A hypothesis to explain ganglion cell death caused by vascular insults at the optic nerve head: possible implication for the treatment of glaucoma.

Some apparent characteristics of ganglion cell death in glaucoma Glaucoma is a progressive optic neuropathy with characteristic optic disc changes and associated visual field defects. 2 The pattern and progression of visual field loss due to ganglion cell death varies between glaucoma patients suggesting that there is some variability in the magnitude of the insult responsible for the cell loss. Ganglion cell death with a spatial and temporal distribution typical of “glaucoma” can be experimentally induced in animals. One way to try and mimic glaucoma in experimental animals is to raise the intraocular pressure (IOP). It is clear from such studies that ganglion cells do not all die at the same time. Furthermore, the rate of deterioration of ganglion cells is proportional to the magnitude of the insult. The reason for the initiation of ganglion cell death in glaucoma is unknown, but a number of explanatory theories have been proposed with the vasogenic theory perhaps the most widely accepted hypothesis. 10–12