Neuroprotective Agents in Glaucoma

Glaucoma is an irreversible condition resulting from the increase in intraocular pressure (IOP); which leads to permanent loss of vision with the destruction of retinal ganglion cells (RGCs). The IOP elevations are controlled in normal by the physiological flow of aqueous humour. A population with age above 40 is more susceptible to glaucoma. Other factors like gender, genetics, race etc. plays major roles in the development of the disease. Current treatment methods available for the disease includes drugs come under the classes of beta receptor blockers, carbonic anhydrase inhibitors, cholinergic agonists, prostaglandins etc. N-methyl-D-aspartate (NMDA) antagonists, inducible nitric oxide synthase (iNOS) inhibition, cytoskeletal agents, Rho-kinase inhibitors etc are few novel targets sites which are in research focus for the treatment of the disease. Developments in nanomedicine are also being evaluated for their potential in treating the growing glaucomatous population. Nanosystems are suggested to avoid the difficulties in tackling the various ocular barriers to a limit, help to decrease the instillation frequency of topical medication and can provide drug delivery in a sustained or controlled manner. This review focuses on the current and emerging treatment methods for glaucoma along with some of the nanoformulations for ocular drug delivery.

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“…18,51,52 Some of the compounds having neuroprotective property and thus improves RGCs survival are mentioned in Table 2. 53…”

Section: Neuroprotectives In Glaucomamentioning

confidence: 99%

“…64,65 Mitochondrial dysfunction is reported to be involved in apoptosis of neurons and ubiquinone can counteract these effects. 53…”

Section: Gingko Bilobamentioning

confidence: 99%

A Review on Newer Ocular Drug Delivery Systems with an Emphasis on Glaucoma

Peter

Panonnummal

2020

Adv Pharm Bull

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“…Neuroprotective therapies for glaucoma should aim to halt RGC loss thus preventing further structural and functional damage of the optic nerve (4) . Since its introduction in 1996, the use of brimonidine has become an increasingly popular ocular hypotensive therapy (5) .…”

Section: Introductionmentioning

confidence: 99%

Role of Visual Field Testing and OCT in Evaluation of Brimonidine as a Neuroprotector in Primary Open Angle Glaucoma

Nassar¹,

Khairy²,

Gohary³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Glaucoma is the leading cause of global irreversible blindness optic neuropathy and retinal ganglion cell (RGC) death are the hallmarks of glaucoma. If intraocular pressure (IOP) is held within "normal" ranges, the disease process and RGC death can still progress in some patients. Neuroprotective therapies for glaucoma should aim to halt RGC loss thus preventing further structural and functional damage of the optic nerve Objective: The aim of the current work was to study the ability of visual field testing and optical coherence tomography to reveal the neuroprotective role of brimonidine. Patients and Methods: This prospective randomized controlled trial study included a total of 98 eyes from 50 patients affected by primary open-angle glaucoma (POAG). They were recruited from a larger population of 70 POAG patients, attending at Menofiya University Hospitals. Results: The use of visual field-testing parameters have revealed that brimonidine had insignificantly halted glaucoma progression: MD (-0.1115 dB and -.2465 dB), VFI (-0.5882 and-1.1471) and PSD (0.1729 and 0.1894). On the other hand, some OCT parameters: average RNFL thickness (-0.7273 u and-2.2121 u), inferior RNFL thickness (-0.735 u and -1.559 u), superior RNFL thickness (-0.6364u and -1.4848 u), rim area (-0.0162 mm 2 and-0.0797 mm 2 ), average cup disc ratio (-0.01765 and 0.01824) and vertical cup disc ratio (-0.0167 and 0.0321) for study and control groups respectively, gave promising neuroprotective results for brimonidine. Conclusion:It could be concluded that the use of visual field-testing parameters (MD, VFI and PSD) has revealed that brimonidine had insignificantly halted glaucoma progression.

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“…GON can be regarded as a neurodegenerative disease (like Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis) [10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Pathophysiological mechanisms common to the both types of disease are: disorder of the cerebral/ocular blood flow autoregulation, endothelial dysfunction and alteration of microcirculation, glutamate release, activation of mitochondrial enzymes (caspases), activation of apoptosis neuronal damage [15,17].…”

Section: Introductionmentioning

confidence: 99%

Decreasing Medication of Intraocular Pressure in Open Angle Glaucoma

2014

Med. Con.

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The primary open-angle glaucomas (POAG) are multi-factorial, chronic, progressive and bilateral optic neuropathies characterized by morphological changes at the optic nerve head and retinal nerve fiber layer in the absence of other ocular disease or congenital anomalies. These changes are associated with progressive retinal ganglion cells death and visual field loss. Simultaneously with the nerve fiber layer loss occurs an activation of glial cells and tissue reshaping which lead to the characteristic excavation of the optic nerve (ON) and a reduction of the blood flow.Among the risk factors involved in glaucoma, the intraocular pressure (IOP) is the principal and most known. In the present, the goal of the "classical" treatment in glaucoma (drugs, laser, surgery) is to decreased IOP until values to not endanger ON. There are cases in which (IOP) is reduced until minimum acceptable values, but, glaucomatous optic neuropathy (GON) continues to evolve.

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Neuroprotective Agents in Glaucoma

Cited by 5 publications

References 163 publications

A Review on Newer Ocular Drug Delivery Systems with an Emphasis on Glaucoma

A Review on Newer Ocular Drug Delivery Systems with an Emphasis on Glaucoma

Role of Visual Field Testing and OCT in Evaluation of Brimonidine as a Neuroprotector in Primary Open Angle Glaucoma

Decreasing Medication of Intraocular Pressure in Open Angle Glaucoma

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