A Timeline of Discovery and Current Research on Primary Open-Angle Glaucoma and Emergence of Potentially Permanent Treatment Solutions

Yonosuke Dejesus,Guadalupe Moreno Ceballos

doi:10.9741/2766-7227.1007

Yonosuke Dejesus, Guadalupe Moreno Ceballos

Open Access

https://doi.org/10.9741/2766-7227.1007

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Abstract

This research examines the timeline of the discovery and research of Primary Open-Angle Glaucoma (POAG). By reviewing the literature on genetic and molecular mechanisms, we aim to emphasize a long-term treatment solution (iSTENT) to mitigate intraocular pressure (IOP) related to POAG etiology and disease progression. POAG is a multifactorial, autosomal dominant, adult-onset eye disease wherein the optic nerve cells become damaged due to a buildup of excess aqueous humor, resulting in increased IOP. Consequently, POAG leads to progressive loss of peripheral vision and is the leading cause of blindness in the US. Due to the multifactorial nature of glaucoma’s inheritance pattern and disease pathology, over 20 disease-associated loci have been implicated with POAG and its mechanisms remain relatively obscure. POAG remains a hotbed for multifactorial genetic research and the relationships between heterogeneity and environmental/genetic factors. To develop a more permanent solution for Glaucoma, we highlight a surgical insertion of a stent in the trabecular meshwork providing long-lasting dilation to the blocked drainage channels implicated with increased IOP and POAG progression. This procedure would allow for aqueous humor outflow from the eye and subsequent reduction of pressure-induced retinal ganglion cell damage. POAG’s progressive loss of vision due to polygenic inheritance and environmental factors is currently experienced by over 2.25 million Americans and will continue to grow as POAG-associated genes are maintained in subsequent generations. Therefore, a complete understanding of the history, etiology, and genetic mechanisms is critical for the development of effective and long-lasting treatment options.

Highlights

Using current and historical research, we investigate a molecular mechanism of Primary Open-Angle Glaucoma (POAG) to emphasize a permanent treatment solution to intraocular pressure (IOP)-induced retinal ganglion cell injury/death using an in-development medical device known as the iStent
POAG’s influence from both genetic and environmental modifiers diminishes the accurate evaluation of POAG prognosis
Current research has identified several of the proteinaceous, structural defects of POAGimplicated gene products such as Myocilin from the MYOC gene

Summary

Introduction

Primary Open-Angle Glaucoma (POAG) is an adult-onset eye disease that causes progressive blindness, typically beginning with a gradual loss of peripheral vision. As IOP increases due to blocked or collapsed drainage channels in the trabecular meshwork, retinal ganglion cells (optic nerve cells) become severely damaged or undergo apoptosis (cell death) resulting in the permanent progressive loss of vision (See Figure 2 for an illustration of the development of glaucoma).

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