Pathology
Glaucoma is the leading cause of irreversible blindness in people over 50 years of age. It is a neurodegenerative disease of the eye associated with many risk factors. Its initial diagnosis is associated with increased pressure within the eye called intraocular pressure (IOP). Elevated IOP levels over time can damage the optic nerve and cause the demise of retinal ganglion cells (RGCs). Increased IOP is due to impaired trabecular meshwork (TM) to efficiently drain the aqueous humor fluid. The root causes of glaucoma can be traced to the loss of TM sensing cells and IOP diurnal irregularities.
Epidemiology
Incidence of glaucoma is expected to increase in the US and worldwide due to increasing global aging populations. In 2024, there are 3 million cases of glaucoma in the US alone and 80 million cases worldwide. The latter is expected to rise to 112 millions by 2040. In the US, African Americans are more adversely affected by glaucoma than other groups. Compare to Caucasians, they are 15 times more likely to experience visual impairment linked to glaucoma and 6 to 8 times more likely to experience blindness because of glaucoma.
Current treatments
While there is no cure for glaucoma, there are a number of treatments that can reduce IOP levels and slow disease progression and vision loss. These include eyedrops or sustained release implant that contain pharmacological agents such as prostaglandins, Rho kinase inhibitors, nitric oxide, cholinergic agents, alpha-adrenergic agonists, and beta blockers. For non-responders to eyedrop medication, alternative treatments include Selective Laser Trabeculoplasty (SLT) , Minimally Invasive Glaucoma Surgery (MIGS) , drainage implant (aqueous shunt), or trabeculotomy.
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