Management of Open-Angle Glaucoma

Diagnosis and Characteristics

The primary open-angle glaucoma (POAG) is a chronic, progressive optic neuropathy characterized by a characteristic acquired atrophy of the optic nerve and loss of retinal ganglion cells and their axons, according to the American Academy of Ophthalmology 1
Typical clinical features of POAG include an open anterior chamber angle on gonioscopy and glaucomatous changes to the optic disc and retinal nerve fiber layer, as stated by the American Academy of Ophthalmology 2

The American Academy of Ophthalmology recommends that the treatment of POAG focuses primarily on lowering intraocular pressure (IOP) to slow the progression of the disease 1
Prostaglandin analogs, such as bimatoprost, latanoprost, and travoprost, are among the most effective medications for lowering IOP, as reported by the American Academy of Ophthalmology 3
Acetazolamide, an oral carbonic anhydrase inhibitor, is used to treat glaucoma and can lower IOP by 20-30%, according to the European Glaucoma Society 4

The current guidelines for the management of primary open-angle glaucoma do not mention metamizol (Novalgin) as contraindicated, as stated by the American Academy of Ophthalmology 5, 6, and 1, 2
Metamizol has no known negative effect on IOP, unlike anticholinergic substances which can be problematic in angle-closure glaucoma, according to the European Glaucoma Society 7