Glaucoma - Fidia Farmaceutici S.p.A.

GLAUCOMA

GLAUCOMA

Glaucoma is a group of diseases that involve progressive loss of neuroretinal rim at the optic nerve, causing a characteristic degenerative optic neuropathy.(1)

Glaucoma is the second leading cause of blindness both in Europe and worldwide, and it is the most frequent cause of irreversible blindness.(2)

Glaucoma can be classified into 2 broad categories: primary open angle glaucoma (POAG), the most common type in the Caucasian population, and angle-closure glaucoma (AAG).(3)

FIDIA’S COMMITMENT

Fidia offers innovative solutions for the management of the disease, aimed at improving patient compliance and meet hir/her therapeutic needs.

CAUSES

A key role in the pathogenesis of glaucoma is attributed to the degeneration of retinal ganglion cells, which progressively leads to visual field damage evolving, without appropriate therapy, into a bilateral, irreversible blindness.(3) The retinal ganglion cell death is related to the level of intraocular pressure, but other factors may also play a role.(4)

Primary open angle glaucoma is usually chronic, slowly progressive, and characterized by decreased aqueous humor outflow and subsequent optic nerve damage without any identifiable etiology.(1) Acute angle-closure glaucoma is caused by a rapid or sudden increase in pressure inside the eye.

SYMPTOMS

Patients with mild to moderate glaucoma are often asymptomatic, so the disease can often be hard to notice until damage has already occurred.(1) Patients may experience gradual loss of peripheral and/or central vision as the disease advances. Population-level surveys suggest that only 10% to 50% of people with the disease are aware they have it.(4)

Symptoms of acute angle closure glaucoma are blurred vision, halos around lights, pain, frontal headache on the side of the affected eye, and occasionally nausea and vomiting, palpitations and abdominal cramps. (2)

MANAGING

Currently, lowering intraocular pressure is the only proven method to delay glaucoma advancement. However, many new therapies are being developed, including antioxidants, adenosine receptor antagonists, Rho-pathway inhibitors, stem cell therapy, and neurotrophic factors. These therapies focus on neuroprotection or neuroenhancement of retinal ganglion cells, and they may eventually halt glaucoma progression or reverse the process of the disease itself (1). When drug treatments are not sufficient or not well tolerated by the patient, the surgical option can be pursued, to lower the pressure inside the eye(5).

REFERENCES
1. Gauthier AC et al. Neuroregeneration and neuroprotection in glaucoma. Yale Journal of Biology and Medicine 2016; 89:73-79.
2. Terminology and guidelines for glaucoma, 4th edition. European Glaucoma Society.
3. Frezzotti P, Giorgio A, Motolese I, De Leucio A, Iester M, et al. (2014) Structural and Functional Brain Changes beyond Visual System in Patients with Advanced Glaucoma. PLoS ONE 9(8): e105931.
4. Robert N.Weinreb, MD; Tin Aung, MD, PhD; Felipe A. Medeiros, MD, PhD, The Pathophysiology and Treatment of Glaucoma. A Review , JAMA. 2014;311(18):1901-1911.
5. Stefan C, Batras M, Iliescu Daniela A, Timaru Cristina M, De Simone A, Hosseini-Ramhormozi J. Current options for surgical treatment of glaucoma. Rom J Ophthalmol. 2015;59(3):194-201.