Warjri Gazella B, Gowtham Lakshminarayanan, Venkatraman Vatsalya, Velpandian Thirumurthy, Dada Tanuj, Angmo Dewang
Department of Ophthalmology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India.
Department of Ocular Pharmacology, L V Prasad Eye Institute, Hyderabad, Telangana, India.
J Curr Glaucoma Pract. 2025 Jan-Mar;19(1):28-37. doi: 10.5005/jp-journals-10078-1467. Epub 2025 Mar 24.
A review of the published literature was done to understand the role of endocannabinoids in glaucoma.
As evidence mounts that intraocular pressure (IOP) is not the only factor in the pathogenesis and progression of glaucoma, a look into other aspects is the need of the hour. From the first instance of a drop in IOP linked to marijuana in the 1970s to the present, research has been ongoing, mostly in animals and models, with a scarcity of human studies, to delve into the world of the endocannabinoid system (ECS).
PubMed, ScienceDirect, and Google Scholar were searched for studies relating to endocannabinoids and their role in glaucoma.
The ECS comprises ligands, receptors, and the synthesizing and degrading enzymes and is ubiquitous throughout the human body, including the visual system, from the eye to the occipital lobe. Apart from the IOP-lowering effect of the system, another property being investigated and implicated as an attribute of its receptors is neuroprotection. This neuroprotection seems to be mediated by excitotoxicity reduction and changes in vascular tone by acting on cannabinoid receptors.
The possibilities are indeed immense, and further research into the complex relationship between ECS and glaucoma is imperative to enable us to develop therapies for this otherwise chronic, progressive neuropathy, where the only armament in our hands is early diagnosis and maintenance therapy.
We still do not have drugs for the prevention of retinal ganglion cell loss and for neuroprotection in glaucoma. Drugs that target cannabinoid receptors can revolutionize glaucoma management owing to their IOP-lowering action and neuroprotective effects. Based on the findings, we argue that further studies on the ECS and its implications in glaucoma are warranted to develop newer, effective, and better-targeted treatment strategies.
Warjri GB, Gowtham L, Venkatraman V, . Role of Endocannabinoids in Glaucoma: A Review. J Curr Glaucoma Pract 2025;19(1):28-37.
对已发表的文献进行综述，以了解内源性大麻素在青光眼发病机制中的作用。
随着越来越多的证据表明眼压并非青光眼发病机制和病情进展的唯一因素，当下迫切需要研究其他方面。从20世纪70年代首次发现大麻与眼压降低有关至今，相关研究一直在进行，主要是在动物和模型中，人体研究较少，旨在深入探究内源性大麻素系统（ECS）。
通过检索PubMed、ScienceDirect和谷歌学术，查找与内源性大麻素及其在青光眼发病机制中的作用相关的研究。
内源性大麻素系统由配体、受体以及合成和降解酶组成，遍布人体全身，包括视觉系统，从眼睛到枕叶。除了该系统的降眼压作用外，其受体的另一特性——神经保护作用也在研究中，并被认为与之有关。这种神经保护作用似乎是通过作用于大麻素受体，减少兴奋性毒性和改变血管张力来介导的。
内源性大麻素系统的可能性确实巨大，进一步研究其与青光眼之间的复杂关系对于开发针对这种慢性进行性神经病变的治疗方法至关重要，因为目前我们治疗青光眼的唯一手段是早期诊断和维持治疗。
我们仍然没有预防青光眼视网膜神经节细胞丢失和神经保护的药物。靶向大麻素受体的药物因其降眼压作用和神经保护作用，可能会彻底改变青光眼的治疗方式。基于这些发现，我们认为有必要进一步研究内源性大麻素系统及其在青光眼发病机制中的作用，以制定更新、更有效、更具针对性的治疗策略。
Warjri GB, Gowtham L, Venkatraman V, . 内源性大麻素在青光眼发病机制中的作用：综述. 《青光眼临床实践杂志》2025;19(1):28 - 37.
