This first volume of the New Concepts in Glaucoma series was conceived as a platform to express new ideas and approaches to understanding and solving primary open-angle glaucoma. The authors have attempted to expand levels of knowledge, present new ideas and challenge existing theories. Although the authors have painted a broad picture, the central theme of the book is to ask the right questions and seek the answers for patients with primary open-angle glaucoma.

Foreword Volume 2 of our serial publication continues our desire to address glaucoma with a combination of science and speculation. As science expands, the emphasis is on data, interpretation, and dogma. We disagree; open minds open new approaches. Using methodologies that are primarily molecular and genetic, we seek to refine the causes of glaucoma as well as how it is best treated, especially incorporating thoughts and hypotheses about new methods of treatment. Glaucoma is a complex disease, and genetics proves that a variety of proteins are culpable at one level. At another level, however, there are likely final common pathways and numerous feedback loops which have defied explanations to date. The search for answers goes on in basic science researcher’s laboratories and clinical ophthalmologist’s offices and operating rooms. We are all well-served by understanding that glaucoma is a neurodegenerative disease. Current attempts to solve the disease have focused on two strategic arenas: the trabecular meshwork function and its impact on intraocular pressure as a major risk factor for the disease; and the optic nerve dysfunction leading to visual loss. Genetic mutations have yielded puzzling clues to the cause, but without resolution. For example, mutations in myocilin and optineurin genes are closely connected to the phenotype, but how do they cause the disease? In the next two years, priority areas of research are signaling pathway discoveries, biomarker panels, epigenetic factors, and continued genomic studies to yield answers to the common final pathways of the disease. The final pathways are complex and redundant, such that the overlap of bio-informatics will be challenging. Current promising leads suggest the innate immune system holds important clues to both trabecular meshwork and optic nerve pathophysiology. When the primary open-angle glaucoma disease pathways are unraveled, drug discoveries and new treatment modalities will be available for better regulation of intraocular pressure and neuroprotection for the optic nerve. This volume discusses the glaucoma pipeline from several perspectives as well as future candidate classes. As always, the authors herein are urged to speculate on how the cure of glaucomatous optic nerve damage will yield to new treatments. John R. Samples Clinical Professor, Elson S. Floyd College of Medicine, Washington State University School of Medicine www.glaucomaconcepts.com Paul A. Knepper Associate Professor of Ophthalmology, Feinberg School of Medicine, Northwestern University Medical School Research Scientist, University of Illinois at Chicago

Successful interventional glaucoma remains a sought-after goal for the glaucoma clinician for many reasons. Medical costs, compliance, and adherence remain major barriers for the treatment of our patients. A truly definitive treatment for glaucoma is most likely to be largely surgical, as it is doubtful that patients will continue to use glaucoma drugs in the future for anything other than transient lowering of intraocular pressure. In the coming era, it seems probable that neuroprotection and neurorestoration will be combined with MIGS to lower pressure. The different types of MIGS are increasing in proportion to their efficacy. To date, there are no fewer than 12 choices available to glaucoma specialists. Choice of procedure depends on the underlying anatomy as well as the patient’s individual characteristics. Truthfully, the number of available surgeries depends upon their taxonomy. Most are based on the outflow system and the canal, as illustrated in this book.

Handbook of Basic and Clinical Ocular Pharmacology and Therapeutics provides a review of the basic anatomy, physiology, biochemistry and pathology of the eye with a focus drug therapy, drug delivery and use of therapeutic medical miniature devices. An understanding of the pharmacological actions of drugs acting on the eye requires the student and health care practitioner to learn additional principles in basic and clinical sciences that are unique to this organ. As a sensory organ, the eye is relatively inaccessible to the systemic circulation due to the blood-vitreous, blood-aqueous and blood-retinal barriers. Consequently, the administration of drugs for therapeutic effects in the eye necessitates an understanding of physico-chemical properties of the molecules and pharmacokinetic principles involved in the access to its site of action via topical, intracameral and intravitreal administration. This book includes information on the general principles of pharmacokinetics and pharmacodynamics of drugs as it pertains to the eye and in combating ocular disorders and diseases. Using a disease-themed approach, the book discusses basic and clinical pharmacological principles involved in the therapy of these diseases including the ocular side effect of systemically-administered drugs, drugs used in ophthalmic surgery and miscellaneous agents, the therapeutic utility of biologics, drug conjugates, combination products, gene and cellular therapy are also covered. Handbook of Basic and Clinical Ocular Pharmacology and Therapeutics is useful as a primary and secondary source of reference for up-to-date information about the pharmacological mechanisms of action, pharmacokinetics, side effects, drug-drug interactions and therapeutic indications of drugs for pharmacologists, pharmaceutical scientists, students in the health care disciplines (nursing, pharmacy, optometry, medical), and practitioners in optometry and ophthalmology. - Explains the mechanisms of action, side-effects and therapeutic uses of drugs, biologics, miniature devices, gene and cellular therapies for the eye - Provides a comprehensive review of the anatomy, physiology, biochemistry, pharmacology, microbiology, genetics and pathology of parts of the eye involved in drug therapy to combat eye disorders and diseases - Explores the pharmacological and clinical basis of drugs, drug conjugates, combination products used in the treatment of anterior and posterior segment diseases

Written for ophthalmology residents and practitioners, this book provides the most comprehensive resource covering all the major aspects of aqueous humor and intraocular pressure dynamics. In addition to chapters on the conventional and new technologies for intraocular pressure assessment, there is a novel chapter on the engineering perspectives of continuous monitoring of the intraocular pressure. Based on the newer insights in aqueous outflow, this text offers a rational approach to the medical and surgical management of glaucoma.

The series Advances in Stem Cell Biology is a timely and expansive collection of comprehensive information and new discoveries in the field of stem cell biology. iPSCs - Novel Concepts, Volume 15 addresses how important induced pluripotent stems cells are and how can they can help treat certain diseases. Somatic cells can be reprogrammed into induced pluripotent stem cells by the expression of specific transcription factors. These cells have been transforming biomedical research over the last 15 years. This volume will address the advances in research of how induced pluripotent stem cells are being used for treatment of different disorders, such as liver disease, type-1 diabetes, Parkinson's disease, macular degeneration of the retina and much more. The volume is written for researchers and scientists in stem cell therapy, cell biology, regenerative medicine and organ transplantation; and is contributed by world-renowned authors in the field. - Provides overview of the fast-moving field of stem cell biology and function, regenerative medicine and therapeutics - Covers spinal cord injuries, type-1 diabetes, liver disease, Parkinson's disease, graft vs. host disease, and much more - Contributed by world-renown experts in the field

Primary Open-Angle Glaucoma was the topic of the tenth World Glaucoma Association Consensus meeting. As with prior meetings, it was a daunting task to seek and obtain consensus on broad subject matter that ranges from diagnosis, risk profiling and screening of the disease. As it is unclear how each of us decides how we practice and the evidence to guide us often is sparse, this consensus, as well as the others, is based not only on the published literature, but also on expert opinion. Although consensus does not replace and is not a surrogate for scientific investigation, it does provide considerable value, especially when the desired evidence is lacking. The goal of this consensus is to provide a foundation for diagnosing and managing primary open-angle glaucoma and how it can be best done in clinical practice. Identification of those areas for which we have little evidence and, therefore, the need for additional research always is a high priority. We hope that this consensus report will serve as a benchmark of our understanding. However, this consensus report is intended to be fluid. It is expected that it will be revised and improved with the emergence of new evidence.