Abstract
Glaucoma is a chronic silent disease and an irreversible cause of blindness worldwide. Research has made many efforts to improve disease control and especially to anticipate both early diagnosis and treatment of advanced stages of glaucoma. In terms of prevention, networking between professionals and nonprofessionals is an important goal to disseminate information and help diagnose the disease early. On the other hand, the most recent approaches to treat glaucoma outcomes in its advanced stages include electrical stimulation, stem cells, exosomes, extracellular vesicles, and growth factors. Finally, neuronal plasticity-based rehabilitation methods are being studied to reeducate patients in order to stimulate their residual visual capacity. This review provides an overview of new approaches to future possible glaucoma treatment modalities and gives insight into the perspectives available nowadays in this field.
Highlights
Glaucoma is one of the leading causes of blindness in the world, second only to cataracts [1, 2]
Glaucoma is a disease of enormous social impact, both from the human point of view, because it is highly disabling and compromises the quality of life and autonomy of those affected [5], and from an economic point of view: for its clinical-therapeutic management, a substantial percentage of public healthcare expenditure is invested [6]
The most accredited etiopathogenetic hypothesis would be the death of retinal ganglion cells due to mechanical stress and apoptosis following ischemic and/or chemical mechanisms, which would seem to have glutamate and NMDA receptor activation as protagonists, which would cause an exponential increase in intracellular calcium concentration, triggering irreversible damage to DNA and cell death [14, 15]
Summary
Glaucoma is one of the leading causes of blindness in the world, second only to cataracts [1, 2]. According to the current scientific panorama, the therapeutic possibilities are Journal of Ophthalmology aimed at acting both on the initial stages of the disease and on the final outcomes, i.e., on the advanced stages of glaucoma for which the lesions are considerable and no longer reversible, but in which it is possible to intervene by enhancing the residual functions at the highest level. In this context, the aim of our manuscript is to provide a comprehensive review of the recently investigated new approaches to treat early and late stages of the disease. A third author (R.N.) was involved to achieve consensus
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