Open-angle glaucoma treatment market

1. Open-angle glaucoma treatment market Open-angle glaucoma is a chronic, progressive, and irreversible multifactorial optic neuropathy that is characterized by open-angle of the anterior iridocorneal chamber, typical optic nerve head changes, gradual loss of peripheral vision (characteristic visual field changes) followed by central visual field loss (blindness) for which intraocular pressure (IOP) is a significant risk factor. Open-angle glaucoma is the commonest form of glaucoma and a significant cause of blindness. High intraocular pressure (IOP) is a considerable risk factor for the disease. Open-angle glaucoma treatment aims to lower the IOP and thus reduce the risk of progressive loss of vision. IOP can be reduced by medications (eye drops), laser therapy, or surgery. Open-angle glaucoma treatment should be initiated if signs of damage as a result of open-angle glaucoma are evident, such as disc haemorrhage, nerve fibre layer defects, asymmetric cupping, vertical ovalization or notching of the cup or if symptoms of elevated IOP are present (e.g., halos, blurred vision, pain, IOP consistently above 28 mmHg to 30 mmHg) due to the high risk of optic nerve damage. The targeted intraocular pressure should be achieved with the fewest medications and minimum adverse effects. Several different classes of pressure-lowering medicines are available, and medication choice may be influenced by cost, adverse effects, and dosing schedules. In general, prostaglandin analogues (Latanoprost, travoprost, bimatoprost, etc.) are the first line of medical therapy. These are the active market holders in Glaucoma treatment market and major players for open-angle glaucoma. These drugs reduce intraocular pressure by reducing outflow resistance resulting in increased aqueous humour flow through the uveoscleral pathway. However, they are associated with local adverse effects, such as conjunctival hyperemia, elongation, and darkening of eyelashes, prostaglandin-associated periorbitopathy, and others. If there is an intolerance to the use of prostaglandin analogues, the second-line agents, such as β-Adrenergic blockers (Timolol, Betaxolol, etc.); α agonists (Apraclonidine, Brimonidine); Carbonic anhydrase inhibitors (Dorzolamide, Brinzolamide); cholinergic agonists (Pilocarpine) are used. Although drugs, such as the β-adrenergic blockers and α-adrenergic agonists are active only during the day and not at night, as well as, some of these agents, such as β-adrenergic blockers, may also have significant systemic adverse effects. Moreover, combinatorial therapy of these medications can be used. The FDA approval of new classes of nitric oxide-donating compounds, Vyzulta developed by Bausch & Lomb’s and Rho-kinase (ROCK) inhibitors, Rhopressa developed by Aerie Pharma, open up new possibilities in market and research. Rhopressa is the first entirely new class of glaucoma medication to be available since latanoprost was approved. It is FDA-approved treatment that lowers eye pressure in patients with open-angle glaucoma and ocular hypertension. Vyzulta is combinatorial therapy of Lomb/Nicox, making this the first drug to reduce stress while simultaneously dilating blood vessels to enhance blood flow in open-angle glaucoma patients. Both medications occupied a decent share hold in the Glaucoma market. If the first- and second- line treatment does not achieve adequate intraocular pressure, reduction with acceptable adverse

2. effects, laser or incisional surgeries are indicated. In poorly adherent patients or those with severe disease, surgery may sometimes be offered as first-line therapy. Despite all these available treatments, unfortunately, no competent evidence exists that these agents can prevent disease progression in patients with open-angle glaucoma, which is the major impediment in Open-angle glaucoma market growth. In part, neuroprotection has not succeeded because of an incomplete understanding of the pathophysiological mechanisms associated with optic nerve damage. The detailed knowledge of pathophysiology may change and drive the Open- angle glaucoma treatment market in the future. The frequent research has been directed toward understanding the disease at the cellular, hormonal, and molecular levels in order to overcome the current unmet needs. The future holds the hope of developing drugs that target the autoregulatory function of the capillaries serving the optic nerve head with the expectation that better vascular perfusion will help retard the morbidity of the disease. Moreover, acquisitions and collaborations between key players, research and development, along with the emerging pipeline drugs, are expected to create a productive environment, as well as the launches of upcoming therapies will also provide to the overall growth of Open-angle glaucoma market during the forecast period of 2019–2028.