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Treatments for Open-Angle Glaucoma

Treatments for open-angle glaucoma are needed. Glaucoma is a leading cause of irreversible blindness, which can be terrifying and significantly affect someone’s quality of life.

Unfortunately, this disease is estimated to have damaged the eyesight of over 70 million people worldwide.1

Also, 10% of people who experience blindness in both eyes cannot see as a result of glaucoma.1

One of the most common forms of glaucoma is primary open-angle glaucoma.

This type of glaucoma occurs when the internal pressure of the eye becomes too high.2 When the eye’s internal pressure is too strong, damage can occur to nerves that carry visual information from our eyes to our brains.

Moreover, increased pressure in the eyes can lead to the death of cells in the retina, which are needed for vision.1

The combination of nerve damage and cell death in the eye creates blind spots in your vision, making it harder to see.

Who is prone to primary open-angle glaucoma? 

Open-angle glaucoma tends to be more prevalent among people with nearsightedness, a family history of glaucoma, people of African-American descent, and elderly individuals.1

It is also possible to develop glaucoma after receiving certain treatments for other complications in your eye.

For example, patients receiving steroid injections in their eyes for diabetic eye complications may be at an increased risk of glaucoma.3

What are the symptoms of glaucoma?

Is it possible to tell if you have glaucoma based on any symptoms? Many cases of open-angle glaucoma are problematic because patients might not have any symptoms until the disease has reached a late stage.4

Even if your vision starts becoming defective in one eye, your other eye can typically compensate for this vision loss, thus being unaware of having glaucoma.4

For this reason, the diagnosis of glaucoma is often delayed.4 It is essential for early consultation with your healthcare practitioner about any vision-related concerns to ensure detection and prevent disease progression. 

If glaucoma is left unchecked, the symptoms of this condition can be a great burden.

For instance, patients with glaucoma may experience patchy blind spots in their peripheral vision that can progress to overall vision patchiness.1  

What treatments are available for open-angle glaucoma?

An article in the Cochrane Database of Systematic Reviews suggested that doctors lack guidelines when treating primary open-angle glaucoma.2

Despite the lack of guidelines, several treatments for glaucoma may offer patients hope.

Primary open-angle glaucoma has historically been treated with topical and systemic drugs to lower internal eye pressure.2 Topical drugs are medications applied directly to the eye, usually as eye drops.

On the other hand, systemic drugs are medications that enter the bloodstream and have a more widespread effect on the body. When glaucoma patients are not responsive to these medications, surgical procedures like trabeculectomy may be required to improve their vision.1

Medications currently available for glaucoma 

Given the great variety of drugs available, personalized treatment for glaucoma should be made after careful consideration of the patient’s medical history and outcomes of tested eye pressure.2

Some of the various medications for glaucoma include:

  • beta-blockers,
  • brimonidine,
  • epinephrine,
  • carbonic anhydrase inhibitors, 
  • and more.

What’s next for open-angle glaucoma treatments?

A new multicenter clinical trial in the United States compared the safety and effectiveness of a new drug treatment called DE-126.5

This treatment seemed to reduce pressure within the eye to a similar extent as the beta blocker timolol frequently used for glaucoma.5

This new clinical trial highlights the need for more research to investigate the least invasive treatments for open-angle glaucoma. 

References

  1. Weinreb, R. N., Aung, T., & Medeiros, F. A. (2014). The pathophysiology and treatment of glaucoma: a review. JAMA, 311(18), 1901–1911. https://doi.org/10.1001/jama.2014.3192
  2. Vass, C., Hirn, C., Sycha, T., Findl, O., Bauer, P., & Schmetterer, L. (2007). Medical interventions for primary open angle glaucoma and ocular hypertension. The Cochrane database of systematic reviews, 2007(4), CD003167. https://doi.org/10.1002/14651858.CD003167.pub3
  3. Patil, N. S., Mihalache, A., Hatamnejad, A., Popovic, M. M., Kertes, P. J., & Muni, R. H. (2022). Intravitreal steroids compared with anti-VEGF treatment for diabetic macular edema: A meta-analysis. Ophthalmology Retina, S2468-6530(22)00494-8. Advance online publication. https://doi.org/10.1016/j.oret.2022.10.008
  4. Schuster, A. K., Erb, C., Hoffmann, E. M., Dietlein, T., & Pfeiffer, N. (2020). The diagnosis and treatment of glaucoma. Deutsches Ärzteblatt international, 117(13), 225–234. https://doi.org/10.3238/arztebl.2020.0225
  5. NCT04742283. 2021. Multicenter study assessing the efficacy and safety of DE-126 pphthalmic solution 0.002% compared with timolol maleate ophthalmic solution 0.5% in subjects with primary open angle glaucoma or ocular hypertension. https://clinicaltrials.gov/show/NCT04742283
Andrew Mihalache
Andrew Mihalache
Andrew Mihalache is an enthusiastic learner with a specialization in human physiology at the University of Western Ontario. He possesses a strong passion for epidemiology and medical research and aspires to become a clinician-researcher dedicated to innovating patient healthcare in the future.
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