title: Disease progression and the need for neuroprotection in glaucoma management.
abstract: Glaucoma, the second leading cause of worldwide blindness, is a progressive optic neuropathy characterized by a loss of retinal ganglion cells and their axons beyond typical age-related baseline loss. Diagnosis is defined by optic disc and visual field changes, and the primary goal of glaucoma treatment is to preserve vision. Proven existing therapies (ie, pharmacotherapy, laser, and surgical) focus on reduction of intraocular pressure (IOP), although elevated IOP is no longer a diagnostic feature of glaucoma. New neuroprotectant drugs are being investigated, with the goal of reducing retinal ganglion cell loss, either prophylactically or after the insult has occurred. Various treatment strategies are being evaluated, and include a neuroprotectant only, or a complete therapy approach comprised of both a neuroprotectant supplemented by an IOP-lowering therapy. Dually targeted complete therapy may directly preserve the optic nerve, decrease the risk factors that cause glaucoma damage, and reduce glaucoma-related morbidities. Neuroprotectant therapy outcomes should include functional and structural effects of disease progression and neuroprotectant therapies, as well as patient functioning and economic impact.
authors.affiliation: University of Southern California, 1450 San Pablo St, Room 4900, Los Angeles, CA 90033, USA. rvarma@hsc.usc.edu
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
authors.forename: Patti
authors.initials: P
authors.lastname: Peeples
authors.forename: John G
authors.initials: JG
authors.lastname: Walt
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Bramley
mesh_terms: D001766:Blindness / Q000517:prevention & control*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005901:Glaucoma / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D019636:Neurodegenerative Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D009901:Optic Nerve Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy; D012165:Retinal Ganglion Cells / Q000473:pathology
chemical_list: D018696:Neuroprotective Agents