Ophthalmology Unit, Department of Biological, Biotechnological and Translational Sciences, University of Parma, Via Gramsci, 14, 43126 Parma, Italy.
Ophthalmology Unit, Department of Neurosciences, Biomedicine and Movement, University of Verona, P. le L. A. Scuro, 10, 37134 Verona, Italy.
Nutrients. 2020 Mar 18;12(3):793. doi: 10.3390/nu12030793.
Glaucoma, a heterogeneous set of progressively degenerative optic neuropathies characterized by a loss of retinal ganglion cells (RGCs) and typical visual field deficits that can progress to blindness, is a neurodegenerative disease involving both ocular and visual brain structures. Although elevated intraocular pressure (IOP) remains the most important modifiable risk factor of primary open-angle glaucoma (POAG) and is the main therapeutic target in treating glaucoma, other factors that influence the disease course are involved and reaching the optimal IOP target does not stop the progression of glaucoma, as the visual field continues to narrow. In addition to a managed IOP, neuroprotection may be beneficial by slowing the progression of glaucoma and improving the visual defects. Citicoline (cytidine 5'-diphosphocholine) is a naturally occurring endogenous compound that has been investigated as a novel therapeutic agent for the management of glaucoma. Citicoline has demonstrated activity in a range of central neurodegenerative diseases, and experimental evidence suggests a it performs a neuromodulator and neuroprotective role on neuronal cells, including RGCs, associated with improvement in visual function, extension of the visual field and central benefits for the patient. This review aims to critically summarize the current evidence for the neuroprotective properties of citicoline in glaucoma.
青光眼是一组异质性进行性退行性视神经病变，其特征是视网膜神经节细胞 (RGC) 丧失和典型的视野缺损，可进展为失明，是一种涉及眼部和视觉脑结构的神经退行性疾病。虽然升高的眼内压 (IOP) 仍然是原发性开角型青光眼 (POAG) 的最重要的可改变危险因素，也是治疗青光眼的主要治疗靶点，但涉及到其他影响疾病进程的因素，即使达到最佳的 IOP 目标，也无法阻止青光眼的进展，因为视野仍在缩小。除了控制眼压外，神经保护可能通过减缓青光眼的进展和改善视觉缺陷有益。胞磷胆碱 (胞苷 5'-二磷酸胆碱) 是一种天然存在的内源性化合物，已被研究作为治疗青光眼的新型治疗剂。胞磷胆碱在一系列中枢神经退行性疾病中具有活性，实验证据表明它在神经元细胞（包括 RGC）上发挥神经调节剂和神经保护作用，可改善视觉功能、扩大视野和为患者带来中枢益处。本文旨在批判性地总结胞磷胆碱在青光眼的神经保护特性的现有证据。
