The biology, pathology and therapeutic use of prostaglandins in the eye

Prostaglandins (PGs) are ubiquitous compounds found throughout the body, including the eye. They are involved in a variety of ocular functions, two of which are intraocular pressure (IOP) regulation and mediation of inflammation. Currently, PG analogs are the mainstay of topical IOP lowering therapy for glaucoma. The IOP effects of PGs are mediated by their actions on matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases, thereby facilitating the outflow of aqueous humor from the eye. Clinically used PGs are PGF2a analogs which bind to PGF receptors to influence matrix metalloproteinase transcription through c-Fos and c-Jun. Biological antagonists of endogenous PGs, including steroids and nonsteroidal anti-inflammatory drugs, are commonly used for control of ocular inflammation and management of cystoid macular edema. Recent work has demonstrated that endogenous PGs are implicated in the pathogenesis of diabetic retinopathy, macular degeneration and carcinogenesis.