Damage and repair in retinal degenerative diseases: Molecular basis through clinical translation

Retinal ganglion cells are the bridging neurons between the eye and the central nervous system, transmitting visual signals to the brain. The injury and loss of retinal ganglion cells are the primary pathological changes in several retinal degenerative diseases, including glaucoma, ischemic optic neuropathy, diabetic neuropathy, and optic neuritis. In mammals, injured retinal ganglion cells lack regenerative capacity and undergo apoptotic cell death within a few days of injury. Additionally, these cells exhibit limited regenerative ability, ultimately contributing to vision impairment and potentially leading to blindness. Currently, the only effective clinical treatment for glaucoma is to prevent vision loss by lowering intraocular pressure through medications or surgery; however, this approach cannot halt the effect of retinal ganglion cell loss on visual function. This review comprehensively investigates the mechanisms underlying retinal ganglion cell degeneration in retinal degenerative diseases and further explores the current status and potential of cell replacement therapy for regenerating retinal ganglion cells. As our understanding of the complex processes involved in retinal ganglion cell degeneration deepens, we can explore new treatment strategies, such as cell transplantation, which may offer more effective ways to mitigate the effect of retinal degenerative diseases on vision.