Glaucomatous optic neuropathy

Progressive optic nerve damage in glaucoma. The foundation of therapy remains intraocular pressure reduction via drops, laser, or surgery. That is the only intervention with proven effect on progression. AAO 2020 Glaucoma PPP and EGS 2021 Guidelines do not include systemic 'neuroprotectors'.

ICD-10 H402 drugs

Also known as: Glaucoma, GON, Glaucoma-associated optic atrophy

Drugs used for this condition

ALatanoprostFirst line · Prostaglandin analogues, antiglaucoma agentsFirst-line for primary open-angle glaucoma and ocular hypertension per EGS 2021 and AAO PPP 2020. Instill 1 drop into the affected eye once daily at bedtime. Target IOP reduction 20–25% from baseline. Compared with timolol, latanoprost provides additional 1–2 mmHg IOP reduction without systemic beta-blocking effects.

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

FCortexin (bovine brain cortex polypeptides)Not recommended · Other psychostimulants and nootropics (local classification)International guidelines AAO 2020 Glaucoma PPP, EGS 2021, and ICO Guidelines for Glaucoma do not mention the drug. Glaucoma therapy rests on IOP reduction – drops, SLT laser, and surgery. Systemic peptide 'neuroprotection' is not used by the international ophthalmology community. A few Russian publications on peptide neuroprotection in glaucoma entered international databases, but independent multicentre RCTs have not been reproduced.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit