Although the etiology of glaucoma is still a matter of intense investigation, the following risk factors have been associated with the disease: elevated intraocular pressure, use of systemic or topical corticosteroids, advanced age, thinner central cornea, vascular dysregulation, myopia, larger optic disc, positive family history, and African or Afro-Caribbean origin. It has been estimated that 64.3 million people had glaucoma in 2013 and that this number will increase to 111.8 million in 2040.
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Glaucoma, the leading cause of irreversible blindness worldwide, is a progressive neuropathy that results from mechanical axonal damage at the optic nerve head. The retrograde degeneration of axons of retinal ganglion cells (RGCs) within the optic nerve can ultimately lead to the death of RGCs, which have their cell bodies in the inner retina, culminating in irreversible visual loss. Optic neuropathy is an umbrella term encompassing a large number of disorders that cause optic nerve damage. Finally, published and ongoing clinical trials are summarized. Different aspects of available preclinical studies are analyzed, including cell distribution, potential doses, routes of administration, and mechanisms of action. This review focuses on cell therapies with bone marrow mononuclear cells and bone marrow-derived mesenchymal stem cells, which have shown positive therapeutic effects in animal models of optic neuropathies. Among the numerous treatment approaches investigated to stimulate neuronal survival and axonal extension, cell transplantation emerges as a promising option.
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These diseases have limited therapeutic options, due to the low inherent capacity of RGCs to regenerate and due to the inhibitory milieu of the central nervous system. Following optic nerve injury associated with acute or progressive diseases, retinal ganglion cells (RGCs) of adult mammals degenerate and undergo apoptosis.