With over 3 million Americans diagnosed with glaucoma, and an estimated 6 million by 2050, it’s shocking to think we haven’t had a new innovation in pharmaceutical treatment of the disease in nearly 20 years. All that changed quite rapidly as 2017 came to a close last month with the introduction of not one, but two novel glaucoma therapies.

Vyzulta combines our beloved first line prostaglandin analogue with nitric oxide, a potent vasodilator. The novel approach targets IOP reduction by increasing outflow through the trabecular meshwork and Schlemm’s canal. The combination is a once-daily drop that showed statistically significant IOP reduction compared to prostaglandin latanoprost alone, as well as tried and true Timolol. Many feel this drop could overtake latanoprost as first-line glaucoma treatment (pending affordability and insurance coverage of course).

Rhopressa gained FDA approval in December as the first ever Rho kinase inhibitor medication for glaucoma. The novel once-daily drop increases outflow through the trabecular meshwork, and is the first drop shown to reduce episcleral venous pressure.

While head to head study data did not show superiority against Timolol in patients with IOP > 25 mmHg, it was more effective than Timolol at pressures under 25 mmHg. As such the drop is being marketed as a second line treatment, with advantages including its’ once daily dosage and potentially superior effectiveness in cases of low pressure glaucoma where reducing episcleral venous pressure is essential.

 Glaucoma and cataract specialist Dr. Thomas Hunter of Duke Eye Center discusses these new medications and how they will fit into his specialty practice, as well as surgical updates in treating glaucoma and collaborating between ODs and MDs on glaucoma care in this week’s podcast in honor of Glaucoma Awareness Month!