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NEUROPROTECTION IN GLAUCOMA: A STEP FORWARD. Shahsuvaryan ML

NEUROPROTECTION IN GLAUCOMA: A STEP FORWARD

Shahsuvaryan ML

International Journal of Pharmacology & Toxicology Science 2012; 2(4):11-17.

Abstract

Glaucoma is second only to cataract among visual disorders, but it is a major cause of worldwide irreversible blindness. Bilateral blindness will be present in 5.9 million people with open-angle glaucoma and 5.3 million people with angle-closure glaucoma in 2020. Currently, glaucoma is recognised as an optic neuropathy and the loss of vision in this eye disease is attributed to degeneration of the axons of the retinal ganglion cells through apoptosis. Apoptosis is a genetically programmed mechanism of cell death in which the cell activates a specific set of instructions that lead to the deconstruction of the cell from within. Intraocular concentrations of calcium ion are increased in apoptosis.
Calcium channel blockers, which alter the intracellular calcium concentration by modifying calcium flux across cell membranes and affect various intracellular signaling processes, have been long and widely used to treat essential hypertension and certain types of cardiac diseases such as angina pectoris. Among five subtypes of calcium channels, only specific agents for L-type calcium channels have been used as therapeutics.
There are potentially multiple biological bases for the protective effect of calcium channel blockers on eye structures. The objective of this review is to evaluate the evidence and discuss the rationale behind the recent suggestions that calcium channel blockers may be useful in the treatment of glaucoma. It is time to conduct a randomized controlled trial to provide direct evidence of the effectiveness of specific type non-ophthalmic drug - calcium channel blocker in glaucoma. New intervention as neuroprotection by calcium channel blockers in glaucomatous optic neuropathy remains an important strategy to limit the morbidity of this significant health problem.

Keywords: Apoptosis, Calcium channel blockers, Glaucoma, Neuroprotective.
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