Wareham Lauren K, Risner Michael L, Calkins David J
Department of Ophthalmology and Visual Sciences and the Vanderbilt Eye Institute, Vanderbilt University Medical Center, AA7100 MCN, 1161 21st Ave S., Nashville, TN 37232 USA.
Curr Ophthalmol Rep. 2020;8(4):301-310. doi: 10.1007/s40135-020-00259-5. Epub 2020 Nov 20.
We summarize recent advances in strategies that aim to restore optic nerve function and vision in glaucoma through protective, reparative, and regenerative avenues.
Neuroprotection relies on identification of early retinal ganglion cell dysfunction, which could prove challenging in the clinic. Cell replacement therapies show promise in restoring lost vision, but some hurdles remain in restoring visual circuitry in the retina and central connections in the brain.
Identification and manipulation of intrinsic and extrinsic cellular mechanisms that promote axon regeneration in both resident and transplanted RGCs will drive future advances in vision restoration. Understanding the roles of multiple cell types in the retina that act in concert to promote RGC survival will aid efforts to promote neuronal health and restoration. Effective RGC transplantation, fine tuning axon guidance and growth, and synaptogenesis of transplanted and resident RGCs are still areas that require more research.
我们总结了旨在通过保护、修复和再生途径恢复青光眼视神经功能和视力的策略的最新进展。
神经保护依赖于早期视网膜神经节细胞功能障碍的识别,这在临床上可能具有挑战性。细胞替代疗法在恢复丧失的视力方面显示出前景,但在恢复视网膜视觉回路和大脑中枢连接方面仍存在一些障碍。
识别和操纵促进驻留和移植视网膜神经节细胞轴突再生的内在和外在细胞机制将推动视力恢复的未来进展。了解视网膜中多种细胞类型协同作用促进视网膜神经节细胞存活的作用,将有助于促进神经元健康和恢复的努力。有效的视网膜神经节细胞移植、微调轴突导向和生长以及移植和驻留视网膜神经节细胞的突触形成仍然是需要更多研究的领域。