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Neuroprotection for treatment of glaucoma in adults
Glaucoma is a heterogeneous group of conditions involving progressive damage to the optic nerve, deterioration of retinal ganglion cells and ultimately visual-field loss. It is a leading cause of blindness worldwide. Open-angle glaucoma (OAG), the commonest form of glaucoma, is a chronic condition that may or may not present with increased intraocular pressure (IOP). Neuroprotection for glaucoma refers to any intervention intended to prevent optic nerve damage or cell death. The treatment can target extracellular factors such as reducing IOP, or cellular factors derived from the optic nerve itself such as blocking intracellular death signals. Although neuroprotective agents are intended to act as pharmacological antagonists to prevent cell death, the evidence that they are effective in preventing retinal ganglion cell death, and thus preserving vision in patients with OAG, has not been demonstrated. Long-term RCTs are needed to determine whether or not neuroprotective agents may be beneficial for individuals with OAG.
▶ Sena DF, Ramchand K, Lindsley K. Neuroprotection for treatment of glaucoma in adults. Cochrane Database Syst Rev 2010;(2):CD006539.
Authors' comment: The idea of using neuroprotection to prevent visual loss lacked evidence in this review. Apart from controlling the intraocular pressures, protection of the optic nerve would be ideal in glaucoma patients.
Interventions for strabismic amblyopia
Amblyopia is a common childhood condition which causes a reduction in vision of one or both eyes which is not caused by any eye disease. Amblyopia can be caused by the presence of a squint (misalignment of the eyes where one eye may turn inwards, outwards, upwards or downwards). This review aims to look at the treatment of reduced vision caused by the presence of a squint, not the treatment of the squint itself. Three randomised controlled trials (RCTs) were included in this review. The results of one of these trials indicate that patching therapy combined …