Retinal Ganglion Cell Replacement in Glaucoma Therapy: A Narrative Review

Abstract

Glaucoma is a leading cause of irreversible blindness worldwide. It leads to the progressive degeneration of retinal ganglion cells (RGCs), the axons of which form the optic nerve. Enormous RGC apoptosis causes a lack of transfer of visual information to the brain. The RGC loss typical of the central nervous system is irreversible, and when glaucoma progresses, the total amount of RGCs in the retina enormously diminishes. The successful treatment in glaucoma patients is a direct neuroprotection by decreasing the intraocular pressure, which enables RGC protection but does not revive the lost ones. The intriguing new therapy for advanced glaucoma is the possibility of RGC replacement with new healthy cells. In this review article, the strategies regarding RGC replacement therapy are presented with the latest advances in the technique and the obstacles that it meets.

Keywords: glaucoma; replacement theraphy; retinal ganglion cells.

Figure 1

Linear scan obtained using OCT technique from healthy subject in the macular region with marked retinal layers (obtained using Zeiss Cirrus 6000, Carl Zeiss Meditech, Warsaw, Poland). ONL—outer nuclear layer; OPL—outer plexus layer; INL—inner nuclear layer; IPL—inner plexus layer; RGCL—retinal ganglion cell layer; RNFL—retinal nerve fiber layer; ILM—internal limiting membrane.