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Glaucoma: HELP
Articles from Rome, IT
Based on 154 articles published since 2008
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These are the 154 published articles about Glaucoma that originated from Rome, IT during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7
1 Review Cyclodestructive procedures for non-refractory glaucoma. 2018

Michelessi, Manuele / Bicket, Amanda K / Lindsley, Kristina. ·Ophthalmology, Fondazione G.B. Bietti per lo studio e la ricerca in Oftalmolologia-IRCCS, Via Livenza n 3, Rome, Italy, 00198. ·Cochrane Database Syst Rev · Pubmed #29694684.

ABSTRACT: BACKGROUND: Glaucoma is a leading cause of blindness worldwide. It results in a progressive loss of peripheral vision and, in late stages, loss of central vision leading to blindness. Early treatment of glaucoma aims to prevent or delay vision loss. Elevated intraocular pressure (IOP) is the main causal modifiable risk factor for glaucoma. Aqueous outflow obstruction is the main cause of IOP elevation, which can be mitigated either by increasing outflow or reducing aqueous humor production. Cyclodestructive procedures use various methods to target and destroy the ciliary body epithelium, the site of aqueous humor production, thereby lowering IOP. The most common approach is laser cyclophotocoagulation. OBJECTIVES: To assess the effectiveness and safety of cyclodestructive procedures for the management of non-refractory glaucoma (i.e. glaucoma in an eye that has not undergone incisional glaucoma surgery). We also aimed to compare the effect of different routes of administration, laser delivery instruments, and parameters of cyclophotocoagulation with respect to IOP control, visual acuity, pain control, and adverse events. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 8); Ovid MEDLINE; Embase.com; LILACS; the metaRegister of Controlled Trials (mRCT) and ClinicalTrials.gov. The date of the search was 7 August 2017. We also searched the reference lists of reports from included studies. SELECTION CRITERIA: We included randomized controlled trials of participants who had undergone cyclodestruction as a primary treatment for glaucoma. We included only head-to-head trials that had compared cyclophotocoagulation to other procedural interventions, or compared cyclophotocoagulation using different types of lasers, delivery methods, parameters, or a combination of these factors. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results, assessed risks of bias, extracted data, and graded the certainty of the evidence in accordance with Cochrane standards. MAIN RESULTS: We included one trial (92 eyes of 92 participants) that evaluated the efficacy of diode transscleral cyclophotocoagulation (TSCPC) as primary surgical therapy. We identified no other eligible ongoing or completed trial. The included trial compared low-energy versus high-energy TSCPC in eyes with primary open-angle glaucoma. The trial was conducted in Ghana and had a mean follow-up period of 13.2 months post-treatment. In this trial, low-energy TSCPC was defined as 45.0 J delivered, high-energy as 65.5 J delivered; it is worth noting that other trials have defined high- and low-energy TSCPC differently. We assessed this trial to have had low risk of selection bias and reporting bias, unclear risk of performance bias, and high risk of detection bias and attrition bias. Trial authors excluded 13 participants with missing follow-up data; the analyses therefore included 40 (85%) of 47 participants in the low-energy group and 39 (87%) of 45 participants in the high-energy group.Control of IOP, defined as a decrease in IOP by 20% from baseline value, was achieved in 47% of eyes, at similar rates in the low-energy group and the high-energy groups; the small study size creates uncertainty about the significance of the difference, if any, between energy settings (risk ratio (RR) 1.03, 95% confidence interval (CI) 0.64 to 1.65; 79 participants; low-certainty evidence). The difference in effect between energy settings based on mean decrease in IOP, if any exists, also was uncertain (mean difference (MD) -0.50 mmHg, 95% CI -5.79 to 4.79; 79 participants; low-certainty evidence).Decreased vision was defined as the proportion of participants with a decrease of 2 or more lines on the Snellen chart or one or more categories of visual acuity when unable to read the eye chart. Twenty-three percent of eyes had a decrease in vision. The size of any difference between the low-energy group and the high-energy group was uncertain (RR 1.22, 95% CI 0.54 to 2.76; 79 participants; low-certainty evidence). Data were not available for mean visual acuity and proportion of participants with vision change defined as greater than 1 line on the Snellen chart.The difference in the mean number of glaucoma medications used after cyclophotocoagulation was similar when comparing treatment groups (MD 0.10, 95% CI -0.43 to 0.63; 79 participants; moderate-certainty evidence). Twenty percent of eyes were retreated; the estimated effect of energy settings on the need for retreatment was inconclusive (RR 0.76, 95% CI 0.31 to 1.84; 79 participants; low-certainty evidence). No data for visual field, cost effectiveness, or quality-of-life outcomes were reported by the trial investigators.Adverse events were reported for the total study population, rather than by treatment group. The trial authors stated that most participants reported mild to moderate pain after the procedure, and many had transient conjunctival burns (percentages not reported). Severe iritis occurred in two eyes and hyphema occurred in three eyes. No instances of hypotony or phthisis bulbi were reported. The only adverse outcome that was reported by the treatment group was atonic pupil (RR 0.89 in the low-energy group, 95% CI 0.47 to 1.68; 92 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: There is insufficient evidence to evaluate the relative effectiveness and safety of cyclodestructive procedures for the primary procedural management of non-refractory glaucoma. Results from the one included trial did not compare cyclophotocoagulation to other procedural interventions and yielded uncertainty about any difference in outcomes when comparing low-energy versus high-energy diode TSCPC. Overall, the effect of laser treatment on IOP control was modest and the number of eyes experiencing vision loss was limited. More research is needed specific to the management of non-refractory glaucoma.

2 Review Neuroprotective agents in the management of glaucoma. 2018

Nucci, C / Martucci, A / Giannini, C / Morrone, L A / Bagetta, G / Mancino, R. ·Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. nucci@med.uniroma2.it. · Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. · Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy. ·Eye (Lond) · Pubmed #29472700.

ABSTRACT: Glaucoma is an optic neuropathy, specifically a neurodegenerative disease characterized by loss of retinal ganglion cells (RGCs) and their axons. The pathogenesis of RGC loss in glaucoma remains incompletely understood and a broad range of possible mechanisms have been implicated. Clinical evidence indicates that lowering intraocular pressure (IOP) does not prevent progression in all patients; therefore, risk factors other than those related to IOP are involved in the disease. The need for alternative, non-IOP-lowering treatments focused at preventing progression, that is, neuroprotectants, has become of interest to both the patient and the physician. Experimental evidence accumulated during the past two decades lend a great deal of support to molecules endowed with neuroprotective features. However, translation to the clinic of the latter drugs results unsuccessful mostly because of the lack of reliable in vivo measure of retinal damage, thus hampering the good therapeutic potential of neuroprotective agents given alone or as adjuvant therapy to IOP-lowering agents. Further research effort is needed to better understand the mechanisms involved in glaucoma and the means to translate into clinic neuroprotective drugs.

3 Review Glaucoma and Alzheimer Disease: One Age-Related Neurodegenerative Disease of the Brain. 2018

Mancino, Raffaele / Martucci, Alessio / Cesareo, Massimo / Giannini, Clarissa / Corasaniti, Maria Tiziana / Bagetta, Giacinto / Nucci, Carlo. ·Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy. · Department of Health Sciences, University "Magna Graecia" of Catanzaro, 88100 Catanzaro, Italy. · Department of Pharmacy, Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, 87036 Rende, Italy. ·Curr Neuropharmacol · Pubmed #29210654.

ABSTRACT: BACKGROUND: Open Angle Glaucoma (POAG) is the leading causes of irreversible blindness worldwide. Elevated intraocular pressure is considered an important risk factor for glaucoma; however, a subset of patients experiences a progression of the disease even in presence of normal intraocular pressure values. This implies that risk factors other than intraocular pressure are involved in the pathogenesis of glaucoma. A possible relationship between glaucoma and neurodegenerative diseases such as Alzheimer Disease has been suggested. In this regard, we recently described a high prevalence of alterations typical of glaucoma, using Heidelberg Retinal Tomograph-3, in a group of patients with Alzheimer Disease. Interestingly, these alterations were not associated with elevated intraocular pressure or abnormal Central Corneal Thickness values. Alzheimer Disease is the most common form of dementia with progressive deterioration of memory and cognition. Complaints related to vision are common among Alzheimer Disease patients. METHODS: In this paper researches related to glaucoma and Alzheimer disease are reviewed. RESULTS: Diseases characteristics, i.e. common features, risk factors and pathophysiological mechanisms gathered in the recent literature do suggest that Alzheimer Disease and glaucoma can be considered both age-related neurodegenerative diseases that may co-exist in the elderly. CONCLUSION: In conclusion, preclinical and clinical evidence gathered so far support the notion that glaucoma is a widespread neurodegenerative condition whose common pathogenetic mechanisms with other diseases, i.e. Alzheimer Disease, should be further investigated as they may shed new light on these diseases improving both diagnosis and treatments.

4 Review Glaucoma Drug Therapy in Pregnancy: Literature Review and Teratology Information Service (TIS) Case Series. 2018

Pellegrino, Marcella / D'Oria, Luisa / De Luca, Carmen / Chiaradia, Giacomina / Licameli, Angelo / Neri, Caterina / Nucci, Marta / Visconti, Daniela / Caruso, Alessandro / De Santis, Marco. ·Teratology Information Service, Department of Obstetrics and Gynecology, Fetal Diagnosis and Therapy Unit, Catholic University of Sacred Heart, Policlinico A. Gemelli Hospital, Rome, Italy. · Department of Statistics, Catholic University of Sacred Heart, Policlinico A. Gemelli Hospital, Rome, Italy. ·Curr Drug Saf · Pubmed #29086700.

ABSTRACT: BACKGROUND: There are many contradictions about pregnancy and fetal/neonatal outcomes after topical use of timolol alone or timolol in combination with other antiglaucoma medications. METHODS: Seventy-five pregnant women exposed to antiglaucoma medications were followed prospectively by phone interviews. 27 women used timolol as monotherapy, 48 women used timolol as a part of multidrug therapy. We selected a control group of 187 healthy pregnant women. RESULTS: Topical use of timolol alone or timolol in combination with other antiglaucoma medications does not influence pregnancy or fetal/neonatal outcomes. CONCLUSION: Beta-blocker is the first choice treatment for glaucoma in pregnancy but, when necessary, multidrug therapy should not to be excluded.

5 Review Neuroprotection by (endo)Cannabinoids in Glaucoma and Retinal Neurodegenerative Diseases. 2018

Rapino, Cinzia / Tortolani, Daniel / Scipioni, Lucia / Maccarrone, Mauro. ·Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy. · Department of Medicine, Campus Bio- Medico University of Rome, 00128 Rome, Italy. · European Center for Brain Research, IRCCS Santa Lucia Foundation, 00164 Rome, Italy. ·Curr Neuropharmacol · Pubmed #28738764.

ABSTRACT: BACKGROUND: Emerging neuroprotective strategies are being explored to preserve the retina from degeneration, that occurs in eye pathologies like glaucoma, diabetic retinopathy, age-related macular degeneration, and retinitis pigmentosa. Incidentally, neuroprotection of retina is a defending mechanism designed to prevent or delay neuronal cell death, and to maintain neural function following an initial insult, thus avoiding loss of vision. METHODS: Numerous studies have investigated potential neuroprotective properties of plant-derived phytocannabinoids, as well as of their endogenous counterparts collectively termed endocannabinoids (eCBs), in several degenerative diseases of the retina. eCBs are a group of neuromodulators that, mainly by activating G protein-coupled type-1 and type-2 cannabinoid (CB1 and CB2) receptors, trigger multiple signal transduction cascades that modulate central and peripheral cell functions. A fine balance between biosynthetic and degrading enzymes that control the right concentration of eCBs has been shown to provide neuroprotection in traumatic, ischemic, inflammatory and neurotoxic damage of the brain. RESULTS: Since the existence of eCBs and their binding receptors was documented in the retina of numerous species (from fishes to primates), their involvement in the visual processing has been demonstrated, more recently with a focus on retinal neurodegeneration and neuroprotection. CONCLUSION: The aim of this review is to present a modern view of the endocannabinoid system, in order to discuss in a better perspective available data from preclinical studies on the use of eCBs as new neuroprotective agents, potentially useful to prevent glaucoma and retinal neurodegenerative diseases.

6 Review The supraciliary space as a suitable pathway for glaucoma surgery: Ho-hum or home run? 2017

Figus, Michele / Posarelli, Chiara / Passani, Andrea / Albert, Timothy G / Oddone, Francesco / Sframeli, Angela Tindara / Nardi, Marco. ·Department of Surgical, Medical, and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy. Electronic address: figus@ocupisa.it. · Department of Surgical, Medical, and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy. · IRCCS Bietti Foundation, Rome, Italy. ·Surv Ophthalmol · Pubmed #28506604.

ABSTRACT: The supraciliary space is a physiological route for aqueous humor outflow located anteriorly between the outer surface of the ciliary body and the internal surface of the sclera. Posteriorly, the suprachoroidal space is located between the choroid and the internal surface of the sclera. These spaces have been targeted as suitable and helpful pathways for glaucoma treatment, alternatives to the traditional subconjunctival space. The subconjunctival surgical pathway is affected by several limitations such as poor cosmesis, a lifetime risk for endophthalmitis, and an unpredictable wound healing response. Because of these limitations, the supraciliary space has gained growing interest as a possible target for new glaucoma drainage devices such as: Gold Micro Shunt (SOLX Inc.; Waltham, MA, USA), iStent Supra (Glaukos Corporation, Laguna Hills, CA, USA), CyPass Micro-Stent (Transcend Medical Inc., Menlo Park, CA, USA), Aquashunt (OPKO health Inc., Miami, FL, USA), STARflo (iSTAR Medical, Isnes, Belgium), and Esnoper-Clip implant (AJL Ophthalmics, Álava, Spain). We review the current literature concerning the supraciliary space to evaluate its safety and efficacy as a suitable pathway for glaucoma surgical treatment.

7 Review A Review of the Ahmed Glaucoma Valve Implant and Comparison with Other Surgical Operations. 2017

Riva, Ivano / Roberti, Gloria / Katsanos, Andreas / Oddone, Francesco / Quaranta, Luciano. ·IRCCS - Fondazione "G.B. Bietti" per lo Studio e la Ricerca in Oftalmologia, Rome, Italy. · Department of Ophthalmology, University of Ioannina, Ioannina, Greece. · Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. luciano.quaranta@unibs.it. ·Adv Ther · Pubmed #28283892.

ABSTRACT: The Ahmed glaucoma valve (AGV) is a popular glaucoma drainage implant used for the control of intraocular pressure in patients with glaucoma. While in the past AGV implantation was reserved for glaucoma patients poorly controlled after one or more filtration procedures, mounting evidence has recently encouraged its use as a primary surgery in selected cases. AGV has been demonstrated to be safe and effective in reducing intraocular pressure in patients with primary or secondary refractory glaucoma. Compared to other glaucoma surgeries, AGV implantation has shown favorable efficacy and safety. The aim of this article is to review the results of studies directly comparing AGV with other surgical procedures in patients with glaucoma.

8 Review Glaucoma: recent advances in the involvement of autoimmunity. 2017

Rizzo, Maria Ida / Greco, Antonio / De Virgilio, Armando / Gallo, Andrea / Taverniti, Luciano / Fusconi, Massimo / Conte, Michela / Pagliuca, Giulio / Turchetta, Rosaria / de Vincentiis, Marco. ·ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy. · Department of Surgical Science, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy. · ENT Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy. armando.devirgilio@gmail.com. · Department of Surgical Science, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy. armando.devirgilio@gmail.com. · Otorhinolaryngology Section, Department of Medico-Surgical Sciences and Biotechnologies, ''Sapienza'' University of Rome, Corso della Repubblica, 79, 04100, Latina, LT, Italy. · Ophthalmology Section, Department Organs of Sense, University of Rome "La Sapienza", Viale del Policlinico 155, 00100, Rome, Italy. ·Immunol Res · Pubmed #27475096.

ABSTRACT: Glaucomatous optic neuropathy is the most commonly acquired optic neuropathy encountered in clinical practice. It is the second leading cause of blindness globally, after cataracts, but it presents a greater public health challenge than cataracts, because the blindness it causes is irreversible. It has pathogenesis still largely unknown and no established cure. Alterations in serum antibody profiles, upregulation, and downregulation have been described, but it still remains elusive if the autoantibodies seen in glaucoma are an epiphenomenon or causative. Hypertension, diabetes, and hearing disorders also are associated. This review is a glaucoma update with focus about the recent advances in the last 15 years.

9 Review Involvement of the Anterior Segment of the Eye in Patients with Mucopolysaccharidoses: A Review of Reported Cases and Updates on the Latest Diagnostic Instrumentation. 2017

Bruscolini, A / Amorelli, G M / Rama, P / Lambiase, A / La Cava, M / Abbouda, A. ·a Department of Sense Organs, Section of Ophthalmology , University of Rome "Sapienza," Rome , Italy. · b Cornea and Ocular Surface Unit , Scientific Institute San Raffaele , Milan , Italy. ·Semin Ophthalmol · Pubmed #27420114.

ABSTRACT: Mucopolysaccharidoses (MPS) are a heterogeneous group of rare inherited disorders, characterized by the lack or malfunction of lysosomal enzymes necessary for glycosaminoglycan (GAGs) catabolism, and their subsequent accumulation in many tissues and organs throughout the body. An overview of the current knowledge of corneal and anterior segment manifestations in patients with MPS was provided and clinical guidelines for their diagnosis and management were furnished. The anterior segment of the eye is usually involved in every subtype of MPS, with major complications including varying degrees of corneal opacification and raised intraocular pressure (IOP) with development of glaucoma. Their recognition and management can be very useful in the diagnosis of MPS. Novel techniques are available to objectively measure the grade and extent of corneal clouding and give information about the anatomy of the anterior chamber and the structures of the angle beyond the clouded cornea. It is advisable to take advantage of this new instrumentation in order to obtain thorough information on the ocular involvement and its related anterior chamber complications for a better management of patients with MPS, both in terms of visual prognosis and therapeutic outcome.

10 Review From DNA damage to functional changes of the trabecular meshwork in aging and glaucoma. 2016

Saccà, Sergio Claudio / Gandolfi, Stefano / Bagnis, Alessandro / Manni, Gianluca / Damonte, Gianluca / Traverso, Carlo Enrico / Izzotti, Alberto. ·IRCCS San Martino University Hospital, Department of Neuroscience and Sense Organs, San Martino Hospital, Ophthalmology Unit, Viale Benedetto XV, 16132 Genoa, Italy. Electronic address: sergio.sacca@hsanmartino.it. · Ophthalmology Unit, Department of Biological, Biotechnological and Translational Sciences, University of Parma, Parma, Italy. · University of Genoa, Eye Clinic, Department of Neuroscience and Sense Organs, Viale Benedetto XV, 5, 16148 Genoa, Italy. · Dept. of Clinical Science and Translational Medicine, University Tor Vergata, Rome, Italy. · Dept. of Experimental Medicine, Section of Biochemistry and Center of Excellence for Biomedical Research, University of Genoa, Viale Benedetto XV 1, 16132 Genoa, Italy. · Mutagenesis Unit, IRCCS San Martino University Hospital, IST National Institute for Cancer Research, Department of Health Sciences, University of Genoa, Via A. Pastore 1, Genoa I-16132, Italy. ·Ageing Res Rev · Pubmed #27242026.

ABSTRACT: Glaucoma is a degenerative disease of the eye. Both the anterior and posterior segments of the eye are affected, extensive damage being detectable in the trabecular meshwork and the inner retina-central visual pathway complex. Oxidative stress is claimed to be mainly responsible for molecular damage in the anterior chamber. Indeed, oxidation harms the trabecular meshwork, leading eventually to endothelial cell decay, tissue malfunction, subclinical inflammation, changes in the extracellular matrix and cytoskeleton, altered motility, reduced outflow facility and (ultimately) increased IOP. Moreover, free radicals are involved in aging and can be produced in the brain (as well as in the eye) as a result of ischemia, leading to oxidation of the surrounding neurons. Glaucoma-related cell death occurs by means of apoptosis, and apoptosis is triggered by oxidative stress via (a) mitochondrial damage, (b) inflammation, (c) endothelial dysregulation and dysfunction, and (d) hypoxia. The proteomics of the aqueous humor is significantly altered in glaucoma as a result of oxidation-induced trabecular damage. Those proteins whose aqueous humor levels are increased in glaucoma are biomarkers of trabecular meshwork impairment. Their diffusion from the anterior to the posterior segment of the eye may be relevant in the cascade of events triggering apoptosis in the inner retinal layers, including the ganglion cells.

11 Review Quality of Life in Glaucoma: A Review of the Literature. 2016

Quaranta, Luciano / Riva, Ivano / Gerardi, Chiara / Oddone, Francesco / Floriani, Irene / Konstas, Anastasios G P. ·Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. luciano.quaranta@unibs.it. · Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy. · IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy. · IRCCS-Fondazione G.B. Bietti, Rome, Italy. · 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece. ·Adv Ther · Pubmed #27138604.

ABSTRACT: The ultimate goal of glaucoma management is the preservation of patients' visual function and quality of life (QoL). The disease itself as well as the medical or surgical treatment can have an enormous impact on a patient's QoL. Even the mere diagnosis of a chronic, irreversible, potentially blinding disorder can adversely affect the patient's sense of well-being and QoL by eliciting significant anxiety. Patients with primary open-angle glaucoma rarely present with visual symptoms, at least early in the course of the disease. A better understanding of patient-reported QoL can improve patient-physician interaction and enhance treatment adherence by customizing treatment options based on individual patient profile, thus optimizing long-term prognosis. These aspects are summarized and critically appraised in this article.

12 Review Emerging Concepts in Glaucoma and Review of the Literature. 2016

Greco, Antonio / Rizzo, Maria Ida / De Virgilio, Armando / Gallo, Andrea / Fusconi, Massimo / de Vincentiis, Marco. ·Department of Sense Organs, Sapienza University, Rome, Italy. · Department of Surgical Science, Sapienza University, Rome, Italy. Electronic address: mariaidarizzo@gmail.com. · Department of Surgical Science, Sapienza University, Rome, Italy. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy. ·Am J Med · Pubmed #27125182.

ABSTRACT: Glaucoma is the most commonly acquired optic neuropathy. It represents a public health challenge because it causes an irreversible blindness. Emerging evidence indicates that the pathogenesis of glaucoma depends on several interacting pathogenetic mechanisms, which include mechanical effects by an increased intraocular pressure, decreased neutrophine-supply, hypoxia, excitotoxicity, oxidative stress, and the involvement of autoimmune processes. In particular, alterations in serum antibody profiles have been described. However, it is still unclear whether the autoantibodies seen in glaucoma are an epiphenomenon or causative. Oxidative stress appears to be a critical factor in the neurodestructive consequences of mitochondrial dysfunction, glial activation response, and uncontrolled activity of the immune system during glaucomatous neurodegeneration. In addition, hearing loss has been identified in association with glaucoma. A higher prevalence of antiphosphatidylserine antibodies of the immunoglobulin G class was seen in normal-tension glaucoma patients with hearing loss in comparison with normal-tension glaucoma patients with normacusis. This finding suggests a similar pathological pathway as a sign for generalized disease.

13 Review New strategies for neuroprotection in glaucoma, a disease that affects the central nervous system. 2016

Nucci, Carlo / Russo, Rossella / Martucci, Alessio / Giannini, Clarissa / Garaci, Francesco / Floris, Roberto / Bagetta, Giacinto / Morrone, Luigi Antonio. ·Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome Italy. Electronic address: nucci@med.uniroma2.it. · Department of Pharmacy, Nutritional and Health Sciences University of Calabria, Arcavacata di Rende, Italy; University Center for Adaptive Disorders and Head Pain, Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy. · Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome Italy. · UOC Neuroradiologia, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy; San Raffaele Cassino (FR), Italy. · UOC Neuroradiologia, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. ·Eur J Pharmacol · Pubmed #27089818.

ABSTRACT: Glaucoma is a disease where retinal ganglion cells (RGC) are specifically affected though a number of evidences endorse the hypothesis that glaucoma is a neuro-degenerative disorder of the central nervous system and suggest a possible connection between glaucomatous damage and cerebrovascular alterations. The mechanisms underlying RGC loss are not yet fully known but alterations of the autophagy machinery have been recently proposed as a potential contributing factor as for Alzheimer's disease. Here we review the current literature on new strategies for neuroprotection in glaucoma, focusing on pharmacologic strategies to minimize RGC damage.

14 Review Retinal ganglion cell death in glaucoma: Exploring the role of neuroinflammation. 2016

Russo, Rossella / Varano, Giuseppe Pasquale / Adornetto, Annagrazia / Nucci, Carlo / Corasaniti, Maria Tiziana / Bagetta, Giacinto / Morrone, Luigi Antonio. ·Department of Pharmacy, Nutritional and Health Sciences, University of Calabria, Arcavacata di Rende, Italy. Electronic address: rossella.russo@unical.it. · Department of Pharmacy, Nutritional and Health Sciences, University of Calabria, Arcavacata di Rende, Italy. · Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome Italy. · Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy. · Department of Pharmacy, Nutritional and Health Sciences, University of Calabria, Arcavacata di Rende, Italy; University Center for Adaptive Disorders and Head Pain, Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy. ·Eur J Pharmacol · Pubmed #27044433.

ABSTRACT: In clinical glaucoma, as well as in experimental models, the loss of retinal ganglion cells occurs by apoptosis. This final event is preceded by inflammatory responses involving the activation of innate and adaptive immunity, with retinal and optic nerve resident glial cells acting as major players. Here we review the current literature on the role of neuroinflammation in neurodegeneration, focusing on the inflammatory molecular mechanisms involved in the pathogenesis and progression of the optic neuropathy.

15 Review Macular versus Retinal Nerve Fiber Layer Parameters for Diagnosing Manifest Glaucoma: A Systematic Review of Diagnostic Accuracy Studies. 2016

Oddone, Francesco / Lucenteforte, Ersilia / Michelessi, Manuele / Rizzo, Stanislao / Donati, Simone / Parravano, Mariacristina / Virgili, Gianni. ·Ophthalmology, Fondazione G.B. Bietti per lo studio e la ricerca in Oftalmolologia-IRCCS, Rome, Italy. · Department of Neurosciences, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy. Electronic address: ersilia.lucenteforte@unifi.it. · Department of Translational Surgery and Medicine, Eye Clinic, University of Florence, Florence, Italy. · Department of Surgical and Morphological Sciences, Section of Ophthalmology, University of Insubria, Varese-Como, Italy. ·Ophthalmology · Pubmed #26891880.

ABSTRACT: TOPIC: Macular parameters have been proposed as an alternative to retinal nerve fiber layer (RNFL) parameters to diagnose glaucoma. Comparing the diagnostic accuracy of macular parameters, specifically the ganglion cell complex (GCC) and ganglion cell inner plexiform layer (GCIPL), with the accuracy of RNFL parameters for detecting manifest glaucoma is important to guide clinical practice and future research. METHODS: Studies using spectral domain optical coherence tomography (SD OCT) and reporting macular parameters were included if they allowed the extraction of accuracy data for diagnosing manifest glaucoma, as confirmed with automated perimetry or a clinician's optic nerve head (ONH) assessment. Cross-sectional cohort studies and case-control studies were included. The QUADAS 2 tool was used to assess methodological quality. Only direct comparisons of macular versus RNFL parameters (i.e., in the same study) were conducted. Summary sensitivity and specificity of each macular or RNFL parameter were reported, and the relative diagnostic odds ratio (DOR) was calculated in hierarchical summary receiver operating characteristic (HSROC) models to compare them. RESULTS: Thirty-four studies investigated macular parameters using RTVue OCT (Optovue Inc., Fremont, CA) (19 studies, 3094 subjects), Cirrus OCT (Carl Zeiss Meditec Inc., Dublin, CA) (14 studies, 2164 subjects), or 3D Topcon OCT (Topcon, Inc., Tokyo, Japan) (4 studies, 522 subjects). Thirty-two of these studies allowed comparisons between macular and RNFL parameters. Studies generally reported sensitivities at fixed specificities, more commonly 0.90 or 0.95, with sensitivities of most best-performing parameters between 0.65 and 0.75. For all OCT devices, compared with RNFL parameters, macular parameters were similarly or slightly less accurate for detecting glaucoma at the highest reported specificity, which was confirmed in analyses at the lowest specificity. Included studies suffered from limitations, especially the case-control study design, which is known to overestimate accuracy. However, this flaw is less relevant as a source of bias in direct comparisons conducted within studies. CONCLUSIONS: With the use of OCT, RNFL parameters are still preferable to macular parameters for diagnosing manifest glaucoma, but the differences are small. Because of high heterogeneity, direct comparative or randomized studies of OCT devices or OCT parameters and diagnostic strategies are essential.

16 Review Peripheral iridotomy for pigmentary glaucoma. 2016

Michelessi, Manuele / Lindsley, Kristina. ·Ophthalmology, Fondazione G.B. Bietti per lo studio e la ricerca in Oftalmolologia-IRCCS, Via Livenza n 3, Rome, Italy, 00198. ·Cochrane Database Syst Rev · Pubmed #26871761.

ABSTRACT: BACKGROUND: Glaucoma is a chronic optic neuropathy characterized by retinal ganglion cell death resulting in damage to the optic nerve head and the retinal nerve fiber layer. Pigment dispersion syndrome is characterized by a structural disturbance in the iris pigment epithelium (the densely pigmented posterior surface of the iris) that leads to dispersion of the pigment and its deposition on various structures within the eye. Pigmentary glaucoma is a specific form of open-angle glaucoma found in patients with pigment dispersion syndrome.Topcial medical therapy is usually the first-line treatment; however, peripheral laser iridotomy has been proposed as an alternate treatment. Peripheral laser iridotomy involves creating an opening in the iris tissue to allow drainage of fluid from the posterior chamber to the anterior chamber and vice versa. Equalizing the pressure within the eye may help to alleviate the friction that leads to pigment dispersion and prevent visual field deterioration. However, the effectiveness of peripheral laser iridotomy in reducing the development or progression of pigmentary glaucoma is unknown. OBJECTIVES: The objective of this review was to assess the effects of peripheral laser iridotomy compared with other interventions, including medication, trabeculoplasty, and trabeculectomy, or no treatment, for pigment dispersion syndrome and pigmentary glaucoma. SEARCH METHODS: We searched a number of electronic databases including CENTRAL, MEDLINE and EMBASE and clinical trials websites such as (mRCT) and ClinicalTrials.gov. We last searched the electronic databases on 2 November 2015. SELECTION CRITERIA: We included randomized controlled trials (RCTs) that had compared peripheral laser iridotomy versus no treatment or other treatments for pigment dispersion syndrome and pigmentary glaucoma. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures for systematic reviews. Two review authors independently screened articles for eligibility, extracted data, and assessed included trials for risk of bias. We did not perform a meta-analysis because of variability in reporting and follow-up intervals for primary and secondary outcomes of interest. MAIN RESULTS: We included five RCTs (260 eyes of 195 participants) comparing yttrium-aluminum-garnet (YAG) laser iridotomy versus no laser iridotomy. Three trials included participants with pigmentary glaucoma at baseline, and two trials enrolled participants with pigment dispersion syndrome. Only two trials reported the country of enrollment: one - Italy, the other - United Kingdom. Overall, we assessed trials as having high or unclear risk of bias owing to incomplete or missing data and selective outcome reporting.Data on visual fields were available for one of three trials that included participants with pigmentary glaucoma at baseline. At an average follow-up of 28 months, the risk of progression of visual field damage was uncertain when comparing laser iridotomy with no iridotomy (risk ratio (RR) 1.00, 95% confidence interval (95% CI) 0.16 to 6.25; 32 eyes; very low-quality evidence). The two trials that enrolled participants with pigment dispersion syndrome at baseline reported the proportion of participants with onset of glaucomatous visual field changes during the study period. At three-year follow-up, one trial reported that the risk ratio for conversion to glaucoma was 2.72 (95% CI 0.76 to 9.68; 42 eyes; very low-quality evidence). At 10-year follow-up, the other trial reported that no eye showed visual field progression.One trial reported the mean change in intraocular pressure (IOP) in eyes with pigmentary glaucoma: At an average of nine months of follow-up, the mean difference in IOP between groups was 2.69 mmHg less in the laser iridotomy group than in the control group (95% CI -6.05 to 0.67; 14 eyes; very low-quality evidence). This trial also reported the mean change in anterior chamber depth at an average of nine months of follow-up and reported no meaningful differences between groups (mean difference 0.04 mm, 95% CI -0.07 to 0.15; 14 eyes; very low-quality evidence). No other trial reported mean change in anterior chamber depth. Two trials reported greater flattening of iris configuration in the laser iridotomy group than in the control group among eyes with pigmentary glaucoma; however, investigators provided insufficient data for analysis. No trial reported data related to mean visual acuity, aqueous melanin granules, costs, or quality of life outcomes.Two trials assessed the need for additional treatment for control of IOP. One trial that enrolled participants with pigmentary glaucoma reported that more eyes in the laser iridotomy group required additional treatment between six and 23 months of follow-up than eyes in the control group (RR 1.73, 95% CI 1.08 to 2.75; 46 eyes); however, the other trial enrolled participants with pigment dispersion syndrome and indicated that the difference between groups at three-year follow-up was uncertain (RR 0.91, 95% CI 0.38 to 2.17; 105 eyes). We graded the certainty of evidence for this outcome as very low.Two trials reported that no serious adverse events were observed in either group among eyes with pigment dispersion syndrome. Mild adverse events included postoperative inflammation; two participants required cataract surgery (at 18 and 34 months after baseline), and two participants required a repeat iridotomy. AUTHORS' CONCLUSIONS: We found insufficient evidence of high quality on the effectiveness of peripheral iridotomy for pigmentary glaucoma or pigment dispersion syndrome. Although adverse events associated with peripheral iridotomy may be minimal, the long-term effects on visual function and other patient-important outcomes have not been established. Future research on this topic should focus on outcomes that are important to patients and the optimal timing of treatment in the disease process (eg, pigment dispersion syndrome with normal IOP, pigment dispersion syndrome with established ocular hypertension, pigmentary glaucoma).

17 Review The Outflow Pathway: A Tissue With Morphological and Functional Unity. 2016

Saccà, Sergio Claudio / Gandolfi, Stefano / Bagnis, Alessandro / Manni, Gianluca / Damonte, Gianluca / Traverso, Carlo Enrico / Izzotti, Alberto. ·Department of Neuroscience and Sense Organs, Ophthalmology Unit, IRCCS San Martino University Hospital, San Martino Hospital, Genoa, Italy. · Department of Biological, Biotechnological and Translational Sciences, Ophthalmology Unit, University of Parma, Parma, Italy. · Department of Neuroscience and Sense Organs, Eye Clinic, University of Genoa, Genoa, Italy. · Department of Clinical Science and Translational Medicine, University Tor Vergata, Rome, Italy. · Department of Experimental Medicine, Section of Biochemistry and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy. · Department of Health Sciences, Mutagenesis Unit, IRCCS San Martino University Hospital, IST National Institute for Cancer Research, University of Genoa, Genoa, Italy. ·J Cell Physiol · Pubmed #26754581.

ABSTRACT: The trabecular meshwork (TM) plays an important role in high-tension glaucomas. Indeed, the TM is a true organ, through which the aqueous humor flows from the anterior chamber to Schlemm's canal (SC). Until recently, the TM, which is constituted by endothelial-like cells, was described as a kind of passive filter. In reality, it is much more. The cells delineating the structures of the collagen framework of the TM are endowed with a cytoskeleton, and are thus able to change their shape. These cells also have the ability to secrete the extracellular matrix, which expresses proteins and cytokines, and are capable of phagocytosis and autophagy. The cytoskeleton is attached to the nuclear membrane and can, in millionths of a second, send signals to the nucleus in order to alter the expression of genes in an attempt to adapt to biomechanical insult. Oxidative stress, as happens in aging, has a deleterious effect on the TM, leading eventually to cell decay, tissue malfunction, subclinical inflammation, changes in the extracellular matrix and cytoskeleton, altered motility, reduced outflow facility, and (ultimately) increased IOP. TM failure is the most relevant factor in the cascade of events triggering apoptosis in the inner retinal layers, including ganglion cells. J. Cell. Physiol. 231: 1876-1893, 2016. © 2016 Wiley Periodicals, Inc.

18 Review Cytidine 5'-Diphosphocholine (Citicoline) in Glaucoma: Rationale of Its Use, Current Evidence and Future Perspectives. 2015

Roberti, Gloria / Tanga, Lucia / Michelessi, Manuele / Quaranta, Luciano / Parisi, Vincenzo / Manni, Gianluca / Oddone, Francesco. ·IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy. gloriaroberti82@gmail.com. · IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy. lucia.tanga@gmail.com. · IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy. manuele_michelessi@yahoo.it. · DSMC, Università degli studi di Brescia, USVD "Centro per lo studio del Glaucoma" P.le Spedali Civili, 1, 25123 Brescia, Italy. luciano.quaranta@unibs.it. · IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy. vmparisi@gmail.com. · DSCMT, Università di Roma Tor Vergata, Viale Oxford 81, 00133 Rome, Italy. gianlucamanni53@gmail.com. · IRCCS-Fondazione GB Bietti, Via Livenza, 3, 00198 Rome, Italy. oddonef@gmail.com. ·Int J Mol Sci · Pubmed #26633368.

ABSTRACT: Cytidine 5'-diphosphocholine or citicoline is an endogenous compound that acts in the biosynthetic pathway of phospholipids of cell membranes, particularly phosphatidylcholine, and it is able to increase neurotrasmitters levels in the central nervous system. Citicoline has shown positive effects in Parkinson's disease and Alzheimer's disease, as well as in amblyopia. Glaucoma is a neurodegenerative disease currently considered a disease involving ocular and visual brain structures. Neuroprotection has been proposed as a valid therapeutic option for those patients progressing despite a well-controlled intraocular pressure, the main risk factor for the progression of the disease. The aim of this review is to critically summarize the current evidence about the effect of citicoline in glaucoma.

19 Review Optic nerve head and fibre layer imaging for diagnosing glaucoma. 2015

Michelessi, Manuele / Lucenteforte, Ersilia / Oddone, Francesco / Brazzelli, Miriam / Parravano, Mariacristina / Franchi, Sara / Ng, Sueko M / Virgili, Gianni. ·Ophthalmology, Fondazione G.B. Bietti per lo studio e la ricerca in Oftalmolologia-IRCCS, Via Livenza n 3, Rome, Italy, 00198. ·Cochrane Database Syst Rev · Pubmed #26618332.

ABSTRACT: BACKGROUND: The diagnosis of glaucoma is traditionally based on the finding of optic nerve head (ONH) damage assessed subjectively by ophthalmoscopy or photography or by corresponding damage to the visual field assessed by automated perimetry, or both. Diagnostic assessments are usually required when ophthalmologists or primary eye care professionals find elevated intraocular pressure (IOP) or a suspect appearance of the ONH. Imaging tests such as confocal scanning laser ophthalmoscopy (HRT), optical coherence tomography (OCT) and scanning laser polarimetry (SLP, as used by the GDx instrument), provide an objective measure of the structural changes of retinal nerve fibre layer (RNFL) thickness and ONH parameters occurring in glaucoma. OBJECTIVES: To determine the diagnostic accuracy of HRT, OCT and GDx for diagnosing manifest glaucoma by detecting ONH and RNFL damage. SEARCH METHODS: We searched several databases for this review. The most recent searches were on 19 February 2015. SELECTION CRITERIA: We included prospective and retrospective cohort studies and case-control studies that evaluated the accuracy of OCT, HRT or the GDx for diagnosing glaucoma. We excluded population-based screening studies, since we planned to consider studies on self-referred people or participants in whom a risk factor for glaucoma had already been identified in primary care, such as elevated IOP or a family history of glaucoma. We only considered recent commercial versions of the tests: spectral domain OCT, HRT III and GDx VCC or ECC. DATA COLLECTION AND ANALYSIS: We adopted standard Cochrane methods. We fitted a hierarchical summary ROC (HSROC) model using the METADAS macro in SAS software. After studies were selected, we decided to use 2 x 2 data at 0.95 specificity or closer in meta-analyses, since this was the most commonly-reported level. MAIN RESULTS: We included 106 studies in this review, which analysed 16,260 eyes (8353 cases, 7907 controls) in total. Forty studies (5574 participants) assessed GDx, 18 studies (3550 participants) HRT, and 63 (9390 participants) OCT, with 12 of these studies comparing two or three tests. Regarding study quality, a case-control design in 103 studies raised concerns as it can overestimate accuracy and reduce the applicability of the results to daily practice. Twenty-four studies were sponsored by the manufacturer, and in 15 the potential conflict of interest was unclear.Comparisons made within each test were more reliable than those between tests, as they were mostly based on direct comparisons within each study.The Nerve Fibre Indicator yielded the highest accuracy (estimate, 95% confidence interval (CI)) among GDx parameters (sensitivity: 0.67, 0.55 to 0.77; specificity: 0.94, 0.92 to 0.95). For HRT measures, the Vertical Cup/Disc (C/D) ratio (sensitivity: 0.72, 0.60 to 0.68; specificity: 0.94, 0.92 to 0.95) was no different from other parameters. With OCT, the accuracy of average RNFL retinal thickness was similar to the inferior sector (0.72, 0.65 to 0.77; specificity: 0.93, 0.92 to 0.95) and, in different studies, to the vertical C/D ratio.Comparing the parameters with the highest diagnostic odds ratio (DOR) for each device in a single HSROC model, the performance of GDx, HRT and OCT was remarkably similar. At a sensitivity of 0.70 and a high specificity close to 0.95 as in most of these studies, in 1000 people referred by primary eye care, of whom 200 have manifest glaucoma, such as in those who have already undergone some functional or anatomic testing by optometrists, the best measures of GDx, HRT and OCT would miss about 60 cases out of the 200 patients with glaucoma, and would incorrectly refer 50 out of 800 patients without glaucoma. If prevalence were 5%, e.g. such as in people referred only because of family history of glaucoma, the corresponding figures would be 15 patients missed out of 50 with manifest glaucoma, avoiding referral of about 890 out of 950 non-glaucomatous people.Heterogeneity investigations found that sensitivity estimate was higher for studies with more severe glaucoma, expressed as worse average mean deviation (MD): 0.79 (0.74 to 0.83) for MD < -6 db versus 0.64 (0.60 to 0.69) for MD ≥ -6 db, at a similar summary specificity (0.93, 95% CI 0.92 to 0.94 and, respectively, 0.94; 95% CI 0.93 to 0.95; P < 0.0001 for the difference in relative DOR). AUTHORS' CONCLUSIONS: The accuracy of imaging tests for detecting manifest glaucoma was variable across studies, but overall similar for different devices. Accuracy may have been overestimated due to the case-control design, which is a serious limitation of the current evidence base.We recommend that further diagnostic accuracy studies are carried out on patients selected consecutively at a defined step of the clinical pathway, providing a description of risk factors leading to referral and bearing in mind the consequences of false positives and false negatives in the setting in which the diagnostic question is made. Future research should report accuracy for each threshold of these continuous measures, or publish raw data.

20 Review Glaucoma risks in advanced corneal surgery. 2015

Maurino, Vincenzo / Aiello, Francesco. ·Moorfields Eye Hospital, NHS Foundation Trust, London, UK. Electronic address: vincenzo.maurino@moorfields.nhs.uk. · Moorfields Eye Hospital, NHS Foundation Trust, London, UK; Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. ·Prog Brain Res · Pubmed #26518083.

ABSTRACT: Penetrating corneal transplant (PKP) surgery has been performed for centuries as the procedure of choice to restore vision in cases of advanced corneal disease. However, the last two decades have seen the introduction of lamellar corneal surgery (deep anterior lamellar keratoplasty, DALK; Descemet stripping-automated endothelial keratoplasty, DSAEK; and Descemet membrane endothelial keratoplasty, DMEK) which has shown several advantages over PKP and has rapidly gained popularity, given its benefits. Glaucoma after corneal graft surgery is an important cause of visual loss and graft failure. The main risk factors for developing glaucoma after any type of corneal graft are steroid-related intraocular hypertension and pre-existing glaucoma. The incidence of glaucoma after corneal graft surgery varies according to the specific risk factors and the type of corneal graft performed. One major advantage of modern layer selective lamellar keratoplasty is the reduced risk of glaucoma compared with PKP. This reduced glaucoma risk after corneal lamellar graft surgery is mainly due to the less destructive surgical nature of the lamellar procedures and also the reduced use of postoperative steroid treatment. Glaucoma can complicate not only corneal transplantation but has also been observed following other anterior segment procedures from laser refractive surgery to keratoprosthesis. The aim of this chapter is to describe the incidence, etiology, and management of glaucoma after corneal transplant and some common corneal surgical procedures.

21 Review Brain imaging in glaucoma from clinical studies to clinical practice. 2015

Altobelli, Simone / Toschi, Nicola / Mancino, Raffaele / Nucci, Carlo / Schillaci, Orazio / Floris, Roberto / Garaci, Francesco. ·Diagnostic Imaging section, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy. · Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA. · Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. · Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy. · Diagnostic Imaging section, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. · Diagnostic Imaging Section, Tor Vergata University Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. Electronic address: francesco.garaci@uniroma2.it. ·Prog Brain Res · Pubmed #26518077.

ABSTRACT: Recent advances in Magnetic Resonance Imaging (MRI) technology have brought new insight in central nervous system (CNS) manifestation of glaucoma. New MR techniques allowed to identify in vivo and noninvasively alterations along all the visual pathway in both early and late stages of the disease. Conventional neuroimaging still plays an important role, mostly in the anatomy description and in the differential diagnosis with space occupying lesions but it should be supported by other advanced MR techniques such as diffusion tensor imaging, functional imaging (BOLD-ASL), and magnetic resonance spectroscopy, which offer the possibility to investigate deep white matter tracts integrity and cortical gray matter changes. In a future perspective, MR quantification of CNS damage associated with glaucoma will be of pivotal importance for prognostic stratification and evaluation of neuroprotective therapy response.

22 Review Links among glaucoma, neurodegenerative, and vascular diseases of the central nervous system. 2015

Nucci, Carlo / Martucci, Alessio / Cesareo, Massimo / Garaci, Francesco / Morrone, Luigi Antonio / Russo, Rossella / Corasaniti, Maria Tiziana / Bagetta, Giacinto / Mancino, Raffaele. ·Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. Electronic address: nucci@med.uniroma2.it. · Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. · Diagnostic Imaging Section, Tor Vergata University Hospital, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. · Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy; University Consortium for Adaptive Disorders and Head Pain (UCHAD), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy. · Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy. · Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy. ·Prog Brain Res · Pubmed #26518072.

ABSTRACT: Glaucoma is the leading cause of irreversible blindness worldwide. Although the intraocular pressure (IOP) has been considered for long time the key point and the only treatable risk factor of the disease, there are cases in which glaucoma continues to progress despite normal IOP values. Vision loss in glaucoma is related to a selective decrease in the number of retinal ganglion cells by apoptosis that is associated to alterations of the central visual pathways. Interestingly, similar events have been also described in disorders of the central nervous system (CNS), such as Alzheimer's disease, Parkinson's disease, Leber's hereditary optic neuropathy, and cerebrovascular diseases. In this review, we discuss recent evidence supporting pathological links between glaucoma and disorders of the CNS.

23 Review Natural compounds and retinal ganglion cell neuroprotection. 2015

Morrone, Luigi Antonio / Rombolà, Laura / Corasaniti, Maria Tiziana / Bagetta, Giacinto / Nucci, Carlo / Russo, Rossella. ·Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy; University Consortium for Adaptive Disorders and Head Pain (UCHAD), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy. Electronic address: luigimorron@libero.it. · Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy. · Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy. · Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy; University Consortium for Adaptive Disorders and Head Pain (UCHAD), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy. · Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. ·Prog Brain Res · Pubmed #26497795.

ABSTRACT: Glaucoma, the second leading cause of blindness in the world, is a chronic optic neuropathy often associated with increased intraocular pressure and characterized by progressive retinal ganglion cell (RGC) axons degeneration and death leading to typical optic nerve head damage and distinctive visual field defects. Although the pathogenesis of glaucoma is still largely unknown, it is hypothesized that RCGs become damaged through various insults/mechanisms, including ischemia, oxidative stress, excitotoxicity, defective axonal transport, trophic factor withdrawal, and neuroinflammation. In this review, we summarize the potential benefits of several natural compounds for RGCs neuroprotection.

24 Review Autophagy dysregulation and the fate of retinal ganglion cells in glaucomatous optic neuropathy. 2015

Russo, Rossella / Nucci, Carlo / Corasaniti, Maria Tiziana / Bagetta, Giacinto / Morrone, Luigi Antonio. ·Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy. Electronic address: rossella.russo@unical.it. · Ophthalmology Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy. · Department of Health Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy. · Department of Pharmacy and Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Arcavacata di Rende, Italy; University Consortium for Adaptive Disorders and Head Pain (UCHAD), Section of Neuropharmacology of Normal and Pathological Neuronal Plasticity, University of Calabria, Arcavacata di Rende, Italy. ·Prog Brain Res · Pubmed #26497786.

ABSTRACT: Glaucoma is a neurodegenerative disease caused by the progressive apoptotic death of retinal ganglion cells (RGCs). The mechanisms leading to the RGC loss are still unknown but it is now clear that, besides elevated intraocular pressure (IOP), which is considered the main risk factor, other IOP-independent determinants are responsible for the development of the optic neuropathy. Autophagy is a highly conserved catabolic pathway by which cellular components are degraded through the lysosomes. Dysfunctional autophagic pathway has been associated with several neuropathological conditions and a considerable number of studies have proved autophagy as a potential target for pharmacological modulation to achieve neuroprotection. Here, we review the current literature bridging the degeneration of RGCs to alterations of the autophagic pathway; we also discuss the possible role of autophagy in the pathogenesis and progression of glaucoma in view of the future application of autophagy modulators for glaucoma therapy.

25 Review Rare Diseases Leading to Childhood Glaucoma: Epidemiology, Pathophysiogenesis, and Management. 2015

Abdolrahimzadeh, Solmaz / Fameli, Valeria / Mollo, Roberto / Contestabile, Maria Teresa / Perdicchi, Andrea / Recupero, Santi Maria. ·Ophthalmology Unit, DAI Head/Neck, Umberto I Policlinic, University of Rome "Sapienza", Viale del Policlinico 155, 00161 Rome, Italy. · Ophthalmology Unit, Department of Sense Organs, University of Rome "Sapienza", Viale del Policlinico 155, 00161 Rome, Italy. · Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome "Sapienza", via di Grottarossa 1035-1039, 00189 Rome, Italy. ·Biomed Res Int · Pubmed #26451378.

ABSTRACT: Noteworthy heterogeneity exists in the rare diseases associated with childhood glaucoma. Primary congenital glaucoma is mostly sporadic; however, 10% to 40% of cases are familial. CYP1B1 gene mutations seem to account for 87% of familial cases and 27% of sporadic cases. Childhood glaucoma is classified in primary and secondary congenital glaucoma, further divided as glaucoma arising in dysgenesis associated with neural crest anomalies, phakomatoses, metabolic disorders, mitotic diseases, congenital disorders, and acquired conditions. Neural crest alterations lead to the wide spectrum of iridocorneal trabeculodysgenesis. Systemic diseases associated with childhood glaucoma include the heterogenous group of phakomatoses where glaucoma is frequently encountered in the Sturge-Weber syndrome and its variants, in phakomatosis pigmentovascularis associated with oculodermal melanocytosis, and more rarely in neurofibromatosis type 1. Childhood glaucoma is also described in systemic disorders of mitotic and metabolic activity. Acquired secondary glaucoma has been associated with uveitis, trauma, drugs, and neoplastic diseases. A database research revealed reports of childhood glaucoma in rare diseases, which do not include glaucoma in their manifestation. These are otopalatodigital syndrome, complete androgen insensitivity, pseudotrisomy 13, Brachmann-de Lange syndrome, acrofrontofacionasal dysostosis, caudal regression syndrome, and Wolf-Hirschhorn syndrome.

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