Ординатура / Офтальмология / Английские материалы / Ocular Therapeutics Eye on New Discoveries_Yorio, Clark, Wax_2007

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I. INTRODUCTION

Glaucoma is the most common optic neuropathy characterized by irreversible degeneration of retinal ganglion cells (RGC) and their axons. Treatment options for this neuropathy are currently limited to lowering intraocular pressure. However, glaucomatous neuropathy commonly progresses even after IOP reduction. New strategies to preserve remaining retinal ganglion neurons are therefore essential. In this chapter, we summarize the existing knowledge of RGC neuroprotection that has been applied to animal models with induced RGC degeneration in the context of our understanding RGC pathophysiology. Experimental data show the neuroprotective effects of various agents and strategies, such as supplying neurotrophins, blocking excess glutamate stimulation, stabilizing

Ca2 homeostasis, preventing apoptosis, modulating immunologic status via vaccination, and inducing endogenous neuroprotective mechanisms. These studies have provided optimism that some of these treatments will have beneficial effects in future clinical trials.

Glaucomatous optic neuropathy affects more than 70 million people worldwide and, if left untreated, it can lead to severe visual impairment and blindness (Leske et al., 1983) (it accounts for 10% of total cases of blindness in the US). The degeneration of retinal ganglion cells (RGCs) and their axons in the optic nerve is the cause of visual field loss in glaucoma patients (Quigley et al., 1981). The optic nerve head at the lamina cribrosa location is the most probable area where RGCs are initially injured in glaucoma (Anderson and Hendrickson, 1974; Quigley et al., 1981). Chronic forms