The coma in glaucoma: Retinal ganglion cell dysfunction and recovery

被引:73
|
作者
Fry, Lewis E. [1 ,3 ]
Fahy, Eamonn [1 ,2 ]
Chrysostomou, Vicki [1 ]
Hui, Flora [1 ,2 ]
Tang, Jessica [1 ,2 ]
van Wijngaarden, Peter [1 ,2 ]
Petrou, Steven [4 ,5 ]
Crowston, Jonathan G. [1 ,2 ]
机构
[1] Royal Victorian Eye & Ear Hosp, Ctr Eye Res Australia, East Melbourne, Vic, Australia
[2] Univ Melbourne, Dept Surg, Ophthalmol, Melbourne, Vic, Australia
[3] Monash Univ, Clayton, Vic, Australia
[4] Florey Inst Neurosci & Mental Hlth, Parkville, Vic, Australia
[5] Univ Melbourne, Dept Med, Melbourne, Vic, Australia
关键词
Retinal ganglion cell; Glaucoma; Intraocular pressure; Optic nerve; Retina; Neurorecovery; Neuroprotection; Visual recovery; Recovery of function; Neuroplasticity; Dendritic remodeling; Synaptic loss; OPEN-ANGLE GLAUCOMA; INTRAOCULAR-PRESSURE ELEVATION; NERVE-FIBER LAYER; PHOTOPIC NEGATIVE RESPONSE; OPTICAL COHERENCE TOMOGRAPHY; VISUAL-FIELD IMPROVEMENT; RETROGRADE AXOPLASMIC-TRANSPORT; TREATED OCULAR HYPERTENSION; ACUTE IOP ELEVATION; DBA/2J MOUSE MODEL;
D O I
10.1016/j.preteyeres.2018.04.001
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Retinal ganglion cell (RGC) degeneration causes vision loss in patients with glaucoma, and this has been generally considered to be irreversible due to RGC death. We question this assertion and summarise accumulating evidence that points to visual function improving in glaucoma patients with treatment, particularly in the early stages of disease. We propose that prior to death, RGCs enter periods of dysfunction but can recover with relief of RGC stress. We first summarise the clinical evidence for vision improvement in glaucoma and then detail our experimental work that points to the underlying processes that underpin clinical improvement. We show that functional recovery can occur following a prolonged course of RGC dysfunction and demonstrate how the capacity for recovery can be modified. Detecting RGC dysfunction and augmenting recovery of such 'comatosed' RGCs holds clinical potential to improve early detection of glaucoma and improve visual function.
引用
收藏
页码:77 / 92
页数:16
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