Causative glaucoma treatment: promising targets and delivery systems

Novel therapies for glaucoma: a patent review (2013-2019)

“…The new FDA-approved drugs reduce the outflow resistance offering additivity and complementary to current therapeutics. Alternative therapies offer long-term IOP lowering action or allow the patient to take advantage of innovative delivery systems[74] to reduce long lasting topical drop self-administration (gene therapy and stem cell strategies)[75,76]. The alternative approaches described in this short review were validated in in vitro and in vivo animal models, thus representing the best-in-class strategies to follow in order to maintain functional vision outcome in patients.…”

The management of glaucoma and macular degeneration

“…Glaucoma [1][2][3][4][5][6][7][8] and macular degeneration [9][10][11] are among the ophthalmologic diseases increasingly affecting the aging population worldwide. It is estimated that around 76 million patients will suffer of glaucoma in 2020, whereas the prevalence in the population between 40 and 80 years old is expected to increase to 111.8 million in 2040 [2].…”

“…Both conditions are neuropathies and are associated with vision loss, eventually leading to blindness. Glaucoma is a multifactorial disease, with the most salient feature being an elevated intraocular pressure (IOP), which still is nowadays the only clinically modifiable risk factor for its development and progression [3][4][5][6]. Macular degeneration, also denominated agerelated macular degeneration (AMD) is characterized by the loss of vision in the central part of the visual field, involving the central part of the retina where the macula is found [9][10][11].…”

“…Blurred vision and/or visual hallucinations may also occur in AMD patients. These conditions, together with glaucoma, represent the leading causes of blindness in the industrialized countries [1][2][3][4][5][6]9]. AMD is classified in two main types, the dry or non-neovascular AMD, with a prevalence of 90% among the affected patients [11], and the wet, or neovascular AMD, which involves abnormal neo-vascularization under or nearby the macula [12,13].…”

“…Nowadays there are six classes of pharmacological agents clinically used for the management of glaucoma: the β-adrenergic blockers [15], the systemically or topically acting carbonic anhydrase inhibitors (CAIs) [16][17][18][19], the α-adrenergic agonists [20], the cholinergic agonists [21], the prostaglandin analogs [22], and the recently introduced in clinical practice Rho kinase inhibitors [8]. It should be mentioned that other targets, such as the melatonin receptors [23], the fatty acid amide hydrolase (FAAH) [3,23]; the adenosine receptors [3,4,21], or nitric oxide, alone [5] or combined with other pharmacologic agents [24,25] were also explored and led to interesting experimental approaches for the management of glaucoma, which however were not yet translated to the clinic.…”