Topical carbonic anhydrase inhibitors and glaucoma in 2021: where do we stand?

Ari Stoner, Alon Harris, Francesco Oddone, Aditya Belamkar, Alice Chandra Verticchio Vercellin, Joshua Shin, Ingrida Januleviciene, Brent Siesky

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Carbonic anhydrase inhibitors (CAIs) have been used for many decades in the treatment of glaucoma. Systemic CAIs were an early treatment option to lower intraocular pressure by reducing aqueous humour production; however, frequent side effects including polyuria and paresthesia contributed to the eventual development of topical CAIs. As topical drug development evolved over time, prostaglandin analogues and beta-blockers have become the gold standard of glaucoma therapies. Although prescribed less often than other classes of topical glaucoma therapies, topical CAIs continue to be used in combination therapies with beta-blockers and alpha agonists. Topical CAIs have also been demonstrated to alter biomarkers of ocular haemodynamics, which have relevance in glaucoma. The purpose of this review is to review and summarise the current state of topical CAI prescribing trends, known efficacy and suggested mechanisms and potential influence on ocular haemodynamics for the future of glaucoma management.

Original languageEnglish
Pages (from-to)1332-1337
Number of pages6
JournalBritish Journal of Ophthalmology
Issue number10
StatePublished - Oct 2022
Externally publishedYes


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