Glaucoma, the second leading cause of worldwide blindness, is a progressive optic neuropathy characterized by a loss of retinal ganglion cells and their axons beyond typical age-related baseline loss. Diagnosis is defined by optic disc and visual field changes, and the primary goal of glaucoma treatment is to preserve vision. Proven existing therapies (ie, pharmacotherapy, laser, and surgical) focus on reduction of intraocular pressure (IOP), although elevated IOP is no longer a diagnostic feature of glaucoma. New neuroprotectant drugs are being investigated, with the goal of reducing retinal ganglion cell loss, either prophylactically or after the insult has occurred. Various treatment strategies are being evaluated, and include a neuroprotectant only, or a complete therapy approach comprised of both a neuroprotectant supplemented by an IOP-lowering therapy. Dually targeted complete therapy may directly preserve the optic nerve, decrease the risk factors that cause glaucoma damage, and reduce glaucoma-related morbidities. Neuroprotectant therapy outcomes should include functional and structural effects of disease progression and neuroprotectant therapies, as well as patient functioning and economic impact.
(Am J Manag Care. 2008;14:S15-S19)
Acknowledgment: Laurie Kozbelt assisted in the preparation of this manuscript.
Author Affiliations: From University of Southern California, Los Angeles, CA; Xcenda, Palm Harbor, FL; Allergan, Inc, Irvine, CA.
Funding Source: The research and manuscript were funded by Allergan, Inc.
Author Disclosures: The author (RV) received an honorarium from Allergan, Inc; the author (PP) received compensation from Xcenda, which is a consultant to Allergan, Inc; the author (JGW) is employed by Allergan, Inc; author (TJB) is employed by Xcenda.
Authorship Information: Concept and design (RV, PP, JGW, TJB); acquisition of data (RV, PP, JGW); analysis and interpretation of data (RV, PP, JGW, TJB); drafting of the manuscript (RV, PP, TJB); critical revision of the manuscript for important intellectual content (RV, JGW, TJB); and supervision (TJB).
Address Correspondence to: Rohit Varma, MD, 1450 San Pablo St, Room 4900, Los Angeles, CA 90033. E-mail: firstname.lastname@example.org.
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