Future of therapy looks bright

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Developments include drug delivery methods, focus on ocular hypertension and neuroprotection

An evolution in glaucoma therapy is underway, shifting from a reliance solely on medication and surgery, to a greater understanding of disease pathology and risk factors in the conversion of ocular hypertension to glaucoma. In addition, there is a growing interest in new diagnostic technologies that will facilitate evaluation of the optic nerve, nerve fibre layer and macula, said Dr Murray Fingeret, FAAO, at SECO 2012.

Preservative-free formulas

Tafluprost is the first preservativefree prostaglandin analogue. Dorzolamide hydrochloride-timolol maleate is a fixed combination containing a carbonic anhydrase inhibitor and beta-adrenergic receptor blocking agent.

"The question is whether this is a leap forward in terms of efficacy, and we really don't know yet," he said. Tafluprost is expected to be comparable in IOP-lowering efficacy to other prostaglandins, with fewer effects on the ocular surface.

A plus for compliance?

Dr Fingeret noted that both new drugs are packaged in unit doses, with the cost and 'hassle' of using single-dose vials potentially influencing patient compliance.

"If they have enough motivation, patients will use them, while others may not want to," Dr Fingeret said. "One potential advantage is in having one vial for each day; this will prevent patients from using too many drops and running out before the month is out."