Is glaucoma a sign of Alzheimer's?

What is the story?
Drugs used to treat Alzheimer's disease may protect patients at risk of eye damage from glaucoma, according to media reports.

The UK research team identified that the beta-amyloid plaques linked to Alzheimer’s were also involved in the development of glaucoma.

It is the first time a clear link has been identified between Alzheimer’s and glaucoma and could lead to glaucoma being regarded as an early warning sign for Alzheimer’s, say the papers.

But the study researchers have stressed that people with glaucoma are not at a higher risk of developing Alzheimer’s.

What is the research?
The reports are based on UK research that used a new technology, known as detection of apoptosing retinal cells (DARC), to identify beta-amyloid plaques in the retinas of rats engineered to have glaucoma.

Each rat had been injected in the left eye with hypertonic saline, which raised intraocular pressure, inducing glaucoma.

DARC did not detect any build-up of beta-amyloid plaques in a control group of healthy rats.

Build-up of beta-amyloid plaques in the retina leads to death of ganglion cells in the retina, say the researchers.

They therefore decided to investigate whether Alzheimer’s drugs that halt accumulation of beta-amyloid could be useful in glaucoma.

Using the rat models of glaucoma, they measured the effectiveness of single-agent and combined Alzheimer’s drug treatments on reducing the rate of retinal ganglion cell death.

All three of the single-agent drugs, a beta-secretase inhibitor, a beta-secretase and a membrane-anchored aspartic protease, reduced cell death in
rats with glaucoma more than
no treatment.

The main effect of each of the three treatments appeared to be a suppression of the early peak of retinal ganglion cell death that occurs in the first three weeks of glaucoma.

However, a combination of the three was most effective, reducing retinal ganglion cell death by 84 per cent compared with 74 per cent for the single-agent drugs.

What do the researchers say?
Lead researcher Dr Francesca Cordeiro, from the Institute of Ophthalmology at University College London, said: ‘We are trying an approach that has never been tried before, not even to treat Alzheimer’s disease.

‘Our success in treating glaucoma in the laboratory by combining different Alzheimer’s treatments represents a brand new treatment strategy.

‘Since we have shown drugs for Alzheimer’s can tackle glaucoma, potentially we could use damaged retina to screen Alzheimer’s drugs that target amyloid build up,’ said Dr Cordeiro.

‘However, not everyone with Alzheimer’s will develop glaucoma or vice versa. Glaucoma has a number of risk factors.’

What do other experts say?
David Wright, chief executive of the International Glaucoma Association, said the potential for using neuro-protective drugs, such as those used for treating Alzheimer’s, in the management of glaucoma had been known for some time but early studies had failed to live up to expectations.

‘This latest research suggests a three-way approach to targeting beta-amyloid in glaucoma may be more effective.

‘If the drugs became available for the management of glaucoma, it would significantly enhance the present glaucoma management regime, which relies on reduction of the level of intraocular pressure,’ he said.

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