PERAN NEURODEGERATIVE PADA PATOGENESIS GLAUCOMA : LITERATURE REVIEW
DOI:
https://doi.org/10.31004/prepotif.v9i3.50333Keywords:
Glaucoma, Neurodegeneration, PatogenesisAbstract
Glaukoma merupakan salah satu penyebab utama kehilangan penglihatan permanen di dunia dan digolongkan sebagai penyakit neurodegeneratif multifaktorial. Kondisi ini dipengaruhi oleh faktor tekanan intraokular (TIO) maupun faktor non-TIO, yang keduanya berkontribusi terhadap kerusakan dan kematian Retinal Ganglion Cells (RGCs). Penelitian ini bertujuan untuk mengevaluasi peran mekanisme neurodegeneratif dalam patogenesis glaukoma melalui pendekatan tinjauan pustaka. Sebanyak 10 studi terkait mekanisme neurodegenerasi dianalisis, menunjukkan bahwa 5 studi (50%) menyoroti peran neuroinflamasi, 3 studi (30%) menekankan stres oksidatif, 1 studi (10%) membahas neurodegenerasi akson, dan 1 studi (10%) mengulas mekanisme eksitotoksisitas. Hasil tinjauan ini memperlihatkan bahwa proses neurodegeneratif memiliki peran sentral dan kompleks dalam perkembangan glaukoma. Mekanisme-mekanisme tersebut tidak bekerja secara terpisah, tetapi sering berinteraksi dan memperkuat satu sama lain. Neuroinflamasi, misalnya, kerap dipicu oleh stres oksidatif yang menyebabkan kerusakan jaringan saraf, sehingga meningkatkan aktivasi mikroglia fenotipe M1 dan astrosit reaktif A1. Aktivasi sel-sel ini kemudian memperburuk kerusakan Optic Nerve Head (ONH) dan mempercepat kematian RGCs. Temuan ini menegaskan bahwa glaukoma tidak hanya dipandang sebagai gangguan akibat peningkatan TIO, tetapi sebagai penyakit neurodegeneratif kompleks yang melibatkan interaksi berbagai mekanisme patologi. Pemahaman yang lebih komprehensif mengenai proses neurodegeneratif ini diharapkan dapat mendukung pengembangan strategi terapi yang lebih efektif dalam mencegah progresivitas glaukoma.References
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