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3234515 
Journal Article 
Emerging drugs for ocular hypertension 
Lee, AJ; Goldberg, I 
2011 
Yes 
Expert Opinion on Emerging Drugs
ISSN: 1472-8214 
16 
1 
137-161 
WOS:000287742400010 
Introduction: Glaucoma is a prevalent ocular disease with
characteristic optic disc and visual field changes. Globally, it is the second most common cause
of visual disability, and the most common cause of irreversible and preventable blindness. Ocular
hypertension (OH) occurs where intraocular pressure elevation occurs in the absence of
glaucomatous disc and visual field changes. OH is a strong risk factor for glaucoma. Ocular
hypotensive medications are the mainstay of glaucoma and OH treatment, and their use modifies the
course of the disease by preventing onset and progression of damage Areas covered: Prostaglandin
analogs, beta-blockers, alpha-agonists, carbonic anhydrase inhibitors and parasympathomimetics
are available in our glaucoma armamentarium and are reviewed. Novel agents have evolved as our
understanding of the complex mechanisms involved in aqueous humor production and obstacles to
aqueous outflow increases. Potential future candidates appear to act on enhancing trabecular
meshwork outflow: the Rhokinase inhibitors, ion-channel modulators and chelating agents. Further
work is needed on other promising agents: serotonergics, melatonins, cannabinoids, adenosine
agonists, components of the actomyosin system, nucleotide analogs and gene silencing. Methods to
improve side effect profiles or efficacy of currently available therapies are also being
developed. As glaucoma treatment adherence is poor, novel drug delivery methods might address
this challenge. Expert opinion: Although there are good intraocular pressure-lowering medications
available, novel mechanisms and drug delivery modes may provide more effective glaucoma control
in future. 
aqueous outflow; aqueous suppressants; glaucoma; novel drugs; ocular hypertension; trabecular meshwork