Neuroprotection in glaucoma: recent advances and clinical translation

Clin Exp Ophthalmol. 2019 Jan;47(1):88-105. doi: 10.1111/ceo.13336. Epub 2018 Jul 1.

Abstract

Intraocular pressure (IOP) reduction is currently the only evidence-based treatment strategy for glaucoma. However, IOP control in some individuals is challenging. Despite optimal treatment, a significant proportion of individuals will progress, with loss of visual field, loss of driving vision and impaired quality of life. A new modality that could augment current treatment and reduce the rate of neurodegeneration to preserve vision throughout life would be a major breakthrough. A vast number of studies have reported effective neuroprotection in animal models of glaucoma; however, translation to the clinic remains a major hurdle. Herein, we explore the therapeutic advancements in non-IOP-dependent neuroprotection research based upon potential pathogenic mechanisms and propose strategies to improve the clinical translation of neuroprotective research in glaucoma.

Keywords: bioenergetics; clinical translation; glaucoma; neuroprotection; retinal ganglion cell.

Publication types

  • Review

MeSH terms

  • Genetic Therapy / methods*
  • Glaucoma / drug therapy*
  • Glaucoma / physiopathology
  • Humans
  • Intraocular Pressure / physiology*
  • Neuroprotection*
  • Neuroprotective Agents / therapeutic use*
  • Quality of Life
  • Retinal Ganglion Cells / pathology*
  • Visual Fields / physiology*

Substances

  • Neuroprotective Agents