What Is New in Glaucoma: From Treatment to Biological Perspectives

Pharmaceutical In Situ Gel for Glaucoma: Recent Trends and Development with an Update on Research and Patents

Glaucoma is a progressive visual polyneuropathy characterized by retinal ganglion cell atrophy and optic nerve head changes. It's generally triggered due to increased intraocular pressure compared with the healthy eye. Glaucoma is treated with various medications in traditional eye drops, such as prostaglandins, carbonic anhydrase inhibitors, beta-blockers, and others. Such treatments are difficult to use and produce lachrymal leakage and inadequate corneal permeability, resulting in lower availability. Ophthalmic in situ gels, introduced in past decades with tremendous effort, are among the finest various choices to solve the drawbacks of eye drops. Employing different polymers with pH-triggered, temperature-triggered, and ion-activated processes have been used to generate ophthalmic in situ gelling treatments. Once those preparations are delivered into the eye, they change phase from sol to gel, allowing the medicine to stay in the eye for longer. These formulations are known as smart gels as they turn into gelling fluids when administered into the eyes. The different mechanisms of in situ gel formulations are used for the management of glaucoma and are discussed in this review article.

Corneal Epithelial Regeneration: Old and New Perspectives

Corneal blindness is the fifth leading cause of blindness worldwide, and therapeutic options are still often limited to corneal transplantation. The corneal epithelium has a strong barrier function, and regeneration is highly dependent on limbal stem cell proliferation and basement membrane remodeling. As a result of the lack of corneal donor tissues, regenerative medicine for corneal diseases affecting the epithelium is an area with quite advanced basic and clinical research. Surgery still plays a prominent role in the treatment of epithelial diseases; indeed, innovative surgical techniques have been developed to transplant corneal and non-corneal stem cells onto diseased corneas for epithelial regeneration applications. The main goal of applying regenerative medicine to clinical practice is to restore function by providing viable cells based on the use of a novel therapeutic approach to generate biological substitutes and improve tissue functions. Interest in corneal epithelium rehabilitation medicine is rapidly growing, given the exposure of the corneal outer layers to external insults. Here, we performed a review of basic, clinical and surgical research reports on regenerative medicine for corneal epithelial disorders, classifying therapeutic approaches according to their macro- or microscopic target, i.e., into cellular or subcellular therapies, respectively.

Investigation of Biomedical Students' Knowledge on Glaucoma Reveals a Need for Education: A Cross-Sectional Study

Background: Glaucoma has been recognized as one of the leading global causes of irreversible blindness. Patients with primary open-angle glaucoma rarely present with visual symptoms, at least early in the course of the disease. It is important to recognize and treat the disease before there are irreversible changes. Methods: This cross-sectional study was conducted at the University of Split School of Medicine from October to November 2021. Participants were biomedical students who completed a questionnaire. Results: In total, 312 students participated in this study. Interestingly, only 12.2% of students identified that primary open-angle glaucoma was asymptomatic. Only 42.6% of all students recognized glaucoma as being the main cause of irreversible blindness. Pharmacy students less frequently recognized high blood pressure and diabetes mellitus as risk factors for glaucoma. Students who completed an ophthalmology course more frequently recognized that successful glaucoma treatment prevents blindness, compared to students who did not complete the course, 79.1% vs. 48.7%, p < 0.001. Conclusion: The results showed that students’ knowledge on the subject is low, even after they passed their ophthalmology course. However, knowledge of glaucoma is crucial for early disease identification and the prevention of blindness. Therefore, it is important that all future health care professionals acquire adequate education.

Evaluation of peripapillary retinal nerve fiber layer thickness in patients with primary open-angle glaucoma

Introduction/Objective. Determination of the difference in peripapillary retinal nerve fiber layer (RNFL) thickness in patients with open-angle glaucoma (POAG) in comparison to the healthy population and according to the progression of the disease. Methods. Four groups were formed among 120 patients: group without glaucoma, early, moderate POAG and preperimetric glaucoma group. Visual field and optical coherent tomography were performed. Results. RNFL thickness value was found to be the highest in inferior quadrant, second highest in superior, third in nasal, the lowest in temporal quadrant. The highest average value of RNFL thickness was in superior quadrant of the healthy group (124.3 ? 17.8?m), and the lowest was in temporal quadrant of the moderate group (46.5 ? 10.8?m). Other RNFL thickness values per quadrants among groups were distributed between these two endpoints. AvgThic in patients with moderate POAG was lesser than in patients with early POAG, which was lesser than in the healthy subjects (59.6 ? 10.6?m vs. 73.4 ? 12.1?m vs. 105.5 ? 11.3?m). AvgThic in preperimetric glaucoma group was 83.6 ? 9.2?m. Pearson correlation showed high positive correlation between MD values and following parameters: AvgThic, S, I, Smax, Imax, Savg, Iavg. ROC curves found that the parameter with the best diagnostic ability was AvgThic, with area of 0.803(< 0.0005), sensitivity of 67% and specificity of 83.3%. Conclusion. Peripapillary RNFL thickness parameters: AvgThic, S, I, Smax, Savg, Iavg, Imax have excellent ability to discriminate between healthy eyes and eyes with POAG. The parameter with the highest specificity and sensitivity is AvgThic, which makes it the best for early detection and monitoring of POAG.