Pregabalin Use in Open-Angle Glaucoma

Understanding Open-Angle Glaucoma

The primary open-angle glaucoma is a chronic eye disease characterized by acquired atrophy of the optic nerve and loss of retinal ganglion cells and their axons, with the anterior chamber angle open on gonioscopy, affecting patients bilaterally but often asymmetrically 1
The disease is associated with characteristic structural changes in the optic nerve and functional visual field defects, and is a leading cause of irreversible blindness in the general population 1

Pregabalin has no known negative effects on intraocular pressure in patients with open-angle glaucoma, according to the American Academy of Ophthalmology 2
The American Academy of Ophthalmology recommends that patients with open-angle glaucoma can safely use Pregabalin, as it does not affect intraocular pressure 2

Anticholinergics should be used with caution in patients with narrow-angle glaucoma, but are less problematic in open-angle glaucoma, as stated by the American Academy of Ophthalmology 3

The primary goal of treating open-angle glaucoma is to lower intraocular pressure to prevent further damage to the optic nerve, as recommended by the American Academy of Ophthalmology 4
Prostaglandin analogs are the most commonly prescribed initial eye drops for lowering intraocular pressure in patients with glaucoma, as they are the most effective and well-tolerated, according to the American Academy of Ophthalmology 4
If monotherapy is insufficient, an alternative medication can be substituted or an additional medication can be added, as stated by the American Academy of Ophthalmology 5

Regular monitoring of intraocular pressure and optic nerve status is crucial to assess the success of therapy and make adjustments as needed, as recommended by the American Academy of Ophthalmology 4
Medication adherence is critical for successful treatment, but often poses a challenge, and can be improved with repeated instructions and counseling on proper medication use, as stated by the American Academy of Ophthalmology 6

The use of prostaglandin analogs, such as tafluprost and latanoprost, can lead to corneal epithelial disorders, with associated eye irritation, pain, and foreign body sensation, as reported in studies published in Ophthalmology in 2016 7
When prostaglandin monotherapy fails to achieve target intraocular pressure (IOP), the American Academy of Ophthalmology recommends adding a medication from a different class, such as beta-blockers, carbonic anhydrase inhibitors, or alpha-2 agonists, as supported by evidence from Ophthalmology in 2016 7

Fixed combinations of latanoprost plus timolol have proven significantly more effective than either component alone, with tafluprost/timolol combinations showing superior efficacy to monotherapy while maintaining tolerability, as reported in studies published in Ophthalmology in 2016 7