Title:Neuroprotective Strategies in Glaucoma
Volume: 22
Issue: 14
Author(s): Cynthia A. Gossman, John Christie, Mark K. Webster, David M. Linn and Cindy L. Linn
Affiliation:
Keywords:
Glaucoma, retina, neuroprotection, neuropharmacology, stem cells, gene therapy, glaucoma treatment, cholinergic neuroprotection.
Abstract: Background: Glaucoma is characterized as a neuropathic disease that causes progressive degeneration
of retinal ganglion cells (RGCs) in the retina, resulting in irreversible loss of vision. All conventional treatments for
glaucoma are focused on reducing intraocular pressure (IOP) in the anterior chamber of the eye. However, these
treatments alone are insufficient to halt the progression of the disease. As a result, neuroprotective strategies have
been developed that prevent retinal neuron loss and disease progression. Methods: The goal of this review is to
summarize and discuss neuroprotective strategies in glaucoma at the level of the retina and the ganglion cell layer
instead of treatments targeting IOP. Recent and past neuroprotective therapies used to prevent the loss of retinal
ganglion cells, the loss of axons in the optic nerve and the loss of vision and function associated with glaucoma are
presented. Results: Pharmacological approaches have targeted specific receptors, signaling cascades and neurotrophic
factors to induce neuroprotection in the retina, while others have focused on the mechanism of cellular loss associated with glaucoma,
including excitotoxicity, oxidative stress and apoptotic processes. In addition to neuroprotective pharmacological treatments, stem
cell, gene therapy and viral research have demonstrated neuroprotection against the loss of RGCs in glaucomatous conditions. Conclusion:
It is likely that future development for glaucoma treatment will include a combination of these treatments to prevent the pathophysiology
of glaucoma.
