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Strukturelle Veränderungen im Verlauf der Glaukomerkrankung

Structural alterations during the course of glaucoma disease

Der Ophthalmologe volume 112, pages 410–417 (2015)Cite this article

Zusammenfassung

Hintergrund

Strukturelle Veränderungen im Verlauf der Glaukomerkrankung betreffen zum einen Gewebe des Trabekelwerks und des Ziliarkörpers und zum anderen die Papille mit retinaler Nervenfaserschicht als primären Schädigungsort der Erkrankung.

Fragestellung

Es werden aktuelle Ergebnisse aus experimentellen Arbeiten, Tierversuchen und Messungen an humanen Augen dargestellt und diskutiert.

Ergebnisse

Es zeichnet sich immer mehr ein komplexes Bild von Gewebsveränderungen ab, die von Alter, biochemischen und mechanischen Stressfaktoren abhängen und dann zu einem graduellen, irreversiblen Umbau in Trabekelwerk und Lamina cribrosa des N. opticus führen mit der Folge neuronaler Schädigung.

Schlussfolgerung

Im Verständnis dieser Störungen liegt auch der Schlüssel für zukünftige Glaukomtherapien.

Abstract

Background

Structural changes in the course of glaucoma disease affect the trabecular meshwork and ciliary body in addition to the optic disc as the primary site of glaucoma damage.

Objectives

Latest results from experimental studies, animal models and measurements in human eyes are presented and discussed.

Results

The presenting scenario is complex with age, biochemical and mechanical stress factors leading to subsequent, irreversible tissue change in the trabecular meshwork and cribriform plate of the optic nerve, resulting in neuronal tissue loss.

Conclusion

Knowledge of these changes will be the key for future glaucoma therapies.

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Literatur

  1. Agarwal R, Gupta SK, Srivastava S et al (2009) Current concepts in the pathophysiology of glaucoma. Indian J Ophthalmol 57:257–266

    Article  PubMed Central  PubMed  Google Scholar 

  2. Alvarado JA, Yun AJ, Murphy CG (1986) Juxtacanalicular tissue in primary open angle glaucoma and in nonglaucomatous normals. Arch Ophthalmol 104:1517–1528

    Article  CAS  PubMed  Google Scholar 

  3. Bendschneider D, Tornow RP, Horn FK et al (2010) Retinal nerve fiber layer thickness in normals measured by spectral domain OCT. J Glaucoma 19(7):475–482

    Article  PubMed  Google Scholar 

  4. Burgoyne CF (2011) A biomechanical paradigm for axonal insult within the optic nerve head in aging and glaucoma. Exp Eye Res 93:120–132

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Da Pozzo S, Iacono P, Marchesan R et al (2006)The effect of ageing on retinal nerve fibre layer thickness: an evaluation by scanning laser polarimetry with variable corneal compensation. Acta Ophthalmol Scand 84(3):375–379

    Article  Google Scholar 

  6. De La Paz MA, Epstein DL (1996) Effect of age on superoxide dismutase activity of human trabecular meshwork. Invest Ophthalmol Vis Sci 37:1849–1853

    Google Scholar 

  7. Dolman CL, Mc Cormick AQ, Drance SM (1980) Aging of the optic nerve. Arch Ophthalmol 98:2053–2058

    Article  CAS  PubMed  Google Scholar 

  8. Downs JC, Roberts MD, Sigal I (2011) Glaucomatous cupping of the lamina cribrosa: a review of the evidence for active progressive remodeling as a mechanism. Exp Eye Res 93:133–140

    Article  PubMed Central  Google Scholar 

  9. El-Rafei A, Engelhorn T, Waerntges S et al (2013) Magn Reson Imaging 3:1081–1091

  10. Feuer WJ, Budenz DL, Anderson DR et al (2011) Topographic differences in the age-related changes in the retinal nerve fiber layer of normal eyes measured by Stratus optical coherence tomography. J Glaucoma 20(3):133–138

    Article  PubMed Central  PubMed  Google Scholar 

  11. Fortune B, Burgoyne C, Cull G, Wang L (2012) Onset and progression of retinal nerve fibre layer damage in experimental glaucoma occur earlier by scanning laser polarimetry than by spectral domain OCT. Invest Ophthalmol Vis Sci 54:5653–5661

    Article  Google Scholar 

  12. Gabelt BT, Kaufmann PL (2005) Changes in aqueous humor dynamics with age and glaucoma. Prog Retin Eye Res 24:612–637

    Article  CAS  PubMed  Google Scholar 

  13. Gottanka J, Johnson DH, Martus P, Lütjen-Drecoll E (1997) Severity of optic nerve damage in eyes with POAG is correlated with changes in the trabecular meshwork. J Glaucoma 6:123–132

    Article  CAS  PubMed  Google Scholar 

  14. Harwerth RS, Wheat JL, Fredette MJ, Anderson DR (2010) Linking structure and function in glaucoma. Prog Retin Eye Res 29:249–271

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Hernandez MR (2000) The optic nerve head in glaucoma: role of astrocytes in tissue remodelling. Prog Retin Eye Res 19:297–321

    Article  CAS  PubMed  Google Scholar 

  16. Johnson M (2006) What controls aqueous humour outflow resistance? Exp Eye Res 82:545–557

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Jonas JB, Mardin CY, Schlötzer-Schrehardt U, Naumann GOH (1991) Morphometry of the lamina cribrosa. Invest Ophthalmol Vis Sci 32:401–405

    CAS  PubMed  Google Scholar 

  18. Jonas JB, Schmidt AM, Müller-Bergh JA, Naumann GOH (1995) Optic nerve fibre count and diameter of the retrobulbar optic nerve in normal and glaucomatous eyes. Graefes Arch Clin Exp Ophthalmol 233:421–424

    Article  CAS  PubMed  Google Scholar 

  19. Jonas JB, Wang N (2013) Cerebrospinal fluid pressure and glaucoma. J Ophthalmic Vis Res 8(3):257–263

    PubMed Central  PubMed  Google Scholar 

  20. Lämmer R, Schroeder S, Martus P et al (2007) Quantification of neuroretinal rim loss using digital planimetry in long-term follow-up of normals and patients with ocular hypertension. J Glaucoma 16(5):430–436

    Article  Google Scholar 

  21. Leung CK, Cheung CY, Weinreb RN et al (2010) Evaluation of retinal nerve fiber layer progression in glaucoma: a study on optical coherence tomography guided progression analysis. Invest Ophthalmol Vis Sci 51(1):217–222

    Article  PubMed  Google Scholar 

  22. Liton PB, Gonzalez P (2008) Stress response of the trabecular meshwork. J Glaucoma 17:378–385

    Article  PubMed Central  PubMed  Google Scholar 

  23. Morgan JE (2000) Optic nerve head structure in glaucoma: astrocytes as mediators of glaucomatous damage. Eye 14:437–444

    Article  PubMed  Google Scholar 

  24. Quigley HA (2011) Glaucoma. Lancet 377:1367–1377

    Article  PubMed  Google Scholar 

  25. Raum C, Viestenz A, Mardin CY (2010) Long-term follow-ups of patients with glaucoma with digital planimetry. Klin Monatsbl Augenheilkd 227:215–220

    Article  CAS  PubMed  Google Scholar 

  26. Schlötzer-Schrehardt U, Naumann GOH (1995) Trabecular meshwork in PEX syndrome with and without open-angel glaucoma. A morphometric, ultrasturctural study. Invest Ophthalmol Vis Sci 36:1750–1764

    PubMed  Google Scholar 

  27. Sigal IA, Flanagan JG, Tertinegg I, Ethier CR (2010) 3D morphometry of the human optic nerve head. Exp Eye Res 90(1):70–80

    Article  CAS  PubMed  Google Scholar 

  28. Tektas O-Y, Lütjen-Drecoll E (2009) Structural changes of the trabecular meshwork in different kinds of glaucoma. Exp Eye Res 88:769–775

    Article  CAS  PubMed  Google Scholar 

  29. Ueda J, Wentz-Hunter K, Yue BY (2002) Distribution of myocillin an extracellular matrix components in the juxtacanallicular tissue of human eyes. Invest Ophthalmol Vis Sci 43:1068–1076

    PubMed  Google Scholar 

  30. Vrabec JP, Levin LA (2007) The neurobiology of cell death in glaucoma. Eye 21:11–14

    Article  Google Scholar 

  31. Wang N, Chintala SK, Fine ME, Schuman JS (2001) Activation of tissue-specific stress response in the aqueous outflow pathway of the eye defines the glaucoma disease phenotype. Nat Med 7:304–309

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Welge-Lüßen U, Birke K (2010) Oxidativer Stress im Trabekelwerk beim POWG. Klin Monatsbl Augenheilkd 227:99–107

    Article  PubMed  Google Scholar 

  33. Wessel JM, Tornow RP, Schmid M et al (2013) Longitudinal analysis of progression in glaucoma using spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci 54:3613–3620

    Article  PubMed  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Mardin und U. Schlötzer-Schrehardt geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Affiliations

  1. Universitätsaugenklinik Erlangen, Schwabachanlage 6, 91054, Erlangen, Deutschland

    C.Y. Mardin F.E.B.O & U. Schlötzer-Schrehardt

Authors
  1. C.Y. Mardin F.E.B.O
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  2. U. Schlötzer-Schrehardt
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Corresponding author

Correspondence to C.Y. Mardin F.E.B.O.

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Mardin, C., Schlötzer-Schrehardt, U. Strukturelle Veränderungen im Verlauf der Glaukomerkrankung. Ophthalmologe 112, 410–417 (2015). https://doi.org/10.1007/s00347-014-3152-7

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  • DOI: https://doi.org/10.1007/s00347-014-3152-7

Schlüsselwörter

  • Trabekelwerk
  • Papille
  • Axon
  • Degeneration
  • Alter

Keywords

  • Trabecular meshwork
  • Optic disc
  • Axons
  • Degeneration
  • Age