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timolol (Timpilo / timolol, ophthalmic)

✓ Approved

Merck & Co. · ADRB1 · Small Molecule

What is timolol?

timolol is a small molecule developed by Merck & Co.. It is approved for therapeutic indications.

Drug Profile

Brand NamesTimpilo, timolol, ophthalmic
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetADRB1, ADRB2, CHRM3
StatusApproved
Sources: ClinicalTrials.gov, Merck & Co.

Mechanism of Action

Molecular Targets

timolol acts on 3 molecular targets:

ADRB1adrenoceptor beta 1 (BETA1AR, ADRB1R)
ADRB2adrenoceptor beta 2 (ADRBR, B2AR)
CHRM3cholinergic receptor muscarinic 3 (EGBRS, m3AChR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

timolol is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Eye disordersGlaucoma✓ Approved

Related Research Articles

PubMedInternational journal of retina and vitreous2026-08-29

Misdiagnosis of uveal melanoma and other intraocular malignancies in enucleated eyes: a 28-year national review.

Witzenhausen Hans H, Stripling Katerina K, Stålhammar Gustav G

Intraocular tumors are often diagnosed clinically rather than by biopsy, so a benign lesion can be mistaken for malignancy and lead to enucleation. We determined how often uveal melanoma (UM) and other intraocular tumors are clinically misdiagnosed among enucleated eyes at the Swedish national ophthalmic pathology laboratory over 28 years, and the lesions responsible. In this retrospective, registry-based case series, all enucleation specimens accessioned at the St. Erik Ophthalmic Pathology Laboratory, Stockholm, between 1995 and 2022 under a clinical diagnosis of malignancy were reviewed against pathology reports, referral letters, and clinical records. Predefined criteria identified eyes in which a malignant tumor drove enucleation but was not confirmed histopathologically. In an exploratory analysis, the authors rated the projected visual acuity had enucleation been deferred. The misdiagnosis rate was modeled against calendar year by logistic regression and tested in sensitivity analyses. Of 24,242 specimens, 1,661 were enucleations, and after predefined exclusions, 1,419 eyes had been enucleated for a presumed tumor. Thirty-nine (2.7%) were misdiagnoses: 21 diagnosed as UM, 11 with another suspected neoplasm, and 7 with a suspected unspecified malignancy. Intraocular hemorrhage was the lesion most often mistaken for UM. Among the 21 μm eyes, the projected visual impact of enucleation was nil in 13 that had no useful vision at enucleation, a loss of useful vision in 1 (decimal acuity 0.25, a benign leiomyoma), and not estimable in 7. The misdiagnosis rate did not change appreciably (odds ratio 0.97 per year, 95% CI 0.94 to 1.01, P = 0.16), remained between 2.3% and 4.2% in sensitivity analyses, and did not differ between 1995 and 2010 (2.8%) and 2011-2022 (1.8%; P = 0.25). Misdiagnosed eyes were almost always blind, painful, or had opaque media, where clinical and imaging assessment is least reliable. Clinical misdiagnosis preceded 2.7% of tumor-related enucleations over 28 years, at a stable rate, and intraocular hemorrhage was the most frequent mimic of UM. In an exploratory projection based on incomplete records, misdiagnosis seldom appeared to sacrifice useful vision. The findings reinforce the value of multimodal imaging, ocular-oncology consultation, and consideration of biopsy before enucleation when the diagnosis is uncertain.

PMID 42665844
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PubMedCureus2026-08-29

A Narrative Review of Advances in Skin Tissue Engineering: From Physiological Architecture to 3D Bioprinting.

Bhatnagar Swasti S, Das Deepsekhar D

The skin is a complex, multilayered organ. Damage from burns, trauma, chronic ulcers, or surgical defects often outstrips the regenerative capacity of conventional healing. Traditional skin grafting, while standard, is limited due to donor site morbidity, lack of appendages, and altered biomechanical/sensory properties. This narrative review traces the evolution of skin repair from autografting to bioengineered substitutes and 3D bioprinting, emphasizing physiological design principles, biomaterials, and translational challenges. The literature synthesis mainly focused on skin architecture and wound-healing phases, limitations of epidermal/dermal grafts, development of acellular and cellular artificial skin, recent advances in bioinks, extrusion/inkjet/laser-assisted bioprinting, and functional appendage regeneration. Ophthalmic applications, including corneal and eyelid reconstruction, were also reviewed. Artificial skin substitutes evolved from acellular scaffolds to cell-seeded constructs using keratinocytes, fibroblasts, and decellularized extracellular matrix (ECM). Key biomaterials include hydrogels, collagen, and gellan gum as well as novel composites like eggshell membrane-alginate bioinks. In vivo models demonstrate accelerated re-epithelialization, organized collagen and vascularization with bioprinted grafts. Emerging technologies, such as 4D bioprinting with shape-memory polymers, smart dressings with biosensors, and in situ robotic bioprinting, promise adaptive, real-time wound repair. Biomaterials and fabrication strategies developed for cutaneous repair are increasingly relevant to ophthalmology and broader regenerative medicine. 3D bioprinting provides a viable translational route to functional, patient-specific artificial skin, overcoming key graft limitations. Future work must advance vascularized, multilayer constructs and move toward standardized, regulatory-aligned fabrication for clinical translation.

PMID 42666850
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PubMedJournal of current ophthalmology2026-08-29

Genotype-Phenotype Correlation in Dominant Optic Atrophy due to OPA1 c.3011T>C (p.Leu1004Pro): A Family-Based Case Series.

Küçük Hasan Can HC, Koçak Nilüfer N, Özizmirliler Denizcan D, Doğruya Suzan S et al.

To characterize the structural, functional, and optical coherence tomography angigraphy (OCTA) phenotype associated with the OPA1 c3011T>C (p.Leu1004Pro) variant in a multigenerational family with autosomal dominant optic atrophy. In this retrospective familial case series, four affected female relatives across three generations underwent ophthalmic examination including best-corrected visual acuity (BCVA), peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) imaging, Humphrey 24-2 visual fields, and 6 mm × 6 mm swept-source OCTA (SS-OCTA). Quantitative OCTA assessed parafoveal vessel density in the superficial capillary plexus (SCP). Next-generation sequencing in the index case and intrafamilial Sanger sequencing confirmed segregation. All subjects carried the heterozygous OPA1 c.3011T>C variant and showed a consistent optic neuropathy pattern with temporal disc pallor, selective temporal RNFL thinning, and macular GCC loss on a preserved outer retina without microcystic changes. BCVA ranged from 0.22 to 0.82 logMAR, indicating marked intrafamilial functional variability. Visual fields demonstrated central/centrocecal or paracentral defects with relative peripheral sparing, with more extensive central depression in the oldest case. On exploratory 6 mm × 6 mm SS-OCTA, parafoveal SCP vessel density values showed intercase variation without frank macular nonperfusion; findings are interpreted descriptively in the absence of device and age-matched internal controls. The OPA1 p.Leu1004Pro variant was associated with a stereotyped structural optic neuropathy pattern, whereas functional impairment showed marked intrafamilial variability. Exploratory SCP OCTA findings are descriptive only, given the absence of device and age-matched internal controls.

PMID 42667059
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PubMedFrontiers in immunology2026-08-29

Comparative analysis of microbiota in the ocular surface of patients with atopic keratoconjunctivitis and Stevens-Johnson Syndrome with severe ocular complications.

Ueta Mayumi M, Tse Ka Man KM, Nanri Hinako H, Nishigaki Hiromi H et al.

The interplay between host immunity and the microbiome is increasingly recognized as an important factor in ocular surface diseases. Although cutaneous and intestinal dysbiosis have been implicated in atopic dermatitis (AD), the role of the ocular microbiome in its severe ophthalmic manifestation, atopic keratoconjunctivitis (AKC), remains incompletely understood. We performed 16S rRNA gene sequencing to characterize the ocular and fecal microbiota of patients with AD and severe AKC, AD without severe ocular involvement, Stevens-Johnson syndrome (SJS) with severe ocular complications (SOC), and healthy controls. Microbial community composition was compared using principal coordinate analysis (PCoA) and taxonomic profiling. Ocular microbiota composition differed among the study groups. PCoA demonstrated that SJS samples clustered separately from healthy controls, whereas AKC samples occupied an intermediate position between the healthy control and SJS groups. Taxonomic analysis revealed enrichment of Corynebacterium 1 (a SILVA genus-level taxonomic assignment) in SJS, while AKC samples exhibited increased relative abundances of both Corynebacterium 1 and Staphylococcus. In contrast, AD patients without severe ocular involvement maintained an ocular microbial community broadly similar to that of healthy controls, including the presence of Neisseria. Analysis of paired fecal samples did not reveal disease-associated clustering or major compositional differences among the study groups. These findings suggest that, using genus-level 16S rRNA sequencing, disease-associated microbial alterations are more readily detected on the ocular surface than in the fecal microbiome in this cohort. The results support a potential contribution of the local ocular microenvironment to microbial signatures associated with immune-mediated ocular surface inflammation and provide a framework for future studies investigating the role of the ocular microbiome in disease pathogenesis.

PMID 42666841
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PubMedAdvances in ophthalmology practice and research2026-08-29

Evaluating large language model clinical reasoning in glaucoma using retrieval-augmented generation.

Yin Houfa H, Miao Qi Q, Zhou Wanshu W, Hu Chenyang C et al.

Large language models (LLMs) demonstrate strong performance in knowledge-based medical tasks, yet their clinical reasoning capabilities in complex ophthalmic decision-making, particularly glaucoma management, remain insufficiently characterized. Retrieval-augmented generation (RAG) has been proposed as a strategy to improve factual grounding and safety, but its clinical value requires systematic evaluation. We conducted a retrospective, scenario-based comparative evaluation using 40 real-world glaucoma cases spanning primary, secondary, postoperative, and end-stage disease. Six model conditions (GPT, Gemini, and Grok, each with and without RAG) were assessed using a guideline-grounded framework covering medical accuracy, key point coverage, logical completeness, and a separate qualitative safety audit. Model outputs were compared with written responses from four practicing ophthalmologists. All responses were independently scored by two masked glaucoma specialists using a prespecified ordinal rubric, and formal inter-rater reliability and paired sensitivity analyses were performed. RAG-enhanced models consistently outperformed their matched non-RAG counterparts across evaluation domains. In human-rating sensitivity analyses, the composite RAG advantage remained significant for GPT (mean difference=0.119, 95% CI: 0.068-0.173), Gemini (mean difference=0.095, 95% CI: 0.030-0.161), and Grok (mean difference=0.110, 95% CI: 0.033-0.194). Inter-rater agreement of the ordinal rubric was limited, supporting consensus adjudication and cautious interpretation of artificial intelligence-human comparisons. Retrieval augmentation was associated with more accurate, more complete, and more safety-aware glaucoma reasoning under this scenario-based evaluation. These findings support the potential value of RAG-enhanced LLMs as supervised clinical decision-support tools, but they do not establish standalone clinical use. Safety was evaluated as a separate audit layer rather than as part of the weighted composite score.

PMID 42666552
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PubMedJournal of optometry2026-08-28

Contact lenses alter accommodative dynamics but enhance stereopsis in myopic anisometropia: A comparative study with ophthalmic lenses.

Daradas Adithep A, Sankapong Busita B, Klamsakun Chanida C, Samunkhatkit Maturada M et al.

This study compared the binocular and accommodative efficiency of young adults with myopic isometropia versus myopic anisometropia, difference spherical equivalent refraction (SER) ≥ 1.00 diopter (D), when corrected with ophthalmic versus contact lenses. Seventy-two participants were categorized into isometropic (n = 36; age 21.92 ± 3.21 years) and anisometropic (n = 36; age 21.44 ± 2.62 years) myopia groups. Binocular and accommodative parameters were clinically evaluated under both ophthalmic and contact lens correction. Ophthalmic lens correction produced no significant differences (p > 0.05) in binocular visual efficiency between the two groups. Conversely, contact lens correction elicited distinct alterations in accommodative and vergence profiles. Myopic anisometropia showed a highly significant increase in accommodative lag when using contact lenses (p < 0.001) and increased negative relative accommodation (p = 0.007) compared to ophthalmic lenses. Furthermore, contact lenses amplified the fusional divergence demand to compensate for esophoria, thereby diminishing the near negative fusional vergence reserve (p = 0.012). Notably, contact lens wear was associated with better stereoacuity compared to ophthalmic lenses, which suggests a potential functional advantage in stereopsis for higher degrees of anisometropia, though this warrants further exploratory validation. In conclusion, while contact lenses distinctly alter accommodative and vergence dynamics, they may offer functional advantages in stereopsis for higher degrees of anisometropia. These comparative insights provide valuable clinical guidance for selecting refractive correction modalities to support specific binocular functions and stereoscopic performance.

PMID 42659889
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