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Ординатура / Офтальмология / Английские материалы / Glaucoma An Open Window to Neurodegeneration and Neuroprotection_Nucci, Cerulli, Osborne_2008.pdf
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C. Nucci et al. (Eds.)

Progress in Brain Research, Vol. 173

ISSN 0079-6123

Copyright r 2008 Elsevier B.V. All rights reserved

CHAPTER 32

Glaucoma of the brain: a disease model for the study of transsynaptic neural degeneration

Yeni Yu¨cel1,2, and Neeru Gupta1,2

1Department of Ophthalmology and Vision Sciences, Keenan Research Centre at the Li Ka Shing, Knowledge Institute of

St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

2Department of Laboratory Medicine and Pathobiology, Keenan Research Centre at the Li Ka Shing, Knowledge Institute

of St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

Abstract: The identification of mechanisms precipitating neuronal death and injury is an intense area of investigation requiring reliable models to assess the effects of neuroprotective agents. Most are suboptimal since the effects of initial damage are diffuse and may not be reproducible or easily quantifiable. The ideal laboratory model should have the ability to (a) clearly detect evidence of neuronal injury and recovery,

(b) accurately measure morphologically the extent of these changes, and (c) provide functional evidence for damage and recovery. Glaucoma is a disease of visual neurons in the eye and brain. In the visual system, neuroanatomical pathways and retinotopic organization are exquisitely defined, functional modalities are highly characterized and can be dissected physiologically, visual input parameters can be modified, visual functional output can be readily tested and measured, changes in the eye and the visual brain can be directly visualized and imaged, and pathological and compensatory changes in brain centers of vision can be examined and measured specifically. For these reasons, the glaucoma disease model is ideal for the study of response and recovery to injury in the central nervous system due to anterograde and retrograde degeneration from the eye to the brain and the brain to the eye, respectively. The study of this glaucoma model of transsynaptic brain injury may be relevant to understanding more complex pathways and point to new strategies to prevent disease progression in other neurodegenerative diseases.

Keywords: Alzheimer’s disease; neurodegenerative diseases; glaucoma; models; cell atrophy; cell death; blood flow; retinal ganglion cell

Glaucoma is a leading cause of irreversible world blindness estimated to affect more than 79.6 million persons by year 2020 (Quigley and Broman, 2006). Vision loss is caused by cell death and injury to retinal ganglion cells (RGCs) (Quigley, 1999; Weinreb and Khaw, 2004), and the diagnosis of

Corresponding author. Tel.: +1 416 864 6060, Ext. 3168; Fax: +1 416 864 5208; E-mail: yeni.yucel@utoronto.ca

glaucoma is based on characteristic patterns of optic nerve fiber loss revealed by ophthalmological examination. It is often associated with elevated intraocular pressure (IOP), a major risk factor for the development of the disease and one that is modifiable by current IOP-lowering treatments (Weinreb and Khaw, 2004). Reducing IOP medically and surgically has been shown to slow the progression of vision loss in glaucoma, including in those patients without elevated IOP, so-called

DOI: 10.1016/S0079-6123(08)01132-1

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