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An evidence-based review of unoprostone isopropyl ophthalmic solution 0.15% for glaucoma: place in therapy

Authors Fung D, Whitson J

Received 5 January 2014

Accepted for publication 7 February 2014

Published 10 March 2014 Volume 2014:8 Pages 543—554

DOI https://doi.org/10.2147/OPTH.S41562

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4


Derrick S Fung, Jess T Whitson

Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA

Abstract: Glaucoma is a progressive, neurodegenerative optic nerve disease that can cause significant visual morbidity and affects over 60 million people worldwide. The only known modifiable risk factor for glaucoma at this time is elevated intraocular pressure (IOP), which may be treated with medications, laser therapy, and/or incisional surgery. Topical ocular medications are commonly used as first-line therapy for glaucoma, although side effects may limit their use. Unoprostone is a novel 22-carbon ocular hypotensive agent that may be advantageous in treating some patients with open angle glaucoma or ocular hypertension. Unlike the 20-carbon prostanoids, such as latanoprost, that lower IOP primarily through an increase in uveoscleral outflow, unoprostone may lower IOP through increased aqueous outflow via the conventional trabecular meshwork pathway. Although not as efficacious as other prostanoids, unoprostone is effective for IOP reduction both as monotherapy and adjunctive therapy with timolol. Unoprostone has decreased affinity for the prostaglandin F2α receptor, which may explain its well tolerated ocular and systemic side effect profile compared with other prostanoids.

Keywords: unoprostone, Rescula®, prostaglandin, glaucoma, medication


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