Current Medical Therapy and Future Trends in the Management of Glaucoma Treatment

Table 1

IOP-lowering medications, efficacy, and mechanism of action.

Medication Class	Compound	IOP reduction (%)	Mechanism of action
			Increases uveoscleral outflow	Increases trabecular outflow	Decreases aqueous production	Decreases episcleral venous pressure
Prostaglandin analogues	Bimatoprost, latanoprost, tafluprost, travoprost	25–35	Yes	No	No	No
β-Blockers; (i) Nonselective	Timolol, levobonolol, carteolol, metipranolol	20–25	No	No	Yes	No
(ii) β1-Selective	Betaxolol	20	No	No	Yes	No
Carbonic anhydrase inhibitors; (i) Topical	Dorzolamide, brinzolamide	20	No	No	Yes	No
(ii) Systemic	Acetazolamide, methazolamide, dichlorphenamide	30–40	No	No	Yes	No
Adrenergic agonists; (i) α-2 Selective	Brimonidine, apraclonidine	20–25	Yes	No	Yes	No
(ii) Nonselective	Dipivefrin, epinephrine	15–20	Yes	No	Yes	No
Parasympathomimetics	Pilocarpine, echothiophate	20–25	No	Yes	No	No
Novel IOP-lowering medications
Rho-kinase inhibitors	Netarsudil	16–21	No	Yes	Yes	Yes
Nitric oxide-donating prostaglandin analogue	Latanoprostene bunod	32–34	Yes	Yes	No	No
FC rho-kinase inhibitor/latanoprost	Netarsudil/latanoprost	30–36	Yes	Yes	Yes	Yes