title: Emerging Concepts in Glaucoma and Review of the Literature.
abstract: Glaucoma is the most commonly acquired optic neuropathy. It represents a public health challenge because it causes an irreversible blindness. Emerging evidence indicates that the pathogenesis of glaucoma depends on several interacting pathogenetic mechanisms, which include mechanical effects by an increased intraocular pressure, decreased neutrophine-supply, hypoxia, excitotoxicity, oxidative stress, and the involvement of autoimmune processes. In particular, alterations in serum antibody profiles have been described. However, it is still unclear whether the autoantibodies seen in glaucoma are an epiphenomenon or causative. Oxidative stress appears to be a critical factor in the neurodestructive consequences of mitochondrial dysfunction, glial activation response, and uncontrolled activity of the immune system during glaucomatous neurodegeneration. In addition, hearing loss has been identified in association with glaucoma. A higher prevalence of antiphosphatidylserine antibodies of the immunoglobulin G class was seen in normal-tension glaucoma patients with hearing loss in comparison with normal-tension glaucoma patients with normacusis. This finding suggests a similar pathological pathway as a sign for generalized disease.
authors.affiliation: Department of Sense Organs, Sapienza University, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Greco
authors.affiliation: Department of Surgical Science, Sapienza University, Rome, Italy. Electronic address: mariaidarizzo@gmail.com.
authors.forename: Maria Ida
authors.initials: MI
authors.lastname: Rizzo
authors.affiliation: Department of Surgical Science, Sapienza University, Rome, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: De Virgilio
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallo
authors.affiliation: Department of Sense Organs, Sapienza University, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Fusconi
authors.affiliation: Department of Sense Organs, Sapienza University, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: de Vincentiis
mesh_terms: D003937:Diagnosis, Differential; D005901:Glaucoma / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D009900:Optic Nerve / Q000473:pathology / Q000503:physiopathology; D011379:Prognosis; D012307:Risk Factors
keywords: Antiphospholipid antibodies; Dual sensory loss; Glaucoma; Immune system; Normal-tension glaucoma; Oxidative stress; Retinal ganglion cells