Neuroprotection in Glaucoma: A Review

Authors

  • Bassey Fiebai Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State,
  • Elizabeth Awoyesuku Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State

DOI:

https://doi.org/10.60787/tnhj.v11i2.51

Keywords:

Neuroprotection, Glaucoma.

Abstract

Background: Glaucoma, globally the second most common cause of blindness and the commonest cause of preventable visual disability, is a progressive neurodegenerative disease of the retinal ganglion cells and their axons .Neuroprotection is an evolving area in the management of glaucoma. This review aims to highlight the current neuroprotective agents under investigation and the promise they hold for future management of glaucoma.

Method: The available literature on the use of Neuroprotection in Glaucoma was reviewed using available journals and internet based search engines such as pubmed and Medline. Keywords employed were Neuroprotection and Glaucoma.

Results: There is ongoing research on neuroprotective agents in management of glaucoma. A few of the currently available anti glaucoma medications also have neuroprotective functions. The mainstay of glaucoma management however remains lowering of intraocular pressure. Nigerian literature on neuroprotection was not available.

Conclusion: It has become increasingly obvious that glaucoma represents a complex multifactorial disease that produces an accelerated rate of ganglion cell atrophy related to a numerous pathogenic mechanisms that not only most certainly involve IOP, but also include defective auto regulation and ischaemia; neurotrophic factor deficiency; glutamate mediated excitotoxicity, immune related phenomenon; intracellular calcium influx and free radical damage3.IOP lowering still remains the mainstay of treatment. Neuroprotection has promise for preventing retinal cell ganglion death independent of IOP.It therefore presents an exciting development in the pursuit for a treatment modality for this debilitating disease.

Downloads

Download data is not yet available.

References

Kaushik S, Pandav SS, Ram J.Neuroprotection in glaucoma. Journal of Postgraduate Medicine 2003; 49(1):90-95.

Schwartz M.Neurodegeneration and Neuroprotection in Glaucoma: Development of a Therapeutic Neuroprotective Vaccine. Investigative Ophthalmology and Visual Science 2003; 44:1407-1411.

Vasudevan SK, Gupta V, Crowton JG. Neuroprotection in glaucoma. Indian J Ophthalmol 2011; 59:102-113.

The Advanced Glaucoma Intervention Study (AGIS): Study design and methods and baseline characteristics ofstudy patients. Control Clin Trials 1994; 15: 299-325.

Sommer A. Collaborative normal-tension glaucoma study. Am J Ophthalmol 1999; 128:776-777.

Heijl A, Leske MC, Bengtsson B, Hyman L, Hussein M.Reduction of intraocular pressure and glaucoma progression: Results from the Early Manifest Glaucoma Trial. Arch Ophthalmol 2002; 120: 1268-79.

Cheunq W, Guo L, Cordeir MF. Neuroprotection in glaucoma: drug-based approaches. Optom Vis Sci 2008; 85(6): 406-416.

Levin LA, Peeples P. History of Neuroprotection and rationale as therapy for glaucoma. Am J Manag Care 2008 Feb; 14(I Suppl): S11-4

Weinreb RN, Levin LA. Is Neuroprotection a viable therapy for glaucoma? Arch Ophthalmol 1999 Nov;117(11):1540-4

Lebrun-Julien F, DiPolo A. Molecular and cell-based approaches for Neuroprotection in glaucoma. Optom Vis Sci.2008 Jun;85(6):417-24

Krupin T. Neuroprotection and Glaucoma. Cited 2010 June 28.Available from http//medscapeCMEOphthalmology.

Wein FB, Levin LA. Current Understanding ofNeuroprotection in glaucoma. Curr Opin Ophthalmol 2002 Apr;13(2):61-7

Chua B, Goldberg I. Neuroprotective Agents in Glaucoma Therapy: Recent Developments and Future Directions. Expert Review of Ophthalmology 2010; 5(5): 627-636.

Hartwick AT. Beyond intraocular pressure: neuroprotective strategies for future glaucoma therapy. Optom Vis Sci. 2001 Feb;18(2):85-94

Osborne NN, Chidlow G, Layton CJ, Wood JP, Casson RJ, Melena J.Optic nerve and Neuroprotection strategies. Eye(Lond) 2004 Nov;18(11):1075-84

Quigley HA. Neuronal death in glaucoma. Prog. Retin. Eye Res. 1999; 18(1): 39-57.

Tamada Y, Nakajima T, Shearer TR, Azuma M. Proteolysis of neuronal cytoskeletal proteins by calpain contributes to rat retinal cell death induced by hypoxia. Brain Res.2005; 1050(1-2):148-155.

Saylor M, McLoon LK, Harrison AR, Lee MS. Experimental and clinical evidence for Brimonidine as an optic nerve and retinal neuroprotective agent: an evidence- based review. Arch. Ophthalmol. 2009; 127(4): 402-406.

Wheeler L, WoldeMussie E, Lai R. Role of alpha 2 agonists in neuroprotection. Surv. Ophthalmol.2003; 48(Suppl 1) S47-S51.

Fitzgerald M, Payne SC, Bartlett CA, Evill L, Harvey AR, Dunlop SA.Secondary retinal ganglion cell death and the neuroprotective effects of the calcium channel blocker lomerizine. Invest. Ophthalmol. Vis. Sci. 2009; 50(11): 5456-5462.

Koseki N, Araie M, Tomidokoro A et al. A placebo- controlled 3- year study of a calcium channel blocker on visual field and ocular circulation in glaucoma with low normal pressure. Ophthalmology.2008; 115(11):2049-2057.

Downloads

Published

2015-12-03

How to Cite

Fiebai, B., & Awoyesuku, E. (2015). Neuroprotection in Glaucoma: A Review. The Nigerian Health Journal, 11(2), 43. https://doi.org/10.60787/tnhj.v11i2.51
Abtract Views | PDF Download | EPUB Download: 621 / 56