Glaucoma may be neurologic disorder

San Francisco-A new research paradigm may move glaucoma out of the realm of eye disease and characterize it as a neurologic disorder that causes nerve cells in the brain to degenerate and die, similar to what occurs in Parkinson’s and Alzheimer’s diseases.

For many years, the prevailing theory was that vision damage in patients with glaucoma was caused by abnormally high IOP. The new research paradigm focuses on the damage that occurs in retinal ganglion cells (RGCs), which connect the eye to the brain through the optic nerve.

A review in Ophthalmology by Jeffrey L Goldberg, MD, PhD, assistant professor of ophthalmology at the Bascom Palmer Eye Institute and Interdisciplinary Stem Cell Institute, University of Miami, FL, describes RGC-targeted glaucoma treatments that are either being tested in patients or are scheduled to begin clinical trials soon. These include medications injected into the eye that deliver survival and growth factors to RGCs, medications known to be useful for stroke and Alzheimer’s disease, and electrical stimulation of RGCs. Human trials of stem cell therapies are in the planning stages.

“As researchers turn their attention to the mechanisms that cause retinal ganglion cells to degenerate and die, they are discovering ways to protect, enhance, and even regenerate these vital cells,” said Dr. Goldberg. “Understanding how to prevent damage and improve healthy function in these neurons may ultimately lead to sight-saving treatments for glaucoma and other degenerative eye diseases.”

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