Abstract
Neurodegeneration in glaucoma remains a significant challenge, even with efforts to lower intraocular pressure (IOP). Many patients continue to experience visual field loss. This review will highlight the role that insulin signalling plays in neurodegeneration and also in vascular dysfunction.
Neurodegeneration glaucoma and Alzheimer's disease (AD) share many identical characteristics, deposits of beta-amyloid, cell apoptosis, Tau hyperphosphorylation, NFT formation, and mitochondrial dysfunction with elevated OS.
Vascular autoregulation in glaucoma is abnormal with a high level of endothelin-1 (ET-1) and impaired nitric oxide (NO) signaling.
There is insulin resistance by an increase of serine of insulin receptor -1 phosphorylation (p(ser)IRS-1) instead of tyrosine –IRS-1 phosphorylation (p (Tyr) IRS-1) causing alteration in insulin signaling.
C-peptide presence in the brain and insulin detection in neuron culture reinforce the evidence of insulin central secretion.
In this review, we will see the capacity of insulin intravitreal injection to promote visual function, restore the balance between NO/ET-1 secretions, and ameliorate neurite outgrowth and function.