3.5 percent of the population between the ages of 40 and 80 suffer from glaucoma. And this is a lot. To get an idea, 111 million people will suffer from this serious disease in 2040. neurodegenerative disease that affects the optic nerve, the first cause of irreversible blindness in the world.
One of the main problems with glaucoma is that vision loss begins at the periphery visual field and not noticeable; hence its nickname of “silent disease”. When we detect this loss, approximately half of the neurons have already died and we cannot recover them, as happens in Alzheimer’s.
The type of glaucoma open angle It is the one that most affects the European population. It is characterized by an increase in intraocular pressure, generated when there is more fluid than should be inside the eye. Said liquid, in charge of feeding the cells inside the visual organ, must be produced and eliminated at a rate that maintains normal pressure.
If the cells in charge of generating it (ciliary body) do so above their optimal level or the evacuation encounters some impediment in the filtering process, then the pressure increases. Loss of vision appears when this push is transmitted to the retina, the nervous part of the eye –located in the back area–, and the cells that carry the visual message to the brain die.
What are the symptoms of glaucoma?
The National Eye Institute details that these are the symptoms that people with glaucoma could present:
- Vision is lost slowly, beginning with the side or peripheral.
- Intense pain in the eyes.
- Upset stomach, such as nausea.
- Red eyes.
- Blurry vision.
- Myopia that worsens.
- Headache.
What is the treatment for glaocohomas?
Treatments are directed at stop the progress of the disease lowering intraocular pressure. However, today it is not possible to reverse and recover the already lost vision. The order of the therapies to prevent progression is:
- drugs in the form of dropsgenerally aimed at reducing the production of aqueous humor or improving the drainage of said fluid.
- Therapies with laser on the channel through which the fluid drains. The goal is to increase said drainage and reduce intraocular pressure when the drops have no effect.
- Surgery to increase the opening of a drainage area or the filtration of aqueous humor (trabeculectomy) or to implant a drainage device. It is used when the two previous phases no longer manage to lower intraocular pressure.
Ongoing Glaucoma Research
Despite having spent more 150 years since the discovery of glaucoma, we have not been able to fathom why it occurs and how it progresses. It is true that techniques to reduce pressure have improved, but we still do not know how to protect or regenerate lost neurons.
To study any disease it is necessary to analyze what is happening and test the treatments in animals before they reach humans. Thus, in 2004, our working group developed a model of glaucoma in pigs thanks to funding from The Glaucoma Foundation, an American foundation.
We chose this animal because his eye is very human-like. Currently, this model is being used to design devices that lower intraocular pressure.
We also develop other systems that are easier to apply in laboratory animals such as rats. denominated in English microbeads method (microsphere method), is the most widely used experimental glaucoma model in the world and allows progress in the knowledge of the mechanisms that cause the death of neurons.
The research group that I currently direct has also been a pioneer in the study of neuroprotection. That is, to quantify whether, apart from reducing intraocular pressure, the treatments protect neurons from death in glaucoma.
In addition, we have collaborated with pharmaceutical companies to develop longer-lasting and easier-to-apply treatments – especially for the elderly and children – using RNA interference technologies. This would replace the daily drops prescribed in classical therapies.
The cells initially involved in glaucoma are highlighted in this schematic of a retina: Müller glial cells (M) in blue, and retinal ganglion neurons (G) in orange. Elena Vecino and Luis López-Vecino, Author provided
And finally, recently we have discovered the role that play in glaucoma lThe most abundant cells in the retina called Müller’s glia, which function as pressure sensors. In a normal state, they secrete factors that protect the neurons of the retina, but we have shown that when intraocular pressure increases, they are altered and trigger the death of neurons that cause blindness in glaucoma, these cells appear as (G ) in the schematic.
This proposal is very novel and may have an impact on the future of glaucoma treatments. We have just presented the results at the European Vision and Eye Research Meeting. Accepted at the most prestigious international congress in the field of vision (ARVO), they will be published very soon in a high-impact scientific journal.
Undoubtedly, with more investment in research we will be able to cure glaucoma and restore sight to those who have lost it due to it. A long and hopeful road awaits us.
The original note is found in the league: https://theconversation.com/glaucoma-primera-causa-de-ceguera-irreversible-en-el-mundo-podra-curarse-algun-dia-199323.
By Elena Vecino Cordero, Professor of Cellular Biology (UPV/EHU), IdEX Prof. Univ. Bordeaux (France).
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