Role of ocular blood flow in the deep layers of the optic nerve head in glaucoma
Glaucoma is the second most common cause of blindness in the world. It is characterized by degeneration of the optic nerve axons and consequent progressive retinal ganglion cell (RGC) death. However, the underlying mechanisms of RGC death remain unclear. All current treatments for glaucoma focus on lowering intraocular pressure (IOP), because of evidence that glaucoma is associated with increased IOP. However, normal tension glaucoma (NTG; the primary type of glaucoma in Asia) can progress even with successful IOP-lowering treatment. This suggests that the pathogenesis of glaucoma is multifactorial, making it important to develop new IOP-independent treatments for NTG based on a better understanding of the underlying pathophysiology. Recently, we found that decreased ocular blood flow (OBF) was already present in preperimetric glaucoma, and that cases with lower OBF had faster glaucoma progression. This suggests that OBF is a primary IOP-independent risk factor for glaucomatous damage.
This presentation will discuss details of OBF as it relates to glaucoma pathogenesis, explain the findings of research based on SS-OCT observation of patients, and describe how OBF in the deep layers of the optic nerve head affects the condition of the lamina cribrosa and contributes to glaucomatous central visual field defects in NTG.