Potential role for angiotensin-converting enzyme inhibitors in the treatment of patients with normal-tension glaucoma

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We investigate the neuroprotective effect of candesartan, an angiotensin II type 1 receptor blocker, against the neurotoxicity of the retinal ganglion cells (RGCs) in an animal model of glaucoma. Cauterization of 3 episcleral vessels in rats was used to create chronically and elevated intraocular pressure (IOP) in one eye. Rats were then orally treated with candesartan (1mg/kg/day). As compared to the contralateral control eyes, there was a consistently elevated IOP of approximately 2.5-fold during the experimental period. As compared to the contralateral control eyes that had normal IOPs, the RGC survival rate in the central retina of eyes with the chronic, elevated IOP was 46.5% in the untreated animals and 84.2% in the candesartan-treated animals. In the rat chronic glaucoma model, continuous pharmacological treatment using candesartan results in significant neuroprotection against RGC loss.