A review of potential novel glaucoma therapeutic options independent of intraocular pressure

Shalaby, Wesam Shamseldin; Ahmed, Osama M.; Waisbourd, Michael; Katz, L. Jay

doi:10.1016/j.survophthal.2021.12.003

Cited by 25 publications

(29 citation statements)

References 222 publications

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“…Elevated IOP is a significant risk factor for the development and progression of glaucoma [ 13 ]. IOP is currently the only modifiable parameter that clinicians adapt to control or stop glaucomatous damage [ 14 ]. The correlation between raised IOP and glaucoma is not a new one.…”

Section: Glaucoma and Iopmentioning

confidence: 99%

Corneal Hysteresis, Intraocular Pressure, and Progression of Glaucoma: Time for a “Hyst-Oric” Change in Clinical Practice?

Murtagh

O’Brien

2022

JCM

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It is known that as people age their tissues become less compliant and the ocular structures are no different. Corneal Hysteresis (CH) is a surrogate marker for ocular compliance. Low hysteresis values are associated with optic nerve damage and visual field loss, the structural and functional components of glaucomatous optic neuropathy. Presently, a range of parameters are measured to monitor and stratify glaucoma, including intraocular pressure (IOP), central corneal thickness (CCT), optical coherence tomography (OCT) scans of the retinal nerve fibre layer (RNFL) and the ganglion cell layer (GCL), and subjective measurement such as visual fields. The purpose of this review is to summarise the current evidence that CH values area risk factor for the development of glaucoma and are a marker for its progression. The authors will explain what precisely CH is, how it can be measured, and the influence that medication and surgery can have on its value. CH is likely to play an integral role in glaucoma care and could potentially be incorporated synergistically with IOP, CCT, and visual field testing to establish risk stratification modelling and progression algorithms in glaucoma management in the future.

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Section: Glaucoma and Iopmentioning

confidence: 99%

Corneal Hysteresis, Intraocular Pressure, and Progression of Glaucoma: Time for a “Hyst-Oric” Change in Clinical Practice?

Murtagh

O’Brien

2022

JCM

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“…Neuroprotection is an ideal therapeutic approach in glaucoma to keep RGCs alive ( Almasieh and Levin, 2017 ). The goal of neuroprotection in glaucoma is to preserve the optic nerve independent of the IOP reduction and thus prevent or delay the RGC apoptosis and axonal degeneration ( Tsai, 2020 ; Shalaby et al, 2021 ). Hence, any protective intervention that directly aims at promoting the health and survival of RGCs has the potential as an antiglaucoma agent.…”

Section: Bdnf As a Neuroprotective Agentmentioning

confidence: 99%

Brain-Derived Neurotrophic Factor-Mediated Neuroprotection in Glaucoma: A Review of Current State of the Art

et al. 2022

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Retinal ganglion cells (RGCs) are neurons of the visual system that are responsible for transmitting signals from the retina to the brain via the optic nerve. Glaucoma is an optic neuropathy characterized by apoptotic loss of RGCs and degeneration of optic nerve fibers. Risk factors such as elevated intraocular pressure and vascular dysregulation trigger the injury that culminates in RGC apoptosis. In the event of injury, the survival of RGCs is facilitated by neurotrophic factors (NTFs), the most widely studied of which is brain-derived neurotrophic factor (BDNF). Its production is regulated locally in the retina, but transport of BDNF retrogradely from the brain to retina is also crucial. Not only that the interruption of this retrograde transport has been detected in the early stages of glaucoma, but significantly low levels of BDNF have also been detected in the sera and ocular fluids of glaucoma patients, supporting the notion that neurotrophic deprivation is a likely mechanism of glaucomatous optic neuropathy. Moreover, exogenous NTF including BDNF administration was shown reduce neuronal loss in animal models of various neurodegenerative diseases, indicating the possibility that exogenous BDNF may be a treatment option in glaucoma. Current literature provides an extensive insight not only into the sources, transport, and target sites of BDNF but also the intracellular signaling pathways, other pathways that influence BDNF signaling and a wide range of its functions. In this review, the authors discuss the neuroprotective role of BDNF in promoting the survival of RGCs and its possible application as a therapeutic tool to meet the challenges in glaucoma management. We also highlight the possibility of using BDNF as a biomarker in neurodegenerative disease such as glaucoma. Further we discuss the challenges and future strategies to explore the utility of BDNF in the management of glaucoma.

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“…IOP is currently the main line of therapy to slow down the neurodegenerative progression of the disease [14]. Therefore, IOP unrelated therapies are increasingly investigated for the treatment of glaucoma to stop neurodegeneration [15].…”

Section: Introductionmentioning

confidence: 99%

Topical Drug Delivery to the Posterior Segment of the Eye

et al. 2022

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Topical drug delivery to the posterior segment of the eye is a very complex challenge. However, topical delivery is highly desired, to achieve an easy-to-use treatment option for retinal diseases. In this review, we focus on the drug characteristics that are relevant to succeed in this challenge. An overview on the ocular barriers that need to be overcome and some relevant animal models to study ocular pharmacokinetics are given. Furthermore, a summary of substances that were able to reach the posterior segment after eye drop application is provided, as well as an outline of investigated delivery systems to improve ocular drug delivery. Some promising results of substances delivered to the retina suggest that topical treatment of retinal diseases might be possible in the future, which warrants further research.

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A review of potential novel glaucoma therapeutic options independent of intraocular pressure

Cited by 25 publications

References 222 publications

Corneal Hysteresis, Intraocular Pressure, and Progression of Glaucoma: Time for a “Hyst-Oric” Change in Clinical Practice?

Corneal Hysteresis, Intraocular Pressure, and Progression of Glaucoma: Time for a “Hyst-Oric” Change in Clinical Practice?

Brain-Derived Neurotrophic Factor-Mediated Neuroprotection in Glaucoma: A Review of Current State of the Art

Topical Drug Delivery to the Posterior Segment of the Eye

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