title: Glaucoma: Hot Topics in Pharmacology.
abstract: Glaucoma comprises a group of neurodegenerative diseases resulting in retinal ganglion cell death within the optic nerve head. It is projected to affect almost 80 million people worldwide by 2020. The condition's asymptomatic nature translates to over half of glaucoma sufferers being unaware of their condition. By the time of diagnosis, irreversible blindness is likely to have occurred. Prime areas of glaucoma research therefore include identification and optimization of risk factors for the disease, accurate and early diagnostic tools and novel therapeutic methods.
  
  
  
  The goal of this review was to summarize main areas of latest glaucoma research into risk factors of glaucoma, diagnostic tools and treatments. PubMed was used to search for terms including glaucoma risk factors, glaucoma diagnostics, glaucoma treatment, glaucoma drug delivery and glaucoma IOP.
  
  
  
  The evidence for risk factors of low CSF pressure, IOP, smoking, vascular risk factors and light toxicity is described. Latest diagnostic and monitoring techniques for glaucoma include SD-OCT, DARC and IOP telemetry. Current and emerging medical and surgical treatments in glaucoma are discussed. Rho kinase inhibitors have the potential to both lower IOP and also provide neuroprotection, several of which are in clinical trials. Several other new medical treatments such as calcium channel blockers and neurotrophic agents also have the capacity to provide neuroprotection. Minimally Invasive Glaucoma Surgery (MIGS) devices provide an improved safety profile compared to traditional trabeculectomy; the latest ab interno and ab externo devices are described. Novel drug delivery methods, including punctual plugs and contact lenses, help overcome the challenges with patient adherence.
  
  
  
  The ultimate goals are to reduce the individual patient risk factors associated with glaucoma, diagnose the condition early and to find treatments that not only reduce IOP but also reverse neurodegeneration of RGCs. The usage of combinations of novel medical and surgical treatments may help maximize IOP reduction and neuroprotection.
authors.affiliation: Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London. United Kingdom.
authors.forename: Shiama I
authors.initials: SI
authors.lastname: Balendra
authors.affiliation: Department of Ophthalmology, The Princess Alexandra Eye Pavilion, Chalmers St, Edinburgh EH3 9HA. United Kingdom.
authors.forename: Parth Arvind
authors.initials: PA
authors.lastname: Shah
authors.affiliation: Department of Ophthalmology, Central Middlesex Hospital, Acton Lane, Park Royal, London, NE10 7NS. United Kingdom.
authors.forename: Mishank
authors.initials: M
authors.lastname: Jain
authors.affiliation: University of Warmia and Mazury, Olsztyn. Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Grzybowski
authors.affiliation: Glaucoma and Retinal Neurodegeneration Group, Department of Visual Neuroscience, UCL Institute of Ophthalmology, London. United Kingdom.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Cordeiro
mesh_terms: D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D005901:Glaucoma / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D012307:Risk Factors
chemical_list: D002121:Calcium Channel Blockers; D018696:Neuroprotective Agents
keywords: Glaucoma; MIGS; Rho kinase inhibitors; glaucoma diagnosis; glaucoma risk factors; glaucoma treatment; retinal ganglion cell