Important Problems in Glaucoma and New Strategies in Therapy: Neuroprotection and Ocular Surface.

Glaucoma is a multifactorial, neurodegenerative disease which results in loss of vision if left untreated. Although elevated intraocular pressure (IOP) is the major, modifiable risk factor, there are some cases progressing despite effective IOP control. Again, there are also cases with marked optic nerve damage despite IOP considered to be within normal limits. This indicates that there are additional mechanisms of damage independent from elevated IOP in glaucoma. It will be possible to develop novel therapeutic strategies by better understanding of cellular problems and mechanisms of damage in glaucoma. In the glaucoma, ocular surface disease is another problem with marked influence on treatment success. This may be due to both dry eye disease and antiglaucomatous molecules used in the treatment and preservative agents in the drug. This should be taken into account when planning medical treatment. The current treatment in the glaucoma can be built as a triple strategy: IOP control, neuroprotection and solution of ocular surface problems. Here, we will address mechanisms of damage and related problems in the light of current knowledge and attempt to highlight remarkable molecules that are supportive in neuroprotection and ocular surface disease. [ABSTRACT FROM AUTHOR]