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New outflow-enhancing glaucoma medications may soon be available on the market
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ROME — Glaucoma medications that are available today can be divided into outflow and inflow agents.
While beta-blockers, alpha-agonists and topical carbonic anhydrase inhibitors are all inflow agents, "research is now concentrating on outflow side because we all know that the aqueous is a nutrient in the circulatory system of many tissues in the anterior segment. The new treatments are directed at enhancing trabecular meshwork outflow," Douglas J. Rhee, MD, said at the annual joint meeting of Ocular Surgery News and the Italian Society of Ophthalmology.
Of the various outflow agents that are currently under investigation, the one that is closest to market is the Rho-kinase (ROCK) inhibitor (Santen Pharmaceutical). In a human trial of 45 normal subjects, it was shown to lower IOP in a dose response curve.
"The maximum response was about 3 mm Hg, which in patients with an IOP of 14 mm Hg to 15 mm Hg, a 3-mm lowering was actually pretty good," Dr. Rhee said.
Adenosine receptor agonists are another agent that may become available on the market. They work by enhancing extracellular matrix turnover in the trabecular meshwork, he explained.