title: [Value of non-IOP lowering therapy for glaucoma].
abstract: It is well established that an IOP reduction improves, on average, the                         prognosis of all types of glaucoma. It is also known, however, that even an                         ideal IOP does not stop progression in all patients. The insight into the                         pathogenesis of glaucomatous damage leads to new therapeutic approaches.                         Whilst most of these new avenues of treatment are still in the experimental                         phase, others, such as magnesium, Ginkgo, salt and fludrocortisone are                         already used by some physicians. Blood pressure dips can be avoided by                         intake of salt or fludrocortisone. Vascular regulation can be improved                         either locally by carbonic anhydrase inhibitors or systemically with                         magnesium or with low doses of calcium channel blockers. A number of other                         food ingredients such as polyphenolic flavonoids occurring in tea, coffee,                         dark chocolate or red wine and anthocyanosides found in bilberries have                         potential antioxidative effects. The oxidative stress at the level of the                         mitochondria can be reduced by Ginkgo biloba. Experimentally, glaucomatous                         optic neuropathy can be prevented by inhibition of astrocyte activation,                         either by blockage of epidermal growth factor receptor or by counteracting                         endothelin. Glaucomatous optic neuropathy can also be prevented by nitric                         oxide-2 synthase inhibition. Inhibition of matrix metalloproteinase-9                         inhibits apoptosis of retinal ganglion cells and tissue remodelling.                         Up-regulation of heat shock proteins protects the retinal ganglion cells and                         the optic nerve head.
authors: Department of Ophthalmology, University of Basel,                     Switzerland.
authors: A
authors: A
authors: Cybulska-Heinrich
authors: M
authors: M
authors: Mozaffarieh
authors: J
authors: J
authors: Flammer
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004195:Disease Models, Animal; D018450:Disease Progression; D015507:Drugs, Investigational / Q000009:adverse effects / Q000627:therapeutic use*; D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology; D009901:Optic Nerve Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D015507:Drugs, Investigational; D010936:Plant Extracts