Nitric oxide-donating drugs can provide significant reductions in intraocular pressure (IOP) associated with open-angle glaucoma and ocular hypertension compared with timolol, reports Gail F. Schwartz, MD.
In the quest to provide more options to patients with glaucoma, the nitric oxide (NO)-donating drugs can provide significant reductions in IOP associated with open-angle glaucoma (OAG) and ocular hypertension (OHT) in clinical and experimental settings when compared with timolol.
NO offers a few advantages, in that, it can diffuse across cellular membranes and is a potent vasodilator, Gail F. Schwartz, MD.
In addition, it is synthesized endogenously by L-arginine via NO synthase (NOS), which then generates NO, and it activates soluble guanylyl cyclase, which results in up-regulation of cyclic guanosine monophosphate that serves as a second messenger, said Dr. Schwartz, who is in a private glaucoma practice and assistant professor, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.
In the eye, NO causes the trabecular meshwork to relax, regulates the permeability of Schlemm’s canal, and causes vasodilation of the ocular blood vessels. In addition, research has shown that dysfunction of the NO-guanylyl cyclase pathway is associated with an increased incidence of glaucoma, which provides insight into the drug’s mechanism of action.
Gail F. Schwartz, MD
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Dr. Schwartz receives lecture fees from Aerie Pharmaceuticals and Allergan and is a consultant and advisor to Allergan.