya

Mukherjee³

et al. 2018

Int J Basic Clin Pharmacol

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Background: Primary open angle glaucoma remains a high magnitude healthcare problem due to its prevalence and chronicity. The real world scenario of anti glaucoma medical therapy needs periodical auditing as far as drug prescriptions are concerned for formulation of treatment guidelines. Few studies from India have taken a longitudinal approach in this respect. This study was undertaken to identify such lacunae.Methods: This was an open label, prospective, observational study. Each treatment naive patient was followed up for a period of 6 months, where their prescriptions were scanned for the type of the anti glaucoma medications, total number of medications, route of administration, their duration of use and their frequency of dosage and change in medications if any, in each visits.Results: A gradual shift from monotherapy towards combination therapy was observed. Overall averages for prescriptions were topped by monotherapy at 44.25 followed by fixed dose combinations at 38.25, and then combination-polytherapy at 36 and the least number of prescriptions were for concurrent polytherapy at 17.5. Amongst all monotherapy agents, beta blockers were the most frequently prescribed drugs at baseline but their share of prescriptions was almost halved at the end of our study. The prostaglandin analogs on the other hand saw an upsurge in prescriptions from their baseline to the end of this study. Prostaglandin analogs andbeta blockers as fixed dose combination was a popular prescription over the entire study duration.Conclusions: Prescribing trends were remarkable for the shift from primary monotherapy towards fixed dose combinations as the study concluded. The decline in the number of beta blocker prescriptions and a rise in prostaglandin analog prescriptions is a testament to their better effectiveness and tolerability. The future of open angle glaucoma pharmacotherapy lies in prescribing more efficacious drugs either in monotherapy or in fixed combinations.

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“…1 Current treatment options are limited to lowering intraocular pressure (IOP), with medical therapy in the form of topical drops as the first-line treatment. 2 Unfortunately, topical medication use may not be sufficient for long-term IOP control in all patients.…”

mentioning

confidence: 99%

Minimally Invasive Glaucoma Surgery and CyPass® Micro-Stent—A New Era in Glaucoma Surgery

Mosaed¹

2017

US Ophthalmic Review

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In the largest randomized clinical trial to date on a minimally invasive glaucoma surgery device, the CyPass ® Micro-Stent was able to lower intraocular pressure (IOP) more than was modern cataract surgery (phacoemulsification and intraocular lens implantation) alone, and should be considered for patients with mild to moderate glaucoma already scheduled to undergo phacoemulsification surgery. The two-year outcomes of the COMPASS study found mean IOP reductions of 7.4 mmHg in the CyPass Micro-Stent group and no vision-threatening adverse events; more than 98% of subjects in the CyPass Micro-Stent group achieved 20/40 or better best-corrected visual acuity.

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Glaucoma management: relative value and place in therapy of available drug treatments

Cited by 74 publications

References 74 publications

Pharmacotherapy of Glaucoma

Pharmacotherapy of Glaucoma

Prescribing trends of anti glaucoma medication usage in treatment naive patients of primary open angle glaucoma in a tertiary care hospital in Eastern India

Minimally Invasive Glaucoma Surgery and CyPass® Micro-Stent—A New Era in Glaucoma Surgery

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