Recent Advancements in Glaucoma Treatment

26 de enero de 2023

3 min de lectura

Nearly 3 million Americans live with glaucoma, a disease that was first discovered in 1622. A glaucoma is a group of diseases that increase intraocular pressure resulting in damage to the optic nerve. When left untreated, glaucoma can lead to visual disturbances, reduced sight, and blindness. Symptoms of this disease often start so slowly that people do not immediately notice visual impairments until major damage has occurred.

How is glaucoma treated?

Generally, the first course of treatment for a person with glaucoma is beta-blocker or prostaglandin analog eye drops designed to decrease intraocular pressure and reduce the risk of damage to the optic nerve. Other forms of treatment include laser treatment, surgery, and oral medications. However, treatment for glaucoma does not cure or reverse the disease, it simply focuses on slowing the disease or sometimes keeping it stable.

While traditional treatment has proven successful in preventing further damage in many cases of glaucoma, modern advances in treatment options offer a less-invasive, longer-lasting option.

Traditional treatment for glaucoma

First-line therapy to treat glaucoma has been, and still is, topical medications in the form of eye drops.

Topical medications

Topical medications, including eye drops, have been considered the first line of defense in slowing the progression of glaucoma for years. These medications are used to reduce intraocular pressure to minimize damage to the optic nerve.

The most common types of topical medications include:

Nitric oxides: Latanoprostene
Prostaglandins: Latanoprost, Travoprost, and Bimatoprost
Rho kinase inhibitors: Netarsudil

Prostaglandins are the most-recommended medication for glaucoma as they are effective, affordable, and are limited to once-daily usage.

Recent advances in glaucoma treatment

Beyond eye drops, advanced treatments for glaucoma include the following.

Sustained release systems

Intracameral Travoprost Implant

A modern implant, known as iDose by Glaukos, is a titanium travoprost device that is implanted surgically into the anterior chamber angle of the eye. This device is still under research, but it allows the release of microdoses of a proprietary formulation of travoprost to decrease intraocular pressure without the need for daily care.

Bimatoprost contact lens

During phase 2 of the Sight-1 trial, Mediprint has yet to see adverse reactions to their Bimatoprost-coated contact lens. These lenses allow for simple, pain-free treatment and are great for those who currently wear contact lenses as well as those who have never used them before.

Biannual injections

Georgia Tech researchers are working to replace daily eye drops and invasive surgeries with two times a year injections of natural and biodegradable materials. These injections are designed to provide an alternate path for built-up fluid to exit the eyes thus decreasing intraocular pressure. Researchers are continuing to perfect these injections to allow 6 months of efficacy.

Vitamin B3

Teams at UCL Institute of Ophthalmology and Moorfields Eye Hospital have begun trials to recruit nearly 500 patients that have been diagnosed with glaucoma. This trial is set to evaluate the efficacy of nicotinamide, a common form of vitamin B3, in replenishing the powerhouse of cells to protect against rapid vision loss in those with glaucoma. If successful, this trial will help countless glaucoma patients reduce the risk of progressive vision loss due to glaucoma and help them to live a more fulfilling life.

MIGS devices

MIGS devices, otherwise known as micro-invasive devices, are small devices implanted through surgical intervention. By using a MIGS device, treatment is offered earlier than other surgical methods and is safer than traditional glaucoma surgery.

A small device is implanted inside the eye to allow the fluid that causes a rise in intraocular pressure to drain. For those with cataracts, a MIGS device can be implanted during cataract surgery. The eye surgeon can perform a standalone procedure to implant these microdevices. The use of MIGS devices offers similar efficacy to trabeculectomy, the traditional surgery for glaucoma, but is accompanied by lower risks and no need for downtime after surgery.

Takeaway

There are certain risk factors linked to an increased risk of developing glaucoma. It is important to receive a comprehensive eye exam with dilation for early detection and treatment. Glaucoma can cause irreversible vision loss, but treatment can help to slow the disease or even stop it from progressing.

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