Arrigo Alessandro, Aragona Emanuela, Saladino Andrea, Arrigo Davide, Fantaguzzi Federico, Battaglia Parodi Maurizio, Bandello Francesco
Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy.
School of Medicine, University of Messina, Messina, Italy.
Front Aging Neurosci. 2021 Oct 6;13:747050. doi: 10.3389/fnagi.2021.747050. eCollection 2021.
: Glaucoma is a chronic, vision-threatening disease, and a major cause of legal blindness. The current view is no longer limited to the progressive optic nerve injury, since growing evidence strongly support the interpretation of glaucoma as a complex neurodegenerative disease. However, the precise pathogenic mechanisms leading to the onset and progression of central nervous system (CNS) impairment, and the functional consequences of this damage, are still partially understood. The main aim of this review is to provide a complete and updated overview of the current knowledge regarding the CNS involvement in glaucoma, and the possible therapeutic perspectives. : We made a careful survey of the current literature reporting all the relevant findings related to the cognitive dysfunctions occurring in glaucoma, with specific remarks dedicated on the higher-order visual function impairment and the possible employment of neuroprotective agents. : The current literature strongly support the interpretation of glaucoma as a multifaceted chronic neurodegenerative disease, widely affecting the CNS. The cognitive impairment may vary in terms of higher-order functions involvement and in the severity of the degeneration. Although several neuroprotective agents are currently available, the development of new molecules represents a major topic of investigation for future clinical trials. : Glaucoma earned the right to be fully considered a neurodegenerative disease. Glaucomatous patients may experience a heterogeneous set of visual and cognitive symptoms, progressively deteriorating the quality of life. Neuroprotection is nowadays a necessary therapeutic goal and a future promising way to preserve visual and cognitive functions, thus improving patients' quality of life.
青光眼是一种慢性的、威胁视力的疾病，是法定失明的主要原因。目前的观点不再局限于进行性视神经损伤，因为越来越多的证据有力地支持将青光眼解释为一种复杂的神经退行性疾病。然而，导致中枢神经系统（CNS）损伤的发生和进展的确切致病机制，以及这种损伤的功能后果，仍部分未明。本综述的主要目的是全面、更新地概述目前关于中枢神经系统参与青光眼的知识，以及可能的治疗前景。：我们仔细查阅了当前文献，报告了与青光眼患者发生的认知功能障碍相关的所有相关发现，并特别关注了高阶视觉功能损害以及神经保护剂的可能应用。：当前文献有力地支持将青光眼解释为一种多方面的慢性神经退行性疾病，广泛影响中枢神经系统。认知障碍在高阶功能受累方面和退化严重程度方面可能有所不同。尽管目前有几种神经保护剂，但新分子的开发仍是未来临床试验的一个主要研究课题。：青光眼完全有理由被视为一种神经退行性疾病。青光眼患者可能会经历一系列不同的视觉和认知症状，逐渐降低生活质量。如今，神经保护是一个必要的治疗目标，也是未来保护视觉和认知功能、从而改善患者生活质量的有前景的方法。
