Neuroprotection in Glaucoma: Basic Aspects and Clinical Relevance.

Glaucoma is a neurodegenerative disease that affects primarily the retinal ganglion cells (RGCs). Increased intraocular pressure (IOP) is one of the major risk factors for glaucoma. The mainstay of current glaucoma therapy is limited to lowering IOP; however, controlling IOP in certain patients can be futile in slowing disease progression. The understanding of potential biomolecular processes that occur in glaucomatous degeneration allows for the development of glaucoma treatments that modulate the death of RGCs. Neuroprotection is the modification of RGCs and the microenvironment of neurons to promote neuron survival and function. Numerous studies have revealed effective neuroprotection modalities in animal models of glaucoma; nevertheless, clinical translation remains a major challenge. In this review, we select the most clinically relevant treatment strategies, summarize preclinical and clinical data as well as recent therapeutic advances in IOP-independent neuroprotection research, and discuss the feasibility and hurdles of each therapeutic approach based on possible pathogenic mechanisms. We also summarize the potential therapeutic mechanisms of various agents in neuroprotection related to glutamate excitotoxicity.

Erythropoietin in Optic Neuropathies: Current Future Strategies for Optic Nerve Protection and Repair.

Erythropoietin (EPO) is known as a hormone for erythropoiesis in response to anemia and hypoxia. However, the effect of EPO is not only limited to hematopoietic tissue. Several studies have highlighted the neuroprotective function of EPO in extra-hematopoietic tissues, especially the retina. EPO could interact with its heterodimer receptor (EPOR/ßcR) to exert its anti-apoptosis, anti-inflammation and anti-oxidation effects in preventing retinal ganglion cells death through different intracellular signaling pathways. In this review, we summarized the available pre-clinical studies of EPO in treating glaucomatous optic neuropathy, optic neuritis, non-arteritic anterior ischemic optic neuropathy and traumatic optic neuropathy. In addition, we explore the future strategies of EPO for optic nerve protection and repair, including advances in EPO derivates, and EPO deliveries. These strategies will lead to a new chapter in the treatment of optic neuropathy.

Effect of peroxisome proliferator-activated receptors in optic nerve protection / 上海交通大学学报（医学版）

Neuronal death is thought to be irreversible.In optic nerve-related diseases,the death and axonal loss of retinal ganglion cells could lead to irreversible visual impairment.A large number of studies support the hypothesis that the peroxisome proliferator-activated receptors (PPARs),once activated by particular ligands,could have a potential neuroprotective effect on the peripheral organs and the central nervous system suffering from acute or chronic injury.Optic nerve belongs to the extension of white matter in the central nervous system and shares similar pathophysiological processes with the central nervous system,which makes PPARs a hot spot in the field of optic nerve protection.This paper reviewed the effect of PPARs in optic nerve protection and its possible mechanism.

Effect of peroxisome proliferator-activated receptors in optic nerve protection / 上海交通大学学报（医学版）

Neuronal death is thought to be irreversible. In optic nerve-related diseases, the death and axonal loss of retinal ganglion cells could lead to irreversible visual impairment. A large number of studies support the hypothesis that the peroxisome proliferator-activated receptors (PPARs), once activated by particular ligands, could have a potential neuroprotective effect on the peripheral organs and the central nervous system suffering from acute or chronic injury. Optic nerve belongs to the extension of white matter in the central nervous system and shares similar pathophysiological processes with the central nervous system, which makes PPARs a hot spot in the field of optic nerve protection. This paper reviewed the effect of PPARs in optic nerve protection and its possible mechanism.

Profiles of glaucoma medication / 国际眼科杂志(Guoji Yanke Zazhi)

?As a globally recognized irreversible blindness disease, glaucoma can lead to pathological intraocular hypertension, loss of optic ganglion cells and axonal progressive, more and more deep optic cup, and the expanded visual field defect. Various researches show that excitatory amino acid toxicity, oxidative damage, apoptosis, intracellular Ca2+overloading etc. , pathogenic factors are all involved in the occurrence and development of glaucoma. Now, a variety of clinical drugs and operation treatment are applied to control the glaucoma progress. Further more, there are many new drugs and methods in the process of development. This is an article on the current anti-glaucoma drugs.