gms | German Medical Science

Within the past years the definition of the different forms of glaucoma has been changed from simply understanding the disease as a condition caused by high intraocular pressure. Recent findings implicated to redefine the disease as an optic neuropathy with subsequent retinal ganglion cell loss caused by different risk factors. The clinical features of most forms include a characteristic visual field loss and structural changes at the level of the optic nerve head. It has been accepted, that the final common outcome is the loss of retinal ganglion cells. Risk factors, such as elevated intraocular pressure and vascular dysregulation, contribute to structural and biochemical changes within the optic nerve and its supporting tissue. The precise pathomechanisms how especially a specific risk factor finally results in ganglion cell loss at the molecular level are yet not fully understood. The author will focus on advantages and disadvantages of neuroprotective strategies.