The Latest Drugs in Development That Reduce Intraocular Pressure in Ocular Hypertension and Glaucoma

Viran Jayanetti,1 Sartaj Sandhu,2 Jed A Lusthaus3 1Prince of Wales Hospital, Sydney, New South Wales, Australia; 2Sydney Eye Hospital, Sydney, New South Wales, Australia; 3Glaucoma Unit, Sydney Eye Hospital, Sydney, New South Wales, AustraliaCorrespondence: Jed A LusthausGlaucoma Unit, Sydney Eye Hospital, Sydney, New South Wales, AustraliaEmail jed.lusthaus@sydney.edu.auAbstract: Glaucoma causes irreversible vision loss, with elevated intraocular pressure (IOP) being the only known modifiable risk factor. There are a variety of medical and interventional options for lowering IOP; however, despite these treatments, glaucoma continues to be a leading cause of visual impairment. Further research continues to strive for treatment options with improved side effect profiles, additional IOP-lowering effects, and ease of use. This review provides a brief summary of current IOP-lowering therapies and then outlines pipeline ocular hypotensive agents, their mechanisms of action, benefits, and side effect profiles. Advancements are seen within currently used eye drop classes such as prostaglandin analogues, Rho kinase inhibitors and nitric oxide donors, whilst there are also new drug classes, such as tyrosine protein kinase activators. Most developing drugs are topical drop formulations, with a number already having entered Phase III trials. Alternative drug delivery methods are also in development and will be briefly discussed. Pharmacological and drug delivery developments continue to provide glaucoma patients and clinicians with new options and the promise of better outcomes, particularly in terms of improved tolerance and reduced frequency of dosing.Keywords: glaucoma, ocular hypertension, intraocular pressure, ocular hypotensive drug