Pharmacological management of ocular hypertension: current approaches and future prospective

Elevated eye pressure is the main risk factor for glaucoma, and intraocular pressure rises when the balance between aqueous humor formation and outflow resistance is compromised. In a normal eye there is a precise tune of aqueous outflow under the fine control of ciliary body and trabecular meshwork. Current pharmacological therapies for lowering the intraocular pressure in glaucoma include increasing aqueous humor outflow and suppression of aqueous humor production. However, most of antiglaucoma drugs currently on the market do not target the trabecular meshwork that represents the site of the pathology. This review focuses on pharmacological management of ocular hypertension with a particular attention to the future pharmacotherapy scenario.

► Future glaucoma pharmacotherapy scenario is proposed. ► New outflow and inflow drugs are presented. ► siRNA, melatonin, and HSD inhibitors are described. ► Cytoskeleton agents, cannabinoids, and NO/CO modulators are described. ► Analogues of adenosine, serotonin, and dopamine are described.