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Glaucoma is a leading cause of world blindness, and retinal ganglion cell death is its pathological hallmark. There is accumulating evidence that glaucomatous damage extends from retinal ganglion cells to vision centers in the brain. In an experimental primate model of unilateral glaucoma, degenerative changes were observed in magnocellular, parvocellular, and koniocellular pathways in the lateral geniculate nucleus, and these changes were presented in relation to intraocular pressure and the severity of optic nerve damage. Neuropathological findings are also present in lateral geniculate nucleus layers driven by the unaffected fellow eye. Finally, there is information on changes in the visual cortex in relation to varying degrees of retinal ganglion cell loss. The implications of these findings for refining concepts regarding the pathobiology of progression, and the detection and treatment of glaucoma, are discussed.
Dr. Y.H. Yucel, Department of Ophthalmology/Vision Sciences, St. Michael's Hospital, University of Toronto, 1, Spadina Crescent, Toronto, Ontario M5S 2J5, Canada. yeni.yucel@utoronto.
1.3 Pathogenesis (Part of: 1 General aspects)