Neuroprotective agents in glaucoma therapy: Recent developments and future directions

Glaucoma, globally the second most common cause of blindness and the commonest cause of preventable visual disability, is a progressive neurodegenerative disease of the retinal ganglion cells and their axons. While reduction of intraocular pressure remains the clinicians principal method to treat this disease, such treatment is often only partly effective, or provokes unacceptable treatment-associated comorbidities. An alternative treatment paradigm is required to manage this problem more effectively. Neuroprotection aims to protect as yet undamaged, and to rescue already damaged neurons, from the glaucoma insult(s) to retinal ganglion cells. It has the potential to prevent retinal ganglion cell death independently of the particular factors that damage the optic nerve. Research laboratories worldwide have reported exciting developments in the search for potential neuroprotective agents. This article reviews what is known to date, as well as possible future directions.