PT  - JOURNAL ARTICLE
AU  - Ari Stoner
AU  - Alon Harris
AU  - Francesco Oddone
AU  - Aditya Belamkar
AU  - Alice Chandra Verticchio Vercellin
AU  - Joshua Shin
AU  - Ingrida Januleviciene
AU  - Brent Siesky
TI  - Topical carbonic anhydrase inhibitors and glaucoma in 2021: where do we stand?
AID  - 10.1136/bjophthalmol-2021-319530
DP  - 2021 Aug 25
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2021-319530
4099  - http://bjo.bmj.com/content/early/2021/08/24/bjophthalmol-2021-319530.short
4100  - http://bjo.bmj.com/content/early/2021/08/24/bjophthalmol-2021-319530.full
AB  - Carbonic anhydrase inhibitors (CAIs) have been used for many decades in the treatment of glaucoma. Systemic CAIs were an early treatment option to lower intraocular pressure by reducing aqueous humour production; however, frequent side effects including polyuria and paresthesia contributed to the eventual development of topical CAIs. As topical drug development evolved over time, prostaglandin analogues and beta-blockers have become the gold standard of glaucoma therapies. Although prescribed less often than other classes of topical glaucoma therapies, topical CAIs continue to be used in combination therapies with beta-blockers and alpha agonists. Topical CAIs have also been demonstrated to alter biomarkers of ocular haemodynamics, which have relevance in glaucoma. The purpose of this review is to review and summarise the current state of topical CAI prescribing trends, known efficacy and suggested mechanisms and potential influence on ocular haemodynamics for the future of glaucoma management.