Casson Robert J
Ophthalmic Research Laboratories, Adelaide Health & Medical Science Building, University of Adelaide, Adelaide, Australia.
Department of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia.
Clin Exp Ophthalmol. 2022 Mar;50(2):198-212. doi: 10.1111/ceo.13989. Epub 2022 Jan 17.
A number of pharmacological targets are exploited to modify the parameters in the Goldmann equation and reduce the intraocular pressure (IOP). This strategy constitutes the foundation for the medical management of glaucoma, the evolution of which, until only recently, has been in relative stagnation. A burst of innovation has produced new ocular hypotensive drugs and long-acting delivery methods, including intracameral delivery, which are expanding the clinician's medical armamentarium. A number of IOP-independent neuroprotection strategies have shown strong potential in animal models of glaucoma, but translational attempts have been surprisingly limited. However, while pharmacological options are expanding, the traditional role of topical medical therapy is being challenged by selective laser trabeculoplasty, micro-invasive glaucoma surgery, and sustained delivery methods. A scientifically rigorous assessment of new treatments will be critical to empower clinicians with evidence-based information to optimise vision preservation and quality of life outcomes for their patients.
人们利用多种药理学靶点来调整戈德曼方程中的参数，从而降低眼压（IOP）。这一策略构成了青光眼药物治疗的基础，直到最近，青光眼药物治疗的发展一直相对停滞不前。一系列创新成果催生了新的降眼压药物和长效给药方法，包括前房内给药，这些都在扩充临床医生的药物储备。一些不依赖眼压降低的神经保护策略在青光眼动物模型中显示出强大潜力，但转化应用的尝试却出人意料地有限。然而，尽管药理学选择不断增加，但局部药物治疗的传统作用正受到选择性激光小梁成形术、微创青光眼手术和持续给药方法的挑战。对新治疗方法进行科学严谨的评估，对于为临床医生提供循证信息以优化患者的视力保护和生活质量结局至关重要。
