Role of Neuroprotective Agents in the Monitoring and Management of Glaucoma (Code-T0134)

Introduction: Glaucoma is a leading cause of irreversible blindness, characterized by progressive retinal ganglion cell loss and optic nerve damage. While intraocular pressure (IOP) reduction remains the mainstay of treatment, the role of neuroprotective agents in preserving optic nerve function is gaining attention.

Aims and Objectives:

1. To record various parameters of glaucoma in different types of glaucoma patients after subjecting them to suitable topical and systemic neuroprotective agents.

2. To document the only modifiable factor of glaucoma, IOP in various glaucoma patients using suitable topical and systemic neuroprotective agents.

3. To analyse visual field changes using automated visual field analyser in patients using various neuroprotective agents at 1 month, 3 months and 6 months.

4. To detect structural changes in optic nerve head and RNFL thickness using OCT in various types of glaucoma patients using neuroprotective agents.

5. To manage patients of glaucoma considered during study with various modalities.

Methods: A systematic review of clinical studies, trials, and peer-reviewed publications was conducted to assess the impact of neuroprotective agents such as antioxidants, NMDA receptor antagonists, calcium channel blockers, and neurotrophic factors. Key outcomes evaluated included visual field preservation, retinal ganglion cell survival, and overall disease progression.

Results: Neuroprotective agents were found to provide benefits beyond IOP reduction. Antioxidants like brimonidine and citicoline demonstrated significant neuroprotective effects. NMDA receptor antagonists reduced excitotoxicity, while calcium channel blockers improved ocular perfusion. Neurotrophic factors supported neuronal survival. However, inconsistencies in clinical trial outcomes and a lack of long-term studies highlight the need for further research.

Conclusion: Neuroprotective agents offer a promising adjunct to traditional glaucoma management by targeting mechanisms that preserve retinal ganglion cells and prevent optic nerve degeneration. Future large-scale trials are essential to confirm their clinical utility and safety, paving the way for more comprehensive glaucoma treatment strategies.

Keywords: Glaucoma, Neuroprotection, Retinal Ganglion Cells, Antioxidants, NMDA Receptor Antagonists, Calcium Channel Blockers