Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
Int J Mol Sci. 2024 May 21;25(11):5576. doi: 10.3390/ijms25115576.
Glaucoma is a chronic neurodegenerative disease that poses a significant threat of irreversible blindness worldwide. Current treatments for glaucoma focus on reducing intraocular pressure (IOP), which is the only modifiable risk factor. Traditional anti-glaucomatous agents, including carbonic anhydrase inhibitors, beta-blockers, alpha-2 agonists, and prostaglandin analogs, work by either improving uveoscleral outflow or reducing aqueous humor production. Rho kinase (ROCK) inhibitors represent a novel class of anti-glaucomatous drugs that have emerged from bench to bedside in the past decade, offering multifunctional characteristics. Unlike conventional medications, ROCK inhibitors directly target the trabecular meshwork outflow pathway. This review aims to discuss the mechanism of ROCK inhibitors in reducing IOP, providing neuroprotection, and preventing fibrosis. We also highlight recent studies and clinical trials evaluating the efficacy and safety of ROCK inhibitors, compare them with other clinical anti-glaucomatous medications, and outline future prospects for ROCK inhibitors in glaucoma treatment.
青光眼是一种慢性神经退行性疾病,在全球范围内构成了不可逆转失明的重大威胁。目前治疗青光眼的方法主要集中在降低眼压(IOP)上,这是唯一可改变的危险因素。传统的抗青光眼药物,包括碳酸酐酶抑制剂、β受体阻滞剂、α2 受体激动剂和前列腺素类似物,通过增加葡萄膜巩膜途径外流或减少房水生成来发挥作用。Rho 激酶(ROCK)抑制剂是近十年来从实验室到临床的一类新型抗青光眼药物,具有多功能特性。与传统药物不同,ROCK 抑制剂直接靶向小梁网流出途径。本文旨在讨论 ROCK 抑制剂降低眼压、提供神经保护和预防纤维化的作用机制。我们还强调了最近评估 ROCK 抑制剂疗效和安全性的研究和临床试验,将其与其他临床抗青光眼药物进行比较,并概述了 ROCK 抑制剂在青光眼治疗中的未来前景。