Therapeutic options in the treatment of open angle glaucoma and their use in accordance with the latest guidelines

Glaucoma is an optic neuropathy characterized by typical damage of the optic nerve with gradual atrophy of retinal ganglion cells and visual field defects. The goal of glaucoma therapy is to reduce intraocular pressure and reduce daily pressure fluctuations. Currently, in the treatment of primary open-angle glaucoma in Poland, we use four groups of drugs: β-adrenergic receptor antagonists, prostaglandin analogues, α-adrenergic receptor agonists and carbonic anhydrase inhibitors. First-line drugs, according to the guidelines of the Polish Ophthalmological Society, are prostaglandin analogues/prostamide. When considering the addition of a second drug to prostaglandins, brimonidine lowers intraocular pressure more strongly than dorzolamide or brinzolamide, similarly as timolol does. Drug containing two active substances are as effective as substances administered in two separate drops, therefore it is advantageous to use combined drug instead of using two different drugs.