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青光眼和阿尔茨海默病:一种与年龄相关的大脑神经退行性疾病。

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

机构信息

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.

出版信息

Curr Neuropharmacol. 2018;16(7):971-977. doi: 10.2174/1570159X16666171206144045.

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.

摘要

背景

开角型青光眼(POAG)是全球范围内导致不可逆性失明的主要原因。眼压升高被认为是青光眼的一个重要危险因素;然而,即使在眼压值正常的情况下,仍有一部分患者的疾病会进展。这意味着除眼压以外的其他危险因素可能参与了青光眼的发病机制。有人提出青光眼与阿尔茨海默病等神经退行性疾病之间可能存在关联。在这方面,我们最近使用海德堡视网膜断层扫描仪-3(Heidelberg Retinal Tomograph-3)在一组阿尔茨海默病患者中描述了一组与青光眼相关的典型改变,其发病率较高。有趣的是,这些改变与眼压升高或中央角膜厚度值异常无关。阿尔茨海默病是最常见的痴呆类型,其记忆和认知能力逐渐恶化。阿尔茨海默病患者经常出现与视力相关的症状。

方法

本文综述了与青光眼和阿尔茨海默病相关的研究。

结果

在最近的文献中收集到的疾病特征,即常见特征、危险因素和病理生理机制表明,阿尔茨海默病和青光眼可被视为两种与年龄相关的神经退行性疾病,在老年人中可能同时存在。

结论

总之,迄今为止收集的临床前和临床证据支持这样一种观点,即青光眼是一种广泛存在的神经退行性疾病,其与其他疾病(如阿尔茨海默病)的共同发病机制应进一步研究,因为这可能为这些疾病提供新的认识,从而改善诊断和治疗。

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本文引用的文献

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The Glymphatic System: A New Player in Ocular Diseases?类淋巴系统:眼部疾病的新角色?
Invest Ophthalmol Vis Sci. 2016 Oct 1;57(13):5426-5427. doi: 10.1167/iovs.16-20262.
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Senile Dementia and Glaucoma: Evidence for a Common Link.老年痴呆与青光眼:共同关联的证据
J Ophthalmic Vis Res. 2015 Apr-Jun;10(2):178-83. doi: 10.4103/2008-322X.163766.

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