[Glaucoma--neurodegenerative disease].

Glaucoma is a specific optical neuropathy, with local nerve damage and pathogenesis incompletely understood. The progressive death of retinal ganglion cells and optical neural loss suggests the following hypothesis: primary destructive event (ischemia, elevated intraocular pressure and genetic risk factors) and secondary degeneration (apoptosis and excitotoxicity). The concept of neuroprotection is a therapeutical paradigm for preventing and delaying neuronal cell death and maintaining the function of neurons. Other additional concept--neurorescue is used to prevent neuronal death by interrupting the biological cascade of secondary events. Most substances that can be found (glutamate, nitric oxide, a.o) in excess in extra cellular spaces induce damage of retinal ganglion cells, while others (memantine, gingko biloba, nicergoline, flavonoids, ascorbic acid) are used to restore these cells and their axons, i.e., neuroreparation and neuroregeneration in various degrees. This paper is an up-date of numerous studies which demonstrate that open-angle glaucoma is considered to be a neurodegenerative disease connected with alterations of the cardiovascular, central nervous, immune, endocrine, psychological systems and of sleep, requiring the introduction of glaucoma in general medical context.