Degeneration of retina-brain components and connections in glaucoma: Disease causation and treatment options for eyesight preservation

Abstract

Eyesight is the most important of our sensory systems for optimal daily activities and overall survival. Patients who experience visual impairment due to elevated intraocular pressure (IOP) are often those afflicted with primary open-angle glaucoma (POAG) which slowly robs them of their vision unless treatment is administered soon after diagnosis. The hallmark features of POAG and other forms of glaucoma are damaged optic nerve, retinal ganglion cell (RGC) loss and atrophied RGC axons connecting to various brain regions associated with receipt of visual input from the eyes and eventual decoding and perception of images in the visual cortex. Even though increased IOP is the major risk factor for POAG, the disease is caused by many injurious chemicals and events that progress slowly within all components of the eye-brain visual axis. Lowering of IOP mitigates the damage to some extent with existing drugs, surgical and device implantation therapeutic interventions. However, since multifactorial degenerative processes occur during aging and with glaucomatous optic neuropathy, different forms of neuroprotective, nutraceutical and electroceutical regenerative and revitalizing agents and processes are being considered to combat these eye-brain disorders. These aspects form the basis of this short review article.

Graphical abstract

Highlights

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  >80 million people worldwide suffer from chronic ocular hypertension (cOHT) and glaucoma.

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  The cOHT eventuall kills retinal ganglion cells (RGCs) and their axons.

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  The optic nerve terminals atrophy resulting in loss of peripheral vision.

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  Thus, early diagnosis and treatment for cOHT and glaucoma is needed to preserve eyesight.

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  Drugs and devices have been developed to combat cOHT and glaucoma but novel therapeutics are needed.