Biomarkers in Glaucoma: From Diagnosis to Future Therapeutic Strategies

ABSTRACT

Glaucoma is a chronic neurodegenerative disease and one of the leading causes of irreversible blindness worldwide. Although intraocular pressure (IOP) remains the major modifiable risk factor, visual loss may continue despite adequate IOP control, indicating the need for improved approaches to diagnosis and treatment. Current clinical methods have limited sensitivity for detecting early neuronal injury and predicting disease progression. Increasing evidence suggests that molecular alterations related to oxidative stress, neurodegeneration, and immune dysfunction occur before clinically detectable structural changes in the glaucomatous eye. These early changes may provide useful biomarkers for early diagnosis, assessment of disease activity, prediction of progression, and treatment selection. Advances in analytical techniques and data‐driven approaches have further expanded the potential for translating biomarker research into clinical practice. This review summarizes current evidence on glaucoma biomarkers and evaluates their potential clinical relevance for prognosis and treatment. Particular emphasis placed on biomarkers that may support neuroprotective and IOP‐independent therapeutic strategies. Integration of biomarker‐based approaches with precision medicine may facilitate earlier detection, improved monitoring, and more individualized management of glaucoma, with the potential to improve long‐term visual outcomes.