Whereas intraocular pressure is considered a major risk factor in glaucoma, growing evidence now indicates that ocular ischemia plays a major role too. By virtue of this and because many existing medications are able to interact with vasculature, altering ocular blood flow, it is essential that current and future medications for glaucoma be evaluated for their effect on ocular circulation. The authors review published papers examining the effect of topical and some systemic medications on ocular blood flow, focusing mostly on data from the human eye. The authors provide a comprehensive review on the effect of subclasses of medications (eg, carbonic anhydrase inhibitors, β-blockers, α-adrenergic agonists, and prostaglandin analogues on optic nerve head, and on retinal, choroidal, and retrobulbar circulation. The various claims for enhancements or reduction of ocular circulation within each class of medication are reviewed and evaluated.
Glaucoma Research and Diagnostic Center, Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Correspondence to Alon Harris, MS, PhD, Letzter Chair of Ophthalmology, Department of Ophthalmology, Indiana University School of Medicine 702 Rotary Circle, Indianapolis, Indiana 46202, USA; e-mail: email@example.com
Supported in part by Grant EY10801 (AH) from the National Institutes of Health, Bethesda, Maryland, and by an unrestricted grant from Research to Prevent Blindness, New York, New York. Alon Harris is the recipient of the William and Mary Greve Award from Research to Prevent Blindness. Proprietary interest category: N.