New Perspectives in Glaucoma Pathophysiology, Diagnosis, and Treatment

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About this Research Topic

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Background

Glaucoma is a progressive optic neuropathy characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. This disease is one of the most common causes of legal blindness in the world. At first, people with glaucoma lose peripheral vision, but if the disease is not treated promptly, vision loss may get worse, possibly leading to total blindness over time.

Although the pathogenesis of glaucoma is not fully understood, intraocular pressure is still considered the major cause of retinal ganglion cell death. However, glaucoma can even occur if intraocular pressure is within the normal range. In these cases, abnormally low cerebrospinal fluid pressure, impaired microcirculation, mitochondrial deficits, altered immunity, excitotoxicity, and oxidative stress or coexisting diseases may also concur.

Genetics may also play a role in the disease. An increasing body of evidence suggests the presence of susceptibility loci in the DNA. However, the mechanism by which these genes might contribute is not clear.

Due to the complexity of the disease, early diagnosis of glaucoma can be challenging for clinicians. Visual field examination provides late information as damage is expected when at least 30% of retinal ganglion cells have been damaged. Hence the need for new diagnostic tools that allow an easier and earlier diagnosis of the disease.

Glaucoma treatment may also be challenging for clinicians. The reduction of intraocular pressure is the only recognized strategy to treat glaucoma. However, some patients may not respond to the topical medications hence the need for new intraocular pressure lowering molecules or different therapeutic approaches that may comprehend neuroprotection, para surgical or surgical intervention.

A complete understanding of the disease pathophysiology, novel diagnostic tools, and new treatments may assist the ophthalmologists in the early care of their patients, preserving their quality of life.

The aim of this topic is to include studies reporting new pathophysiological insight or new options for diagnosis, treatment, and overall management of this complex disease. Quality of life and psychometric aspects could also be explored.

Keywords: Glaucoma, neuroprotection, glaucoma surgery, glaucoma medication, glaucoma treatment

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