Current Medical Therapy and Future Trends in the Management of Glaucoma Treatment

Cvenkel, Barbara; Kolko, Miriam

doi:10.1155/2020/6138132

Cited by 73 publications

(68 citation statements)

References 157 publications

(187 reference statements)

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“…Unfortunately, oral memantine did not show any significant prevention of glaucoma progression when tested in a clinical trial ( 191 ). Another modulator of glutamate-induced toxicity, brimonidine, has been proposed to slow the rate of glaucoma progression in glaucoma patients in an additive manner other than its IOP-lowering effect ( 192 ). In a rodent model, brimonidine was shown to modulate glutamate uptake by glial cells after induction of ocular hypertension, suggesting neuroprotection through modulation of macroglia ( 193 ).…”

Section: Therapeutic Approachesmentioning

confidence: 99%

Glial Cells in Glaucoma: Friends, Foes, and Potential Therapeutic Targets

et al. 2021

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Glaucoma is the second leading cause of blindness worldwide, affecting ~80 million people by 2020 (1, 2). The condition is characterized by a progressive loss of retinal ganglion cells (RGCs) and their axons accompanied by visual field loss. The underlying pathophysiology of glaucoma remains elusive. Glaucoma is recognized as a multifactorial disease, and lowering intraocular pressure (IOP) is the only treatment that has been shown to slow the progression of the condition. However, a significant number of glaucoma patients continue to go blind despite intraocular pressure-lowering treatment (2). Thus, the need for alternative treatment strategies is indisputable. Accumulating evidence suggests that glial cells play a significant role in supporting RGC function and that glial dysfunction may contribute to optic nerve disease. Here, we review recent advances in understanding the role of glial cells in the pathophysiology of glaucoma. A particular focus is on the dynamic and essential interactions between glial cells and RGCs and potential therapeutic approaches to glaucoma by targeting glial cells.

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Section: Therapeutic Approachesmentioning

confidence: 99%

Glial Cells in Glaucoma: Friends, Foes, and Potential Therapeutic Targets

et al. 2021

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“…Some crucial issues such as systemic side effects and tolerance development advise against cannabinoids usage as IOP lowering drugs. Beside these observations, we must notice that in recent years a huge number of efficient and safe IOP lowering drugs have been delivered to market and new anti-glaucoma agents such as small interfering RNA (siRNA) and Adenosine receptors agonists are available in the pipeline [ 93 ]. In this scenario, clinical application of cannabinoids as IOP lowering agents seems even more unlikely.…”

Section: Discussionmentioning

confidence: 99%

Cannabinoids in Glaucoma Patients: The Never-Ending Story

Passani

Posarelli

Sframeli

et al. 2020

JCM

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Glaucoma is one of the principal causes of irreversible blindness worldwide. Yet, intraocular pressure (IOP) is the main modifiable risk factor for disease progression. In the never-ending challenge to develop new and effective drugs, several molecules have been tested as anti-glaucoma agents thanks to their pressure-lowering capabilities. Among these molecules, the cannabinoids have been investigated as possible anti-glaucoma drugs since the early 1970s. Cannabinoids are a large class of chemical compounds that exploit their effects by interaction with cannabinoid receptors 1 and 2. These receptors are widely expressed in the human retina where they may influence important functions such as photo-transduction, amacrine cell network maintenance, and IOP regulation. Therefore, in past years several studies have been conducted in order to assess the IOP lowering effects of cannabinoids. PRISMA guidelines have been used to perform a literature search on Pubmed and Scopus aiming to investigate the mechanism of IOP lowering effects and the potential benefits of orally administered, inhaled, topical, and intravenous cannabinoids in the treatment of glaucoma patients.

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“…There is an obvious need for the development of new medications for glaucoma, given that current treatments work to lower IOP only. However, these treatments are not successful in all patients [110,111]. NLRP3 may be a promising IOP independent target for the treatment of glaucoma [112].…”

Section: Nlrp3 Inflammasome As a Target For Therapy In Glaucomamentioning

confidence: 99%

Targeting the NLRP3 Inflammasome in Glaucoma

et al. 2021

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Glaucoma is a group of optic neuropathies characterised by the degeneration of retinal ganglion cells, resulting in damage to the optic nerve head (ONH) and loss of vision in one or both eyes. Increased intraocular pressure (IOP) is one of the major aetiological risk factors in glaucoma, and is currently the only modifiable risk factor. However, 30–40% of glaucoma patients do not present with elevated IOP and still proceed to lose vision. The pathophysiology of glaucoma is therefore not completely understood, and there is a need for the development of IOP-independent neuroprotective therapies to preserve vision. Neuroinflammation has been shown to play a key role in glaucoma and, specifically, the NLRP3 inflammasome, a key driver of inflammation, has recently been implicated. The NLRP3 inflammasome is expressed in the eye and its activation is reported in pre-clinical studies of glaucoma. Activation of the NLRP3 inflammasome results in IL-1β processing. This pro inflammatory cytokine is elevated in the blood of glaucoma patients and is believed to drive neurotoxic inflammation, resulting in axon degeneration and the death of retinal ganglion cells (RGCs). This review discusses glaucoma as an inflammatory disease and evaluates targeting the NLRP3 inflammasome as a therapeutic strategy. A hypothetical mechanism for the action of the NLRP3 inflammasome in glaucoma is presented.

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Current Medical Therapy and Future Trends in the Management of Glaucoma Treatment

Cited by 73 publications

References 157 publications

Glial Cells in Glaucoma: Friends, Foes, and Potential Therapeutic Targets

Glial Cells in Glaucoma: Friends, Foes, and Potential Therapeutic Targets

Cannabinoids in Glaucoma Patients: The Never-Ending Story

Targeting the NLRP3 Inflammasome in Glaucoma

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