Insulin Impact in Glaucoma Neurodegeneration and Vascular Dysfunction

 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. 

link : https://doi.org/10.18103/mra.v12i10.5928