Glaucoma and Medical Cannabis

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What is Glaucoma?

It is an eye disease in which there is a blockage in the drainage of the accusative humour and it generates an abnormal intraocular pressure and therefore vision is gradually lost. Aqueous humour is a colourless liquid that nourishes and oxygenates the structures of the eyeball without any blood supply, such as the cornea and lens. It is produced in the ciliary bodies of the posterior chamber of the eye and travels through the pupil to the anterior chamber where it is reabsorbed by the trabecular meshwork. Any factor that slows or blocks the flow will cause a pathological increase in intraocular pressure (IOP), which generates glaucoma.

What is the history of glaucoma?

Glaucoma can be hereditary, congenital, or occur as an adverse effect of some drugs or because of chronic illnesses such as diabetes. As the disease evolves, nerve fibers from the optic nerve are progressively lost, which may end in the loss of vision.

The usual treatment of glaucoma, one of the leading causes of blindness in the world, consists of the administration of intraocular pressure reducing drugs (IOP) or the drainage of excess aqueous humour.

The vasodilatory effect of cannabinoids is proving to be helpful in reducing intraocular pressure.

Research on the use of medical cannabis as a treatment for glaucoma

Current studies suggest that cannabinoids may reduce intraocular pressure (IOP) and could be used effectively in topical therapies for retinal neurodegenerative diseases, either alone or as a combination treatment with other drugs [3].

Cannabinoids are well tolerated after topical application and are attributed with a neuroprotective effect on the ganglion cells of the retina.

There are also more and more scientific observations which indicate that endocannabinoids are relevant in ocular physiology, influencing the maintenance of intraocular pressure, the physiology of the photoreception and neurotransmission in the retina [4], as well as in the neuroprotection of retinal ganglion neurons [5].

Bibliography on glaucoma and the use of medicinal cannabis

[1]Merrit, John C. et al. Effect of Marihuana on Intraocular and Blood Pressure in Glaucoma. Ophthalmology. 1980 Mar;87(3):222-8

[2] P. Pacher, S. Bátkai, and G. Kunos. Cardiovascular Pharmacology of Cannabinoids. Handb Exp Pharmacol. 2005; (168): 599–625

[3] Despina Kokona et al. Endogenous and Synthetic Cannabinoids as Therapeutics in Retinal Disease. Neural Plast. 2016; 2016: 8373020.

[4] Yan Wei et al. Presence and regulation of cannabinoid receptors in human retinal pigment epithelial cells. Mol Vis. 2009; 15: 1243–1251.

[5] Pinar Sueiro et al. Cannabinoid applications in glaucomaArchivos de la Sociedad Española de Oftalmología 86:1 2011 Jan pg 16-23.

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