The Biology, Pathology and Therapeutic Use of Prostaglandins in the Eye

Carol B Toris; Vikas Gulati

Disclosures

Clin Lipidology. 2011;6(5):577-591. 

In This Article

Future Perspective

For decades it was thought that endogenous PGs were solely involved in inflammatory processes. The concept that low doses of PGs applied topically to the eye could reduce IOP without causing inflammation was inconceivable. The idea that topical PG analogs had therapeutic potential sparked renewed interest in the function of endogenous PGs in the eye and eventually led to the development of the most effective IOP-lowering drugs to date with only once-daily dosing. In the future, PGs may be combined with other molecules to improve the IOP effect even more. Improved delivery of topical PG analogs may make once weekly dosing possible in the near future. One day, slow release devices filled with a PG analog may be placed into the vitreous cavity or under the conjunctiva to provide adequate therapeutic effect for months. Gene therapy may enable delivery of PGs to the target tissue to permanently correct the defect. Exploiting the neuroprotective features of PGs could lead to treatments that protect the retinal ganglion cells from damage despite being in a high pressure environment.

A better understanding of the presence and function of PGs in ocular inflammatory conditions may help to better utilize NSAIDs for their steroid sparing effect in the management of these problems. Synthetic PG analogs have successfully separated the IOP-lowering effects of PGs from the proinflammatory effects. A separation of the ocular hypertensive and anti-inflammatory effects of steroids still remains to be achieved. With clarification of the opposing effects of the PGs and steroids on the extracellular matrix may come such a separation in the future.

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