Soltani Ghazaleh, Shalaby Wesam Shamseldin, Razeghinejad Reza
Glaucoma Service, Wills Eye Hospital, Philadelphia, PA, USA.
Ophthalmology Department, Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt.
Med Gas Res. 2025 Jun 1;15(2):220-227. doi: 10.4103/mgr.MEDGASRES-D-24-00023. Epub 2024 Dec 7.
Glaucoma is a chronic optic neuropathy that causes characteristic visual field defects and is considered one of the leading causes of irreversible vision loss worldwide. Lowering intraocular pressure is the only proven treatment for glaucoma. Medical therapy is usually the first-line treatment for open-angle glaucoma and ocular hypertension. Latanoprostene bunod ophthalmic drop 0.024% is a nitric oxide-donating prostaglandin F2α analog. It lowers the intraocular pressure via a dual mechanism of enhancing aqueous humor outflow through both the trabecular meshwork and uveoscleral pathways. Additionally, the nitric oxide component has shown promise in regulating ocular blood flow and promoting the survival of retinal ganglionic cells. Herein, the mechanism of action, efficacy, safety, and tolerability of the latanoprostene bunod and its effects on ocular blood flow are reviewed. Latanoprostene bunod has demonstrated strong efficacy and a favorable safety profile in both clinical trials and real-world studies. Given the promising results of latanoprostene bunod and advancements in drug delivery, topical fixed-combination and sustained-release formulations containing latanoprostene bunod and other agents targeting different intraocular pressure-lowering mechanisms may become available in the future.
青光眼是一种慢性视神经病变，可导致特征性视野缺损，被认为是全球不可逆视力丧失的主要原因之一。降低眼压是唯一经证实的青光眼治疗方法。药物治疗通常是开角型青光眼和高眼压症的一线治疗方法。0.024%的布诺前列素拉坦滴眼液是一种释放一氧化氮的前列腺素F2α类似物。它通过增强房水经小梁网和葡萄膜巩膜途径流出的双重机制来降低眼压。此外，一氧化氮成分在调节眼血流和促进视网膜神经节细胞存活方面已显示出前景。在此，对布诺前列素拉坦的作用机制、疗效、安全性和耐受性及其对眼血流的影响进行综述。布诺前列素拉坦在临床试验和真实世界研究中均显示出强大的疗效和良好的安全性。鉴于布诺前列素拉坦的 promising 结果和药物递送方面的进展，未来可能会有含有布诺前列素拉坦和其他针对不同降眼压机制的药物的局部固定复方和缓释制剂。
