While a variety of complex definitions of neuroprotection exist, a simple diagram (Fig. 1) illustrates the concept best. Neuroprotection in glaucoma refers to the ability of a therapeutic modality to prevent the loss, or decrease the rate of loss, of retinal ganglion cells, thereby preventing subsequent loss of visual function. Many drugs have laid claim to being neuroprotective, however, other than lowering the intraocular pressure (IOP), no therapeutic interventions currently used in the treatment of glaucoma have been proven. Proof of neuroprotection requires three important scientific hurdles to be crossed before therapeutic application in humans, as follows: proof of concept; adequacy of drug delivery; and human clinical trials (Table 1). Until these investigative hurdles are overcome, the claim of neuroprotection in the treatment of glaucoma remains suspect.
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