Remodeling of the Lamina Cribrosa: Mechanisms and Potential Therapeutic Approaches for Glaucoma

Glaucomatous optic neuropathy is the leading cause of irreversible blindness in the world. The chronic disease is characterized by optic nerve degeneration and vision field loss. The reduction of intraocular pressure remains the only proven glaucoma treatment, but it does not prevent further neurodegeneration. There are three major classes of cells in the human optic nerve head (ONH): lamina cribrosa (LC) cells, glial cells, and scleral fibroblasts. These cells provide support for the LC which is essential to maintain healthy retinal ganglion cell (RGC) axons. All these cells demonstrate responses to glaucomatous conditions through extracellular matrix remodeling. Therefore, investigations into alternative therapies that alter the characteristic remodeling response of the ONH to enhance the survival of RGC axons are prevalent. Understanding major remodeling pathways in the ONH may be key to developing targeted therapies that reduce deleterious remodeling.

Automated summary

Glaucomatous optic neuropathy is the main cause of irreversible blindness worldwide. Lowering intraocular pressure is the only proven treatment, but it does not prevent further nerve degeneration. Cells in the optic nerve head, including lamina cribrosa cells, glial cells, and scleral fibroblasts, respond to glaucomatous conditions through extracellular matrix remodeling. Therefore, researching alternative therapies to alter this remodeling response is crucial for enhancing the survival of retinal ganglion cell axons.