Neuroprotection in glaucoma

Vasudevan, Shrihari; Gupta, Viney; Crowston, Jonathan G

doi:10.4103/0301-4738.73700

Cited by 59 publications

(48 citation statements)

References 86 publications

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“…Glutamate concentrations higher than the physiological levels are toxic to the neurons, and the degree of toxicity depends on the duration and magnitude of the increase. Excitotoxic neuronal injury is a self-perpetuating cascade of events caused by a continuous activation of ionotropic glutamate receptors [103,104]. However, an elevated glutamate level in the vitreous could not be confirmed in patients with glaucoma in more recent studies [105][106][107][108].…”

Section: Glutamate Antagonistsmentioning

confidence: 99%

“…Free radicals interfere with macromolecular cellular constituents of the cells and further lead to derangement of protein breakdown, lipid peroxidation and nucleic acid degeneration, resulting in cell death. To counteract this, ocular tissues have highly efficient antioxidant mechanisms that include the superoxide dismutasecatalase system, ascorbic acid and reduced glutathione [104]. Antioxidants such as vitamins C and E may reduce RGC death caused by NMDA-induced toxicity [128,129].…”

Section: Antioxidantsmentioning

confidence: 99%

“…Gingko biloba (EGb761), apart from increasing blood flow, has also been found to have a free radical scavenger property. Its extract is also known to preserve mitochondrial metabolism and enhance ATP production in various tissues [104].…”

Section: Antioxidantsmentioning

confidence: 99%

“…Stem cells are thought to exert neuroprotective effects by generating neurotrophic factors, modulating matrix metalloproteinases, and alter the CNS environment that may promote endogenous healing [104,132]. Research on stem cell mobilization and the possible neuroprotective contribution of granulocyte-colony stimulating factor (G-CSF) showed that G-CSF was strongly expressed by the RGCs, thereby providing neuroprotection in neurodegenerative diseases [133].…”

Section: Stem Cell Therapiesmentioning

confidence: 99%

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Diabetes Mellitus and Retinal Vein Occlusion as Risk Factors for Open Angle Glaucoma and Neuroprotective Therapies for Retinal Ganglion Cell Neuropathy

Bikbova¹,

Oshitari²,

Yamamoto³

2011

J Clin Exp Ophthalmol

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of glaucoma (NTG), and the prevalence of NTG is 3.6% in patients >40-years-of-age in Japan [10]. The average intraocular pressure (IOP) in patients with POAG is 15.4 ± 2.8 mmHg, which is significantly higher than that of normal subjects (14.5 ± 2.5 mmHg) [1][2][3][4][5][6][7][8][9][10] even though the average difference in the IOP is only 0.9 mmHg. Thus, a reduction of the IOP the standard therapy for glaucoma may not be sufficient for the complete management of the patients with glaucoma in Japan. Other therapeutic modalities, such as neuroprotection, should be considered for a complete therapeutic regimen for glaucoma patients.RGC death and axonal degeneration are most likely involved in the progression of DR, RVO, and glaucoma. Many neuroprotective therapies that prevent RGC death and axonal degeneration have been and are being investigated, and some of these neuroprotective factors may be used clinically in the near future. To establish neuroprotective therapies for DR, RVO and glaucoma, a determination of the exact mechanism that leads to a progression of RGC neuropathy to death and axonal degeneration is required [11]. However, the pathogenesis of the onset and progression of RGC neuropathy has still not been definitively determined. Identification of the risk factors for the onset and the progression of disease would help in determining the Abstract Glaucoma, diabetic retinopathy (DR), and retinal vein occlusion (RVO) are major diseases that can lead to blindness and affect mainly the elderly population worldwide. The results of recent investigations have demonstrated that the death of retinal ganglion cells (RGCs) and their axons is the common pathological change in these three disease processes. The exact mechanism that is responsible for the onset and progression of RGC death and axonal degeneration in patients with glaucoma, DR and RVO has not been definitively determined. Thus, identifying the risk factors for the onset and the progression of RGC neuropathy can help in deciding not only the specific treatments but also whether the treatments should be initiated, withheld, or augmented in individuals with glaucoma, DR, and RVO. This review describes the major risk factors for the onset of glaucoma, and the factors associated with the progression of glaucoma that have been obtained from large population-based prevalence and incidence studies. In addition, the potential risk factors for glaucoma, diabetes mellitus, and RVO are discussed in terms of the results obtained by both clinical and laboratory studies. This review introduces potential neuroprotective therapies for damaged RGC in eyes with RGC neuropathy, and the factors that should be considered for a complete therapy for the RGC neuropathy involved in glaucoma, DR and RVO. Neuroprotective therapies combined with a reduction of the IOP should be considered for the complete management of RGC neuropathy involved in glaucoma,

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Section: Glutamate Antagonistsmentioning

confidence: 99%

Section: Antioxidantsmentioning

confidence: 99%

Section: Antioxidantsmentioning

confidence: 99%

Section: Stem Cell Therapiesmentioning

confidence: 99%

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Diabetes Mellitus and Retinal Vein Occlusion as Risk Factors for Open Angle Glaucoma and Neuroprotective Therapies for Retinal Ganglion Cell Neuropathy

Bikbova¹,

Oshitari²,

Yamamoto³

2011

J Clin Exp Ophthalmol

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“…Though there are several theoretically effective neuroprotective therapies but unfortunately they remained somewhat limited in practice. Several pharmacologically active neuroprotective agents which showed great potential in the laboratory have almost invariably failed in the process of translation to clinic [14][15][16]. The current challenge for researchers in this field is to identify clinically effective neuroprotective agents.…”

mentioning

confidence: 99%

Combination Therapy in Glaucoma Treatment

Balabathula¹,

Janagam²,

Vuppala³

2013

Clin Exp Pharmacol

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Development of a Preference-Based Index From the National Eye Institute Visual Function Questionnaire–25

et al. 2014

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IMPORTANCE Understanding how individuals value health states is central to patient-centered care and to health policy decision making. Generic preference-based measures of health may not effectively capture the impact of ocular diseases. Recently, 6 items from the National Eye Institute Visual Function Questionnaire-25 were used to develop the Visual Function Questionnaire-Utility Index health state classification, which defines visual function health states.OBJECTIVE To describe elicitation of preferences for health states generated from the Visual Function Questionnaire-Utility Index health state classification and development of an algorithm to estimate health preference scores for any health state.DESIGN, SETTING, AND PARTICIPANTS Nonintervention, cross-sectional study of the general community in 4 countries (Australia, Canada, United Kingdom, and United States). A total of 607 adult participants were recruited from local newspaper advertisements. In the United Kingdom, an existing database of participants from previous studies was used for recruitment. INTERVENTIONS Eight of 15 625 possible health states from the Visual FunctionQuestionnaire-Utility Index were valued using time trade-off technique. MAIN OUTCOMES AND MEASURESA θ severity score was calculated for Visual Function Questionnaire-Utility Index-defined health states using item response theory analysis. Regression models were then used to develop an algorithm to assign health state preference values for all potential health states defined by the Visual Function Questionnaire-Utility Index.RESULTS Health state preference values for the 8 states ranged from a mean (SD) of 0.343 (0.395) to 0.956 (0.124). As expected, preference values declined with worsening visual function. Results indicate that the Visual Function Questionnaire-Utility Index describes states that participants view as spanning most of the continuum from full health to dead. CONCLUSIONS AND RELEVANCEVisual Function Questionnaire-Utility Index health state classification produces health preference scores that can be estimated in vision-related studies that include the National Eye Institute Visual Function Questionnaire-25. These preference scores may be of value for estimating utilities in economic and health policy analyses.

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Neuroprotection in glaucoma

Cited by 59 publications

References 86 publications

Diabetes Mellitus and Retinal Vein Occlusion as Risk Factors for Open Angle Glaucoma and Neuroprotective Therapies for Retinal Ganglion Cell Neuropathy

Diabetes Mellitus and Retinal Vein Occlusion as Risk Factors for Open Angle Glaucoma and Neuroprotective Therapies for Retinal Ganglion Cell Neuropathy

Combination Therapy in Glaucoma Treatment

Development of a Preference-Based Index From the National Eye Institute Visual Function Questionnaire–25

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