Endothelin: is it a contributor to glaucoma pathophysiology?

Endothelin is a vasoactive peptide that has been shown to play an important role in vascular homeostasis. Recently, endothelin and its receptors have been found in ocular tissues where it appears to have a regulatory function. Endothelin is found in both the aqueous and vitreous humors and its concentration is elevated in glaucoma patients and in animal models of glaucoma. In the current review, the authors present information about the distribution of endothelin and endothelin receptors in the eye and the ocular actions of endothelins. Specifically, endothelin/aqueous humor dynamics, endothelin/nitric oxide interactions, endothelin and ischemia, and endothelin/optic nerve head effects. Observations concerning the potential role of endothelin in glaucoma pathophysiology is presented and discussed relative to its effects on the optic nerve head and in relation to glaucoma theories.