Next-Gen Neuroprotection in Glaucoma: Synergistic Molecules for Targeted Therapy

Area of Science:

• Ophthalmology
• Neuroscience
• Pharmacology

Background:

• Glaucoma is a progressive optic neuropathy causing retinal ganglion cell (RGC) apoptosis and vision loss.
• Intraocular pressure (IOP) reduction is primary, but many patients progress despite treatment.
• Neuroprotective agents target complementary pathogenic pathways.

Purpose of the Study:

• To synthesize current evidence on neuroprotection in glaucoma.
• To review emerging agents targeting glaucoma's complex neurobiology.
• To assess the potential of combination therapies for vision preservation.

Main Methods:

• Literature review of recent PubMed studies on glaucoma neuroprotection.
• Synthesis of experimental and clinical data on neuroprotective agents.
• Analysis of evidence for agents like citicoline, CoQ10, pyruvate, nicotinamide, PQQ, homotaurine, berberine, and GABA.

Main Results:

• Individual agents like citicoline, CoQ10, pyruvate, nicotinamide, PQQ, homotaurine, and berberine show promise in preclinical and clinical studies.
• Combination therapies (e.g., citicoline + CoQ10 + B3) demonstrate additive improvements in RGC electrophysiology, visual function, and quality of life.
• These combinations improve outcomes without altering intraocular pressure (IOP).

Conclusions:

• A multi-targeted neuroprotective approach is suitable for glaucoma's complex pathology.
• Combination therapies may slow glaucoma progression more effectively than monotherapies.
• Further research is needed to optimize dosages and confirm long-term safety and efficacy.