Glaucoma  (青光眼)

青光眼是一种进行性神经退行性疾病，其特征是视网膜神经节细胞丢失、视网膜神经纤维层变薄和视盘杯状变性，导致不可逆的视力障碍和失明。其主要病因是眼压升高、衰老和遗传易感性，其中原发性开角型青光眼是西方人群中最常见的类型。发病机制包括眼压升高和血管功能不全引起的机械应力，导致眼灌注减少。多种相互关联的机制导致神经元损伤，包括缺血/缺氧、线粒体功能障碍、慢性氧化应激、兴奋性毒性、代谢应激、神经营养因子缺乏和神经炎症。氧化应激、线粒体损伤和细胞衰老是关键因素，尤其是在衰老的视网膜中，副炎症（一种对组织应激的适应性反应）的失调可能会进一步加剧疾病进展。

Glaucoma is a progressive neurodegenerative disorder marked by retinal ganglion cell loss, thinning of the retinal nerve fiber layer, and optic disc cupping, leading to irreversible vision impairment and blindness. It is primarily driven by elevated intraocular pressure, aging, and genetic predisposition, with primary open-angle glaucoma being the most prevalent form in Western populations. Pathogenesis involves mechanical stress from increased intraocular pressure and vascular insufficiency, resulting in reduced ocular perfusion. Multiple interconnected mechanisms contribute to neuronal damage, including ischemia/hypoxia, mitochondrial dysfunction, chronic oxidative stress, excitotoxicity, metabolic stress, neurotrophin deficiency, and neuroinflammation. Oxidative stress, mitochondrial impairment, and cellular senescence are key factors, especially in the aging retina, where dysregulation of para-inflammation—an adaptive response to tissue stress—may further exacerbate disease progression.

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