Stem cells in managing glaucoma

Abstract

Glaucoma is a chronic neurodegenerative condition of the visual system characterized by the progressive death of retinal ganglion cells (RGCs), resulting in irreversible vision impairment. Although current therapies effectively lower intraocular pressure, they do not directly target the fundamental neuronal loss that leads to prolonged vision deterioration. Stem cell-based therapies have emerged as a promising regenerative approach, aiming to preserve neural tissue, alter pathological microenvironments, and potentially restore impaired visual circuitry. Recent preclinical and early translational studies suggest that embryonic, induced pluripotent, and mesenchymal stem cells can enhance the lifespan of RGCs via trophic support, immunomodulation, and modulation of glial responses. Progress in pluripotent stem cell differentiation has facilitated the creation of retinal progenitors and RGC-like cells that can partially integrate into experimental animals. Nonetheless, significant obstacles - such as axonal regeneration, functional connection, immunological responses, and long-term safety - must be addressed. Ongoing advancements in stem cell engineering, biomaterials, and delivery methods indicate that regenerative therapies may ultimately augment or surpass pressure-lowering strategies, creating new opportunities for disease modification and visual restoration in glaucoma.

Keywords: Stem cells; Retinal ganglion cells; Glaucoma; Neuroprotection; Induced pluripotent stem cells; Regenerative medicine; Mesenchymal stem cells

Core Tip: Glaucoma is widely acknowledged as a chronic neurodegenerative condition characterized by irreversible loss of retinal ganglion cells, leading to progressive visual deterioration despite good management of intraocular pressure. Stem cell-based approaches present an innovative regenerative framework by delivering neurotrophic support, immunomodulation, and possible cellular replacement. Experimental studies indicate that embryonic, induced pluripotent, and mesenchymal stem cells can extend the survival of retinal ganglion cells and alter the glaucomatous milieu. Despite significant obstacles, stem cell technologies may eventually enhance or transform existing glaucoma treatment protocols.