Improving patient outcomes following glaucoma surgery: state of the art and future perspectives

Figures & data

Figure 1 Schematic overview of the process of wound healing and the most important molecules (growth factors, cytokines, and proteinases) involved.

Abbreviations: FGF, fibroblast growth factor; IL, interleukin; MMP, matrix metalloproteinase; PDGF, platelet-derived growth factor; PIGF, placental growth factor; TGF-β, transforming growth factor beta; VEGF, vascular endothelial growth factor; INFα2b, interferon alpha 2b.

Table 1 New wound modulation agents

Inhibitor	Mechanism of action	Phase of wound healing	Study	Reference
CAT-152	Antibody against TGF-β2	Inflammation, fibrosis	In vitro (HTF), rabbit, phase III trial	^Citation40,Citation41
Decorin	Inhibition of TGF-β2	Inflammation, fibrosis	Rabbit	^Citation42
Suramin	Inhibition of TGF-β, PDGF, and FGF	Inflammation, fibrosis	Rabbit, case series	^Citation43,Citation44
Tranilast	Inhibition of TGF-β, IL-1, and PGE2	Inflammation, fibrosis	In vitro (RTF), rabbit, pilot study	^Citation45^–^Citation47
Lovastatin	Inhibition of Rho pathway of TGF-β	Inflammation, fibrosis	In vitro (HTF)	^Citation48
ALK inhibitor	Inhibition of ALK signaling of TGF-β	Inflammation, fibrosis	In vitro (RTF), rabbit	^Citation49,Citation50
microRNA	Gene suppression of TGF-β	Fibrosis	In vitro (HTF)	^Citation51
Pegaptanib	Aptamer against VEGF165	Angiogenesis	In vitro (HTF and RTF), rabbit	^Citation61
Ranibizumab	Fab fragment against all VEGF isoforms	Angiogenesis, fibrosis	Pilot study	^Citation99
Bevacizumab	Antibody against all VEGF isoforms	Angiogenesis, fibrosis	In vitro (HTF and RTF), rabbit, case reports and series, pilot study, RCT	^Citation53,Citation59,Citation60, ^Citation62^–^Citation75,Citation97, ^Citation98,Citation100
5D11D4	Antibody against PIGF	Inflammation, angiogenesis, fibrosis	In vitro (MTF), mouse	^Citation76
Y-27932	Inhibition of ROCK	Inflammation, fibrosis	In vitro (HTF), rabbit	^Citation93,Citation94
PDT	Phototoxicity of Tenon fibroblasts	Angiogenesis, fibrosis	In vitro (HTF), rabbit, pilot study, RCT	^Citation101^–^Citation104
Saratin	Inhibition of platelet adhesion	Coagulation, fibrosis	Rabbit	^Citation105,Citation106
Sonepcizumab	Antibody against SIP	Fibrosis	Rabbit	^Citation107
Doxycycline	Inhibition of MMP-1, MMP-2, MMP-8, MMP-9, MMP-13	Inflammation, fibrosis	Rabbit	^Citation108
Pirfenidone	Inhibition of TGF-β, CTGF, PDGF, TNF-α	Inflammation, fibrosis	In vitro (HTF), rabbit	^Citation109,Citation110
Tacrolimus	Immunosuppressive agent	Inflammation, fibrosis	Rabbit	^Citation111
Octreotide	Octapeptide of somatostatin	Inflammation, fibrosis	Rabbit	^Citation111

Abbreviations: HTF, human Tenon fibroblasts; RTF, rabbit Tenon fibroblasts; RCT, randomized controlled trial; MTF, murine Tenon fibroblasts; PDT, photodynamic therapy; PIGF, placental growth factor; MMP, matrix metalloproteinase; VEGF, vascular endothelial growth factor; IL, interleukin; PGE2, prostaglandin E2; FGF, fibroblast growth factor; TNF-α, tumor necrosis factor alpha; TGF-β, transforming growth factor beta; PDGF, platelet-derived growth factor; CTGF, connective tissue growth factor; ALK, anaplastic lymphoma kinase; CAT-152, lerdelimumab; ROCK, Rho-associated protein kinase.

Figure 2 Representative blebs from (A) bevacizumab group and (B) placebo group showing less vascularity in the bevacizumab-treated eye at 6 months postoperatively.

Note: Reproduced from intracameral bevacizumab as an adjunct to trabeculectomy: a 1-year prospective, randomised study. Vandewalle E, Abegao Pinto L, Van Bergen T, et al, Vol 98, pages 73–78, Copyright © 2014 with permission from BMJ Publishing Group Ltd.⁷⁵

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