Changing paradigms in the medical treatment of glaucoma.
Glaucoma is defined by a typical optic neuropathy accompanied by characteristic visual field loss and eventual blindness. The major risk factor for glaucoma is elevated intraocular pressure (IOP). Lowering IOP is currently the only proven method for reducing the risk of glaucomatous visual field loss and remains the primary goal of therapy. With the recent introduction of many new medications that lower IOP, the definition of what constitutes maximum tolerated medical therapy has been changing. The treatment can now be tailored better to each individual patient. The regimen needs to be affordable, easy to understand, and least interfering with the patient's quality of life. beta-blockers still are the mainstay of initial therapy, but more and more prostaglandin analogs and also alpha-2 agonists are being used initially. Systemic carbonic anhydrase inhibitors and cholinergics are being used less frequently.
Soltau
Joern B
JB
Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Louisville, KY, USA
Zimmerman
Thom J
TJ
D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D004358:Drug Therapy / Q000639:trends*; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D020714:Maximum Tolerated Dose; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D011465:Prostaglandins, Synthetic / Q000627:therapeutic use; D018341:Receptors, Adrenergic, alpha-2 / Q000627:therapeutic use
D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists; D002257:Carbonic Anhydrase Inhibitors; D009883:Ophthalmic Solutions; D011465:Prostaglandins, Synthetic; D018341:Receptors, Adrenergic, alpha-2