Cerebral Modifications in Glaucoma and Macular Degeneration: Analysis of Current Evidence in Literature and Their Implications on Therapeutic Perspectives

Abstract

Glaucoma and macular degeneration are leading causes of irreversible blindness, significantly compromising the quality of life and having a high economic and social impact. Promising therapeutic approaches aimed at regenerating or bypassing the damaged anatomical-functional components are currently under development: these approaches have generated great expectations, but to be effective require a visual network that, despite the pathology, maintains its integrity up to the higher brain areas. In the light of this, the existing findings concerning how the central nervous system modifies its connections following the pathological damage caused by glaucoma and macular degeneration acquire great interest. This review aims to examine the scientific literature concerning the morphological and functional changes affecting the central nervous system in these pathological conditions, summarizing the evidence in an analytical way, discussing their possible causes and highlighting the potential repercussions on the current therapeutic perspectives.

Efficacy of a Spearmint (Mentha spicataL.) Extract as Nutritional Support in a Rat Model of Hypertensive Glaucoma

“… 31 , 32 The metabolic and neurotrophic imbalances in retinal tissues can be related to the morphological and functional changes along the visual pathway and in numerous brain areas outside the visual pathway known to affect the CNS in glaucoma. 7 …”

“…Current research advancing this understanding links glaucoma to degeneration of the central nervous system (CNS), moving it away from being considered just a traditional eye disease. A recent review assessing the morphological and functional changes affecting the CNS in glaucoma 7 reported structural alterations along the visual pathway and in numerous cognitive functions outside the visual pathway, such as for visual memory, working memory, attention, and motor coordination. These observations suggest that independent mechanisms of neurodegeneration in glaucoma are potentially affecting neural tissues in addition to the known anterograde and/or retrograde neuronal degeneration.…”

“…These observations suggest that independent mechanisms of neurodegeneration in glaucoma are potentially affecting neural tissues in addition to the known anterograde and/or retrograde neuronal degeneration. 7 – 9 Recent evidence also suggests that metabolic stress and bioenergetic insufficiency play key roles in the progression of glaucoma ultimately resulting in RGC degeneration through the promotion of oxidative stress and inflammation. 10 , 11 Furthermore, levels of neurotrophic factors such as brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) could play a key role in the progression of glaucoma.…”

Glaucoma – a neurodegenerative disease with cerebral neuroconnectivity elements

“…The role of these studies showed that a decrease of volume with structural micro-alterations, which especially affects the white matter, is to show the neurodegenerative character of glaucoma with implications for future therapies [ 41 , 59 ], but also to emphasize the cerebral modifications of the cerebral networks in glaucoma [ 43 , 44 ].…”

Retinal Microvascular Dysfunction Occurs Early and Similarly in Mild Alzheimer’s Disease and Primary-Open Angle Glaucoma Patients

“…The possibility that Alzheimer's disease (AD) and primary open angle glaucoma (POAG) may share a common underlying aetiology has been increasingly realised over recent years [1]. This stems not only from their obvious similarities as chronic neurodegenerative diseases associated with aging, but also from the results of numerous epidemiological [2,3], pathological [4][5][6] and vascular studies [7][8][9][10].…”