scholarly journals Ethnic Considerations for Glaucoma: A Review

Author(s):  
Matt Bawn

Glaucoma is undoubtedly a major worldwide disease and cause of blindness. The term glaucoma however encompasses a group of disorders with differing age of incidence, intraocular pressures and varying degrees of hereditability in which vision loss occurs through a characteristic mode of retinal ganglion cell death. There are also significant differences in frequencies of incidence and gene associations for this group of disorders amongst different groups of populations. The current literature often states definitive trends in incidence for ethnic groups that fail to take into account an overall genetic fine structure for these groups. The present review intends to present an overview of some of the background necessary to discuss the genetic basis of glaucoma before describing some of the literature concerning the illness in Gypsy, Japanese, Scandinavian, Latino (Mexican and Brazilian) and Sub-Saharan African populations. It is intended that this review will give the reader a clearer picture of the diversity of worldwide glaucoma presentation which perhaps prove to question the current Ethnic view.

2020 ◽  
Vol 11 (9) ◽  
Author(s):  
Olivia J. Marola ◽  
Stephanie B. Syc-Mazurek ◽  
Gareth R. Howell ◽  
Richard T. Libby

Abstract Glaucoma is a neurodegenerative disease characterized by loss of retinal ganglion cells (RGCs), the output neurons of the retina. Multiple lines of evidence show the endothelin (EDN, also known as ET) system is important in glaucomatous neurodegeneration. To date, the molecular mechanisms within RGCs driving EDN-induced RGC death have not been clarified. The pro-apoptotic transcription factor JUN (the canonical target of JNK signaling) and the endoplasmic reticulum stress effector and transcription factor DNA damage inducible transcript 3 (DDIT3, also known as CHOP) have been shown to act downstream of EDN receptors. Previous studies demonstrated that JUN and DDIT3 were important regulators of RGC death after glaucoma-relevant injures. Here, we characterized EDN insult in vivo and investigated the role of JUN and DDIT3 in EDN-induced RGC death. To accomplish this, EDN1 ligand was intravitreally injected into the eyes of wildtype, Six3-cre+Junfl/fl (Jun−/−), Ddit3 null (Ddit3−/−), and Ddit3−/−Jun−/− mice. Intravitreal EDN1 was sufficient to drive RGC death in vivo. EDN1 insult caused JUN activation in RGCs, and deletion of Jun from the neural retina attenuated RGC death after EDN insult. However, deletion of Ddit3 did not confer significant protection to RGCs after EDN1 insult. These results indicate that EDN caused RGC death via a JUN-dependent mechanism. In addition, EDN signaling is known to elicit potent vasoconstriction. JUN signaling was shown to drive neuronal death after ischemic insult. Therefore, the effects of intravitreal EDN1 on retinal vessel diameter and hypoxia were explored. Intravitreal EDN1 caused transient retinal vasoconstriction and regions of RGC and Müller glia hypoxia. Thus, it remains a possibility that EDN elicits a hypoxic insult to RGCs, causing apoptosis via JNK-JUN signaling. The importance of EDN-induced vasoconstriction and hypoxia in causing RGC death after EDN insult and in models of glaucoma requires further investigation.


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