Collagen degradation in glaucoma: will it gain a therapeutic value?

The extracellular matrix is in a constant state of turnover, and several studies suggest that this homeostasis is out of balance in open-angle glaucoma. Recent evidence suggests that matrix metalloproteinases, which are the enzymes primarily responsible for degradation, play a role in numerous modern glaucoma therapies, including topical prostaglandin analogues, topical steroids, and argon laser trabeculoplasty. Additionally, direct and indirect regulation of this system has been shown to increase aqueous humor outflow facility. It is possible that therapies directed at modulating specific enzymes represent the next generation of glaucoma therapy.