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  • Clinical Implications
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Clinical Implication

Clinical implications of pharmacogenetics for glaucoma therapeutics

The Pharmacogenomics Journal volume 3, pages 197–201 (2003)Cite this article

Glaucoma is a leading cause of irreversible blindness worldwide and is estimated to affect nearly 70 million people and to cause blindness in about 7 million people.1 The pathology shared by the heterogeneous group of glaucoma disorders is progressive optic nerve damage that is characterized by ‘cupping’ of the optic disk. This progressive glaucomatous optic atrophy gradually leads to visual field loss. The precise mechanisms leading to optic nerve axon damage have not been fully elucidated. Intuitively, direct treatment of the optic nerve is an obvious therapeutic strategy; however, there are no completed clinical trials that have tested the proof-of-concept that ‘neuroprotection’ is a viable treatment for glaucoma.2 At present, ophthalmologists treat the only known modifiable risk factor for glaucoma, clinically significant elevated intraocular pressure (IOP).

Given our current understanding of the human genome and glaucoma therapeutics, the question is, are there genetic determinants for the pharmacodynamic variation in drug response to glaucoma medications? In order to begin to answer this question we need to assess the following two issues: (1) What is the evidence that lowering IOP is important for ‘protecting’ the susceptible optic nerve in patients with glaucoma? (2) What are the variables in assessing the IOP response to glaucoma medications?

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Acknowledgements

Supported by grants from the National Institutes of Health EY00353 (SEM) and the Research Career Development Award from Research to Prevent Blindness (SEM). Ms Shayne Davidson created Figure 1, which was modified with permission from ‘Angle of respose’ figure in Alward, W.L.M. A new angle on ocular development, Science 299: 1527, 2003.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA

    N C McLaren & S E Moroi

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  1. N C McLaren
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  2. S E Moroi
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Correspondence to S E Moroi.

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DUALITY OF INTEREST

SE Moroi, has received travel support, honorariums, and grants from Alcon Laboratories, Inc., Pharmacia & Upjohn, and Merck Research Laboratories; NC McLaren, none.

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McLaren, N., Moroi, S. Clinical implications of pharmacogenetics for glaucoma therapeutics. Pharmacogenomics J 3, 197–201 (2003). https://doi.org/10.1038/sj.tpj.6500181

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