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Advances In and Insights into the Treatment of Glaucoma
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Advances In and Insights into the Treatment of Glaucoma

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 20 May 2025 | Viewed by 4802

Special Issue Editor

Dr. Da-Wen Lu

E-Mail Website
Guest Editor
Department of Ophthalmology, Tri-Service General Hospital & National Defense Medical Center, Taipei 11490, Taiwan
Interests: ophthalmology; eye diseases; neuroprotection

Special Issue Information

Dear Colleagues,

Glaucoma is a chronic neurodegenerative disorder affecting the visual system which can result in vision loss and blindness. Glaucomatous optic neuropathy (GON) is the major cause of irreversible visual loss worldwide and can result from a range of disease etiologies. The defining features of GON are retinal ganglion cell (RGC) degeneration and characteristic cupping of the optic nerve head (ONH) due to tissue remodeling, while intraocular pressure remains the only modifiable GON risk factor currently targeted by approved clinical treatment strategies.

This Special Issue will summarize the different mechanisms of action, efficacy and side effects of current and recently launched intraocular pressure (IOP)-lowering medications. Conventionally, prostaglandin analogues are recommended as the first-choice treatment for POAG because of their efficacy and limited systemic side effects. Yet, the combination of agents of different classes with different mechanisms of action is associated with superior IOP-lowering efficacy compared to each of the components used alone. More information on new IOP-lowering medications including the nitric-oxide-donating prostaglandin analogue latanoprostene bunod, rho-kinase inhibitor netarsudil and fixed combination netarsudil/latanoprost will also be discussed. In addition, analysis on the pathogenesis of glaucoma with the combination of mechanisms and treatment strategies will also be covered.

This Special Issue, entitled "Advances in and Insights into the Treatment of Glaucoma", aims to collect original articles and review articles related to treatment and future perspectives in the management of glaucoma, which will help to advance knowledge in this field of research. This study will help ophthalmologists to design and develop new therapeutic strategies that can better control glaucoma progression.

Dr. Da-Wen Lu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. There is an Article Processing Charge (APC) for publication in this open access journal. For details about the APC please see here. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • glaucoma
  • glaucoma treatment
  • molecular mechanism

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Published Papers (3 papers)

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Research

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17 pages, 263 KiB  
Article
Association of Matrix Metalloproteinases Polymorphisms with Glaucoma Risk, Glaucoma Phenotype, and Response to Treatment with Selective Laser Trabeculoplasty or Latanoprost
by Makedonka Atanasovska Velkovska, Katja Goričar, Tanja Blagus, Vita Dolžan and Barbara Cvenkel
Int. J. Mol. Sci. 2024, 25(24), 13464; https://doi.org/10.3390/ijms252413464 - 16 Dec 2024
Viewed by 468
Abstract
In open-angle glaucoma, the increase in intraocular pressure (IOP) is caused by an increased resistance to aqueous humour outflow in the trabecular meshwork. Since genetic variability of matrix metalloproteinase (MMP) genes may influence extracellular matrix remodelling, we investigated their association with glaucoma risk [...] Read more.
In open-angle glaucoma, the increase in intraocular pressure (IOP) is caused by an increased resistance to aqueous humour outflow in the trabecular meshwork. Since genetic variability of matrix metalloproteinase (MMP) genes may influence extracellular matrix remodelling, we investigated their association with glaucoma risk and/or response to treatment. The retrospective part of the study included patients with primary open-angle glaucoma and ocular hypertension (OHT); in the prospective part of the study, newly diagnosed patients with POAG or OHT were randomised to receive either latanoprost or selective laser trabeculoplasty (SLT) as the initial treatment. The reduction in IOP was measured 6 weeks after treatment. The following MMP single nucleotide polymorphisms were genotyped: MMP2 rs243865, rs243849, and rs7201; MMP3 rs3025058; MMP9 rs17576, rs17577, rs20544, and rs2250889; MMP14 rs1042704, rs1042704, and rs743257. Logistic regression was used to calculate odds ratios to assess the association between MMP polymorphism and risk of POAG or OHT, glaucoma phenotypes and response to treatment. Only carriers of the MMP3 rs3025058 TT genotype had a significantly higher risk of OHT, more advanced glaucoma, and a higher C/D ratio in the additive and dominant models. None of the investigated MMP polymorphisms were associated with response to treatment with latanoprost and SLT in our study population. Full article
(This article belongs to the Special Issue Advances In and Insights into the Treatment of Glaucoma)
11 pages, 1911 KiB  
Article
Uveoscleral Outflow Routes after MicroPulse Laser Therapy for Refractory Glaucoma: An Optical Coherence Tomography Study of the Sclera
by Luca Agnifili, Andrea Palamini, Lorenza Brescia, Annamaria Porreca, Francesco Oddone, Lucia Tanga, Maria Ludovica Ruggeri, Alberto Quarta, Rodolfo Mastropasqua, Marta Di Nicola and Leonardo Mastropasqua
Int. J. Mol. Sci. 2024, 25(11), 5913; https://doi.org/10.3390/ijms25115913 - 29 May 2024
Cited by 1 | Viewed by 952
Abstract
To analyze in vivo scleral changes induced by MicroPulse transscleral laser therapy (MP-TLT) in refractory glaucoma using anterior segment–optical coherence tomography (AS-OCT). Forty-two candidate patients for MP-TLT were consecutively enrolled and underwent AS-OCT at baseline and after six months. MP-TLT success was defined [...] Read more.
To analyze in vivo scleral changes induced by MicroPulse transscleral laser therapy (MP-TLT) in refractory glaucoma using anterior segment–optical coherence tomography (AS-OCT). Forty-two candidate patients for MP-TLT were consecutively enrolled and underwent AS-OCT at baseline and after six months. MP-TLT success was defined as an intraocular pressure (IOP) reduction by one-third. The main outcome measures were the mean superior (S-), inferior (I-), and total (T-) intra-scleral hypo-reflective space area (MISHA: mm2) and scleral reflectivity (S-SR, I-SR, T-SR; arbitrary scale) as in vivo biomarkers of uveoscleral aqueous humor (AH) outflow. The IOP was the secondary outcome. The relations between the baseline-to-six months differences (D) of DS-MISHA, DI-MISHA, and DT-MISHA and DS-SR, DI-SR, DT-SR, and DIOP, were investigated. At 6 months, the median IOP reduction was 21% in the failures and 38% in the successes. The baseline S-MISHA, I-MISHA, and T-MISHA did not differ between the groups, while S-SR and T-SR were higher in the successes (p < 0.05). At six months, successful and failed MP-TLTs showed a 50% increase in S-MISHA (p < 0.001; p = 0.037), whereas I-SR and T-SR reduced only in the successes (p = 0.002; p = 0.001). When comparing DS-MISHA, DI-MISHA, and DT-MISHA and DS-SR, DI-SR, and DT-SR, there were no significant differences between the groups. In the successful procedures, DIOP was positively correlated with DT-MISHA and DI-MISHA (ρ = 0.438 and ρ = 0.490; p < 0.05). MP-TLT produced potentially advantageous modifications of the sclera in refractory glaucoma. Given the partial correlation between these modifications and post-treatment IOP reduction, our study confirmed that the activation of the uveoscleral AH outflow route could significantly contribute to the IOP lowering after MP-TLT. Full article
(This article belongs to the Special Issue Advances In and Insights into the Treatment of Glaucoma)
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Review

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14 pages, 629 KiB  
Review
The Application of Rho Kinase Inhibitors in the Management of Glaucoma
by Li-Ching Liu, Yi-Hao Chen and Da-Wen Lu
Int. J. Mol. Sci. 2024, 25(11), 5576; https://doi.org/10.3390/ijms25115576 - 21 May 2024
Cited by 2 | Viewed by 2815
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Advances In and Insights into the Treatment of Glaucoma)
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