Research Progress on Intraocular Pressure-lowering Drugs, Commonly Used Clinical Adjuvants, and Emerging Neuroprotective Agents for Glaucomatous Optic Neuropathy

Abstract Glaucomatous optic neuropathy (GON) is the leading cause of irreversible blindness worldwide, characterized by progressive retinal ganglion cell (RGC) loss. Current clinical treatment relies primarily on IOP-lowering drugs, but a subset of patients continues to experience progressive optic nerve damage. Adjuvant therapies such as antioxidants and calcium channel blockers have limited efficacy. Emerging neuroprotective strategies including NMDA receptor antagonists, neurotrophic factors, and gene therapy remain in preclinical or early-stage trials. This review systematically summarizes the mechanisms, clinical applications, and limitations of these three drug categories, with emphasis on emerging neuroprotective agents, aiming to guide future research directions.