Targeting Episcleral Venous Pressure to Reduce IOP

By directly targeting distal outflow and EVP, ATP-sensitive potassium channel openers like QLS-111 could redefine treatment.

Michael P. Fautsch, PhDBarbara M. Wirostko, MD, FARVO

Glaucoma Physician March 1, 2025 Vol 29, Issue March 2025 Page(s): 15-16

Clinical Report: Targeting Episcleral Venous Pressure to Reduce IOP

Overview

Revise to better explain the mechanism of ATP-sensitive potassium channel openers in relation to EVP and IOP.

Background

Intraocular pressure (IOP) management is crucial for preventing glaucoma-related vision loss. Traditional treatments primarily focus on modifying aqueous humor production and drainage, often overlooking the role of episcleral venous pressure (EVP) as a significant factor in IOP regulation. Understanding and targeting EVP could lead to innovative therapeutic strategies that improve patient outcomes.

Data Highlights

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Key Findings

QLS-111, an ATP-sensitive potassium channel opener, shows promise in lowering IOP by targeting EVP.
Current treatments do not selectively address distal outflow pathways, which account for 50% to 80% of total IOP.
Studies indicate that bypassing the trabecular meshwork reduces IOP but does not reach EVP levels.
CKLP1, a prodrug developed by Mayo Clinic, demonstrated a 20% to 30% reduction in IOP in preclinical models.
Research supports that netarsudil can lower IOP by reducing EVP, highlighting the importance of this target in glaucoma therapy.

Clinical Implications

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Conclusion

Targeting episcleral venous pressure represents a novel approach in glaucoma treatment, potentially leading to more effective IOP management strategies. Continued research and clinical trials are essential to validate these findings and integrate them into standard care.

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