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During the year 2008, the Catalyst For a Cure (CFC) made key observations of changes to the visual pathways from the eye to the brain that occur in glaucoma, some of these changes occurring very early in the disease.
These findings contain significant implications, whose further study may well lead to new diagnostics or treatment possibilities for glaucoma.
The projection of the retina to the brain along the optic nerve serves as the conduit for information from the eye to the visual centers in the brain. This can only be accomplished by the transport of important scaffolding material and nutrients along individual fibers in the optic nerve. CFC investigators found that early in glaucoma, there is a failure of transport that shows up first not in the eye, but in the visual centers of the brain.
This failure appears to go hand in hand with a build-up of oxidative stress and a slowing down of tiny energy batteries in the nerve called mitochondria.
While this is happening, the CFC observed that the connections in the retina that begin the transfer of visual information appear to be targeted for removal in glaucoma. This is affected by specialized sentinels in the retina called microglia. Early in the development of glaucoma, microglia scan the retina for signs of damaged connections and mark those connections for removal by the immune system.
In 2009, the CFC will continue to chase down the mechanisms underlying transport loss, oxidative stress and loss of connections so that they may be targeted hopefully as new therapeutic interventions in glaucoma.
The year 2008 marked in many ways a turning point for the Catalyst for a Cure. Completed work from the end of the second phase (2005-2007) achieved peer acknowledgment in key science publications, while new work commenced building from knowledge gleaned during the second phase.
Of note were two papers published in the Journal of Neuroscience. These described early changes in glaucoma associated with the neurochemistry of the retina and optic nerve and the persistence of retinal neurons long after those changes occur. Papers in Investigative Ophthalmology and Visual Science described how silencing the immune system in glaucoma can increase survival of the optic nerve and the use of magnetic resonance imaging to track disease progression. Finally, in another study in Investigative Ophthalmology and Visual Science, CFC investigators linked a potentially protective signal from retinal cells to a special pressure sensor that could be activated in glaucoma.
These and other results were presented as part of a larger showcase of findings at the 2008 Vanderbilt Eye Institute Symposium “Neurodegeneration in Glaucoma: from Mechanisms to New Treatments.” The symposium, sponsored in part by the Glaucoma Research Foundation, brought together glaucoma researchers and physicians from all over the United States and Canada to share their latest investigations and novel ideas.
Last reviewed on December 23, 2011
This article appeared in the May 2009 issue of Gleams.Subscribe