Rho Kinase Inhibitors for Glaucoma and Optic Neuropathy Treatment: Enzyme Activity, Cell Effects, IOP-Lowering and Neuroprotection Perspectives

Rho kinases, (Rho-Associated Coiled-Coil Kinases; ROCKs) are ubiquitous enzymes found inside all cells of the body. Consequently, ROCKs are involved in numerous cellular functions such as cell contraction, cell migration and proliferation. As such, their over-expression / activation has been implicated in diseases ranging from diabetes, erectile dysfunction, hypertension, asthma, cancer, cardiovascular hypertrophy, inflammatory diseases, pulmonary hypertension and so on. In the eye, ROCKs are involved in the development of glaucoma, Fuchs corneal dystrophy, diabetic retinopathy and age-related macular degeneration. Inhibitors of ROCKs have proven useful drugs to treat the afore-mentioned disorders, and in particular they are effective intraocular pressure lowering agents with added neuroprotective activities. This review addresses the latter aspect of ROCK physiology, pharmacology and pathology, and the clinical utility of ROCK inhibitors towards preservation of eyesight from the ravages of glaucomatous optic neuropathy