Charles F. Prentice Award Lecture 2006: A neuron doctrine for glaucoma
Charles F. Prentice Award Lecture 2006: A neuron doctrine for glaucoma
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DOI：
10.1097/opx.0b013e31817841b5
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发表时间：
2008-06-01
影响因子：
1.4
通讯作者：
Harwerth, Ronald S.
中科院分区：
文献类型：
--
作者：
Harwerth, Ronald S.
青光眼是一组潜在致盲的视神经病变，其特征是视网膜神经节细胞（RGCs）及其轴突的进行性病理损失。形成视神经。原因尚不清楚，因此，疾病进展的诊断和评估依赖于眼科检查，以确定和量化青光眼神经病变的临床特征，如视野缺损的模式和/或视网膜神经纤维层变薄。为了将这些临床测量与青光眼的基本病理联系起来，已经提出了青光眼的神经元学说，将标准测试（标准自动视野检查和光学相干断层扫描）的数据与RGCs的丢失联系起来。这一理论是通过对猕猴实验性青光眼的初步实验室研究得出的，然后通过以患者为基础的临床研究进行修改和完善。当结果转化为RGCs的共同参数时，该理论的最终表述产生了主观和客观测量之间的一致性，用于青光眼的正常视力和缺陷视力。因此，对于个体患者而言，结构-功能关系的改变通常应与青光眼引起的视野缺损的程度和位置一致。
The glaucomas are a group of potentially blinding optic neuropathies that are characterized by progressive pathological losses of the retinal ganglion cells (RGCs) and their axons that. form the optic nerve. The causes are unknown and, therefore, the diagnosis and assessment of progression of disease depends on ophthalmic testing to identify and quantify clinical characteristics of glaucomatous neuropathy, such as the pattern of visual field defects and/or thinning of the retinal nerve fiber layer. To relate these clinical measurements to the basic pathology of glaucoma, a neuron doctrine for glaucoma has been proposed to correlate data from standard tests (standard automated perimetry and optical coherence tomography) to the loss of RGCs. The doctrine was derived through initial laboratory studies of experimental glaucoma in macaque monkeys and, then, modified and refined though patient-based clinical investigations. The final formulation of the doctrine produced concordance between subjective and objective measurements when the results were translated to their common parameter of RGCs, for both normal vision and defective vision from glaucoma. Thus, it was concluded that for individual patients, alterations in structure-function relationships usually should be in agreement for the degree and location of visual field defects caused by glaucoma.