Glaucoma: Current and New Therapeutic Approaches
Abstract
:1. Introduction
2. Present IOP-Reducing Medications
2.1. Beta Adrenergic Antagonists (β-Blockers)
2.2. Adrenergic Agonists
2.3. Carbonic Anhydrase Inhibitors (CAIs)
2.4. Prostaglandin Analogues (PGAs)
2.5. Muscarinic Receptor Agonist
2.6. Hyperosmotic Agent
2.7. Rho Kinase Inhibitor
2.8. Fixed Combinations
3. Beyond IOP: Mechanisms of Neurodegeneration in Glaucoma
3.1. Neurodegenerative Processes
3.2. Oxidative Stress
3.3. Neuroinflammation
3.4. Autophagy
3.5. Excitotoxicity
3.6. Decreased Ocular Perfusion
4. Exploring the Frontiers of Neuroprotection Treatments
4.1. Nitric Oxide
4.2. Rho Kinase Inhibitor
4.3. Coenzyme Q10
4.4. Citicoline(Cytidine-5′-Diphosphocholine)
4.5. Gingko Biloba Extract (GBE)
4.6. Tumor Necrosis Factor-α Inhibitors
4.7. Nuclear Factor Kappa B (NF-κB) Inhibitors
4.8. Memantine
4.9. Calcium Channel Blockers (CCBs)
4.10. Platelet-Derived Growth Factor (PDGF)
4.11. Neurotrophic Factors
4.12. Erythropoietin
5. A Multifaceted Approach: The Future of Glaucoma Management
5.1. Nanotechnology-Based Ophthalmic Delivery System
5.2. Intracameral Implant
5.3. Genome-Wide Analyses
5.4. Stem Cell Therapy
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Pathological Mechanism | Result or Impact | Neuroprotective Interventions |
---|---|---|
Deprivation of Neurotrophins | Glutamate NMDA Receptors Activation, Calcium Influx of RGCs | Neurotrophins |
Glutamate Increase | Increased activation of NMDA receptors | Coenzyme Q10, Memantine |
Glutamate NMDA Receptors Activation | Leads to calcium influx into RGCs | Brimonidine, BDNF-TrkB signaling |
Calcium Influx of RGCs | Leads to an increase in free radicals (e.g., NO), Mitochondrial Dysfunction | Calcium channel blockers |
Oxidative Stress | Leads to RGCs death | Antioxidant (e.g., EPO), NOS inhibitors |
Decreased Ocular Perfusion | Leads to RGCs death | Gingko biloba extract |
Neuroinflammation | Leads to RGCs death | |
Mitochondrial Dysfunction | Leads to excitotoxicity and RGCs death | Citicoline |
RGCs Death | Final outcome |
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Lee, H.-P.; Tsung, T.-H.; Tsai, Y.-C.; Chen, Y.-H.; Lu, D.-W. Glaucoma: Current and New Therapeutic Approaches. Biomedicines 2024, 12, 2000. https://doi.org/10.3390/biomedicines12092000
Lee H-P, Tsung T-H, Tsai Y-C, Chen Y-H, Lu D-W. Glaucoma: Current and New Therapeutic Approaches. Biomedicines. 2024; 12(9):2000. https://doi.org/10.3390/biomedicines12092000
Chicago/Turabian StyleLee, Hsin-Pei, Ta-Hsin Tsung, Yu-Chien Tsai, Yi-Hao Chen, and Da-Wen Lu. 2024. "Glaucoma: Current and New Therapeutic Approaches" Biomedicines 12, no. 9: 2000. https://doi.org/10.3390/biomedicines12092000