[New perspectives in the pharmacological treatment of glaucoma]

Open angle glaucoma is an optic neuropathy, the etiology of which is still unknown and which has not yet satisfactory therapy. Intraocular hypertension due to a decrease in trabecular out flow facility, is a risk factor. The side effects caused by ocular hypotensive treatments justify the search for better-tolerated drugs. A survey of the new approaches is reported: carbonic anhydrase inhibition, renin-angiotensin system inhibition, glucocorticoid antagonism, the use of prostaglandins etc. are evoked, as well as other more speculative ways: antioxidant treatments. Glaucoma which is characterized by ganglion cell degeneration probably related to a vascular defect, deserves to be studied from this point of view. Recent data on vascular and haemorheological abnormalities and the possible involvement of excitotoxic neurotransmitters in pathological process open a novel way for really innovative pharmacological research.