The trabecular meshwork in glaucoma: An inflammatory trabeculopathy?

Area of Science:

• Ophthalmology
• Immunology
• Cell Biology

Background:

• Glaucoma is an optic neuropathy linked to elevated intraocular pressure (IOP).
• Trabecular meshwork dysfunction, driven by oxidative stress and senescence, increases resistance to aqueous humor outflow.
• Inflammatory mechanisms in glaucoma pathophysiology are increasingly recognized but poorly understood, especially within the trabecular meshwork.

Purpose of the Study:

• To synthesize current knowledge on the role and mechanisms of inflammation in the healthy and glaucomatous trabecular meshwork.
• To explore the contribution of trabecular inflammation to glaucoma pathophysiology.
• To review the impact of cellular senescence, oxidative stress, and eye drop preservatives on trabecular inflammation.

Main Methods:

• Literature review focusing on inflammation in glaucoma.
• Analysis of mechanisms underlying cellular senescence and oxidative stress in the trabecular meshwork.
• Examination of inflammatory mediators within the trabecular meshwork.
• Review of ocular surface and trabecular meshwork toxicity from glaucoma eye drops and preservatives.

Main Results:

• Inflammatory processes affect all ocular structures in glaucoma, stemming from dysregulated para-inflammation.
• Retinal inflammation accelerates retinal ganglion cell (RGC) degeneration, and ocular surface inflammation is worsened by preserved eye drops.
• Pathophysiology of trabecular meshwork inflammation in glaucoma remains largely unknown.

Conclusions:

• Trabecular inflammation is a significant, yet understudied, factor in glaucoma development and progression.
• Further research into trabecular meshwork inflammation mechanisms is crucial for novel therapeutic strategies.
• The toxicity of glaucoma eye drops and preservatives may exacerbate trabecular inflammation and ocular surface disease.