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Therapeutic options in the treatment of open angle glaucoma and their use in accordance with the latest guidelines

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Misiuk-Hojło M., Tomczyk-Socha M.
OphthaTherapy
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2024
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vol. 11
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issue 1
7-13
EN
Glaucoma is an optic neuropathy characterized by typical damage of the optic nerve with gradual atrophy of retinal ganglion cells and visual field defects. The goal of glaucoma therapy is to reduce intraocular pressure and reduce daily pressure fluctuations. Currently, in the treatment of primary open-angle glaucoma in Poland, we use four groups of drugs: β-adrenergic receptor antagonists, prostaglandin analogues, α-adrenergic receptor agonists and carbonic anhydrase inhibitors. First-line drugs, according to the guidelines of the Polish Ophthalmological Society, are prostaglandin analogues/prostamide. When considering the addition of a second drug to prostaglandins, brimonidine lowers intraocular pressure more strongly than dorzolamide or brinzolamide, similarly as timolol does. Drug containing two active substances are as effective as substances administered in two separate drops, therefore it is advantageous to use combined drug instead of using two different drugs.
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Latanoprost drops without added detergent in the treatment of glaucoma

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Misiuk-Hojło M., Mimier-Janczak M., Łątkowska M.
OphthaTherapy
|
2024
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vol. 11
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issue 2
147-150
EN
Chronic nature of both the disease and its therapy forces ophthalmologists to choose the treatment with the lowest potential for adverse reactions, which may be caused by the active substance, excipient or preservative. Detergents used in ophthalmic drops include a derivative of macrogolglycerol hydroxystearate-40 (MGHS-40), which in in vitro tests showed pro-inflammatory and cytotoxic properties towards corneal epithelial cells, and this effect increased with increasing concentration and time. The analyzed observational study showed that latanoprost without MGHS-40 effectively reduces intraocular pressure, and the factors encouraging ophthalmologists to choose this preparation were good local tolerance and a simple composition (without detergents, preservatives and antioxidants), improving compliance. In the observational study, 82.3% received latanoprost without MGHS-40, and almost 60% started antiglaucoma treatment with this preparation.
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