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Review
. 2020 Apr 10:2020:9329310.
doi: 10.1155/2020/9329310. eCollection 2020.

Innovative IOP-Independent Neuroprotection and Neuroregeneration Strategies in the Pipeline for Glaucoma

James C Tsai  1
Affiliations
Review

Innovative IOP-Independent Neuroprotection and Neuroregeneration Strategies in the Pipeline for Glaucoma

James C Tsai. J Ophthalmol. .

Abstract

While sustained reduction of intraocular pressure (IOP) has been shown to halt and/or delay the progressive death of retinal ganglion cells (RGCs) in glaucoma, there exists great interest in the development and validation of IOP-independent therapeutic strategies for neuroprotection and/or neuroregeneration. Multiple etiologies for RGC death have been implicated in glaucoma including defective axonal transport, ischemia, excitotoxicity, reactive oxygen species, trophic factor withdrawal, and loss of RGC electrical activity. However, IOP lowering with medical, laser, and surgical therapies is itself neuroprotective, and investigators are seeking to identify agents that are able to confer neuroprotection independent of IOP reduction, as well as providing for regeneration of nonviable RGCs and their axons to restore and/or maintain functional vision. These innovative strategies in the pipeline include investigation of neurotrophic factors, gene therapy, immune system modulation, and novel neuroregeneration pathways. Alongside this new knowledge, enhanced opportunities for discovery of vision preservation and/or restoration therapies must be weighed against the potential disadvantages of perturbing the complex central nervous system environment.

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Conflict of interest statement

Over the past 12 months, Dr. Tsai has received consulting honoraria from Eyenovia and ReNetXBio.

References

    1. Tham Y. C., Li X., Wong T. Y., Quigley H. A., Aung T., Cheng C. Y. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systemic review and meta-analysis. Ophthalmology. 2014;121(11):2081–2090. doi: 10.1016/j.ophtha.2014.05.013. - DOI - PubMed
    1. Varma R., Ying-Lai M., Francis B. A., et al. Prevalence of open-angle glaucoma and ocular hypertension in latinos: the Los Angeles Latino Eye study. Ophthalmology. 2004;111(8):1439–1448. doi: 10.1016/j.ophtha.2004.01.025. - DOI - PubMed
    1. Klein B. E., Klein R., Sponsel W. E., et al. Prevalence of glaucoma: the Beaver Dam Eye Study. Ophthalmology. 1992;99(10):1499–1504. doi: 10.1016/s0161-6420(92)31774-9. - DOI - PubMed
    1. American Academy of Ophthalmology Preferred Practice Patterns Committee Glaucoma Panel. Preferred Practice Patterns. Primary Open-Angle Glaucoma. San Francisco, CA, USA: American Academy of Ophthalmology; 2016. - PubMed
    1. Kass M. A., Heuer D. K., Higginbotham E. J., et al. The ocular hypertension treatment study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Archives of Ophthalmology. 2002;120(6):701–713. doi: 10.1001/archopht.120.6.701. - DOI - PubMed

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