Present and New Treatment Strategies in the Management of Glaucoma



Kolko M*, 1, 2, 3
1 Department of Neuroscience and Pharmacology, the Panum Institute, University of Copenhagen, Denmark
2 Department of Ophthalmology, Roskilde University Hospital, Copenhagen, Denmark
3 Center of Healthy Aging, Department of Cellular and Molecular Medicine, the Panum Institute, University of Copenhagen, Denmark


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© M. Kolko; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neuroscience and Pharmacology, University of Copenhagen, Blegdamsvej 3b, 2200 Copenhagen, Denmark; Tel: 0045 29807667; E-mail: mkolko@dadlnet.dk


Abstract

Glaucoma is a neurodegenerative disease characterized by retinal ganglion cell (RGC) death and axonal loss. It remains a major cause of blindness worldwide. All current modalities of treatment are focused on lowering intraocular pressure (IOP), and it is evident that increased IOP is an important risk factor for progression of the disease. However, it is clear that a significant number of glaucoma patients show disease progression despite of pressure lowering treatments. Much attention has been given to the development of neuroprotective treatment strategies, but the identification of such has been hampered by lack of understanding of the etiology of glaucoma. Hence, in spite of many attempts no neuroprotective drug has yet been clinically approved. Even though neuroprotection is without doubt an important treatment strategy, many glaucoma subjects are diagnosed after substantial loss of RGCs. In this matter, recent approaches aim to rescue RGCs and regenerate axons in order to restore visual function in glaucoma. The present review seeks to provide an overview of the present and new treatment strategies in the management of glaucoma. The treatment strategies are divided into current available glaucoma medications, new pressure lowering targets, prospective neuroprotective interventions, and finally possible neuroregenrative strategies.

Keywords: Glaucoma, intraocular pressure lowering drugs, neuroprotection, neuroregeneration, treatment strategies.