Medical Management of Glaucoma in the 21st Century from a Canadian Perspective

Figure 5

Glaucoma pharmaceutical management algorithm (SLT, MIGS, or other surgeries may be performed at any step of the algorithm). FC, fixed combination; BID single agent, dorzolamide, brinzolamide, and brimonidine; PG, prostaglandin analogue (latanoprost, travoprost, and bimatoprost); PG-βB FC, prostaglandin + timolol (latanoprost + timolol, travoprost + timolol); BID-βB FC, BID-dosed combination with timolol (dorzolamide + timolol, brinzolamide + timolol, brimonidine + timolol); AA-CAI F, α agonist + CIA (brimonidine + brinzolamide); SLT, selective laser trabeculoplasty; MIGS, microinvasive glaucoma surgery. Patient and disease characteristics should be considered at all stages of algorithm and the therapy should be individualized according to patient needs (i.e., ability to tolerate any component of the therapy). In addition, at all stages of the treatment algorithm it is imperative to monitor for adverse effects as well as disease progression (RNFL/VF/disc).