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A Journal on Ophthalmology
Minerva Oftalmologica 2002 September-December;44(3-4):147-50
The ''biologic'' rehabilitation in glaucoma
Nuzzi R., Donati S., Brogliatti B., Grignolo F. M.
The glaucoma degenerative pathology turns in an irreversible damage to the visual structures and in particular to the optic nerve head. The patients have a progressive restriction of the visual field that is not strictly associated to the ocular hypertension. The low perfusion and the reduced flow of neuronal growth factors cause the cupping in the cribrous lamina. The low regrowing potential of the nervous system need of a deep study to understand how to operate for a functional rehabilitation of the visual structures. Experimental studies show the efficacy of the growth factors to inhibit or limit the neuronal apoptosis and necrosis. We can operate on the different enzymatic steps to deviate or inhibit the apoptosis pathway and the cell response to damage. It is also important to verify the role of the immune system and its role on the tissue atrophy and regeneration. The positioning of extra cellular matrix support can favour the nervous fibre regrowing. The implants of different histological types on the degenerated areas can permit the functional and anatomic reconstitution. The transplantation from in vitro cultures or from other retinal areas of glial cells, neuronal precursor cells, staminal cells represent the basis of the biologic rehabilitation. The comparison with the artificial visual structures implants is studied.