Primary Open Angle Glaucoma: The Pathophysiolgy, Mechanisms, Future Diagnostic and Therapeutic Directions
Benedict C. Umezurike, Moses Obeimen Akhimien, Okechukwu Udeala, Uzoamaka G. Green, Ugonma Okpechi-Agbo, Maureen U. Ohaeri
Ophthalmology Research: An International Journal · pp. 1–17 · Published 22 Jun 2019
10.9734/or/2019/v10i330106Abstract
Primary open angle glaucoma (POAG) is a multifactorial chronic optic neuropathy, characterized by progressive loss of retinal ganglion cells (RGC), leading to structural damage to the optic nerve head (ONH), retinal nerve fiber layer (RNFL), with visual field defects. It is occasioned by major risk factors of high intraocular pressure (IOP) and age. The pathogenesis of POAG is the imbalance between the production and drainage of the aqueous humour (AH). The resultant fluid back-up increases the IOP with consequent optic nerve damage, causing POAG. Modern diagnosis, using scanning laser polarimetry (SLP), confocal scanning laser ophthalmoscopy (CSLO), optical coherence tomography (OCT) etc, plays a vital role in the assessment of the ONH, RNFL and the macular, in POAG. OCT operates on the principles of interferometery, utilizing light beams and their pattern of back-scattering, to build high resolution cross-sectional images of ocular tissues. It gives an objective evaluation of structural alterations in the ONH or macular area of the retina in vivo. POAG is managed medically using classes of drugs like α-adrenergic agonists, beta-adrenergic receptor antagonist, prostaglandin agonists, carbonic anhydrase inhibitors, ccholinergic agonists etc. Surgical intervention is indicated with laser or incisional surgeries, when medical option fails. Future pharmacotherapeutic directions in POAG management consider transgenic model, genetic model, neuroregeneration (stem cell technique), neurodegeneration (Seeing glaucoma as a neurologic disorder much like in Parkinson's and Alzheimer's diseases and the mechanisms that cause the degeneration of RGCs), autoimmune response and T-cell autoimmune response attack.
References (36)
- 1 Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040 [DOI]
- 2 Global estimates of visual impairment: 2010 [DOI]
- 3 Primary open-angle glaucoma [DOI]
- 4 Racial variations in the prevalence of primary open-angle glaucoma. The Baltimore Eye Survey [DOI]
- 5 The Framingham Eye Study monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973-1975.
- 6 Clinical Ophthalmology: A Systematic Approach [DOI]
- 7 Macular Segmentation with Optical Coherence Tomography [DOI]
- 8 Cerebrospinal Fluid Pressure in Glaucoma [DOI]
- 9 Scanning Laser Polarimetry to Measure the Nerve Fiber Layer of Normal and Glaucomatous Eyes [DOI]
- 10 Frequency Doubling in Visual Responses*† [DOI]
- 11 Refractive errors, intraocular pressure, and glaucoma in a white population11The authors have no proprietary interest in the products or devices mentioned herein. [DOI]
- 12 Evaluation of Retinal Nerve Fiber Layer Progression in Glaucoma: A Study on Optical Coherence Tomography Guided Progression Analysis [DOI]
- 13 Transforming growth factor β2 levels in the aqueous humor in different types of glaucoma and the relation to filtering bleb development [DOI]
- 14 Diabetes Mellitus as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis [DOI]
- 15 Three-dimensional optical coherence tomography at 1050 nm versus 800 nm in retinal pathologies: enhanced performance and choroidal penetration in cataract patients [DOI]
- 16 Orbital Cerebrospinal Fluid Space in Glaucoma: The Beijing Intracranial and Intraocular Pressure (iCOP) Study [DOI]
- 17 Estimating Lead Time Gained by Optical Coherence Tomography in Detecting Glaucoma before Development of Visual Field Defects [DOI]
- 18 Do Findings on Routine Examination Identify Patients at Risk for Primary Open-Angle Glaucoma? [DOI]
- 19 Optical coherence tomography: A guide to interpretation of common macular diseases [DOI]
- 20 Measurement of Retinal Nerve Fiber Layer Thickness and Macular Volume for Glaucoma Detection Using Optical Coherence Tomography [DOI]
- 21 Imaging of the retinal nerve fibre layer for glaucoma [DOI]
- 22 The incidence and time-course of latanoprost-induced iridial pigmentation as a function of eye color [DOI]
- 23 Topical Ophthalmic Beta Blockers: A Comparative Review [DOI]
- 24 Systemic hypertension and glaucoma: mechanisms in common and co-occurrence [DOI]
- 25 MACULAR THICKNESS MEASUREMENTS IN NORMAL EYES WITH TIME-DOMAIN AND FOURIER-DOMAIN OPTICAL COHERENCE TOMOGRAPHY [DOI]
- 26 The glaucoma book : a practical, evidence-based approach to patient care [DOI]
- 27 Optic Nerve Head (ONH) Topographic Analysis by Stratus OCT in Normal Subjects: Correlation to Disc Size, Age, and Ethnicity [DOI]
- 28 Pharmacological management of ocular hypertension: current approaches and future prospective [DOI]
- 29 Glaucoma, the Requisites in Ophthalmology [DOI]
- 30 3D optical coherence tomography super pixel with machine classifier analysis for glaucoma detection [DOI]
- 31 New Glaucoma Medications in the Geriatric Population: Efficacy and Safety [DOI]
- 32 Experimental Aqueous Perfusion in Enucleated Human Eyes [DOI]
- 33 Physicochemical Properties and In Vivo Assessment of Timolol-Loaded Poly(D,L-Lactide-co-Glycolide) Films for Long-Term Intraocular Pressure Lowering Effects [DOI]
- 34 Macular retinal and nerve fiber layer thickness in early glaucoma: Clinical correlations [DOI]
- 35 Becker-Shaffer's: diagnosis and therapy of the glaucomas 8th Edition
- 36 Frequenzverdopplungsperimetrie [DOI]
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