Optic Nerve Regeneration: Considerations on Treatment of Acute Optic Neuropathy and End Stage Disease
Purpose of ReviewAcute and chronic optic neuropathies lead to irreversible vision loss, prompting considerations of regenerative therapy. Th e insult commonly occurs primarily in the anterior optic nerve, which leads to degeneration of retinal ganglion cells (RGCs) and their axons and loss of oligodendrocytes. We review important aspects of optic nerve regeneration and animal models of disease.Recent FindingsPreclinical studies in animals showed that approaches that improve RGC survival and axon regeneration include neurotrophic factor delivery, genetic manipulation, visual stimulation, and cell therapies, but impact on glia must be also considered. While intravitreal delivery of molecules has been most commonly used, direct targeting of the optic nerve should be considered.SummaryTreatment can differ if targeting acute or subacute vs. chronic optic neuropathies, depending on whether most RGC axons and somata are still present and salvageable, or if somata and axons are gone and need to be replaced. Combined neuron and glia directed treatments may lead to more successful vision restoration.
Current Ophthalmology Reports