Abstract
Primary open-angle glaucoma is a chronic optic neuropathy characterized by retinal ganglion cell loss and subsequent visual field impairment. Elevated intraocular pressure remains the only treatable and modifiable risk factor and vascular impairment has been demonstrated in glaucomatous patients. New research has uncovered varying and often contradictory data suggesting more than just a casual correlation with ethnicity, diabetes, gender, obesity and age. Little is known about each variables’ contribution to the etiology of glaucoma and how their presence or absence with other risk factors potentiate or reduce an individual’s overall risk. The realization that glaucoma is more than a simple, binary disease necessitates a next-generation mathematical model with the capability to integrate individual patient characteristics and clinical risk factors to predict its formation and progression.
Highlights
Glaucoma is the second leading cause of blindness.[1,2,3] Primary open-angle glaucoma (POAG) is characterized by progressive retinal ganglion cell death and irreversible visual field loss
Several analytical models attempted to characterize glaucoma progression based on biomechanical changes of the eye, such as scleral thickness, retinal nerve fiber layer (RNFL) thickness and visual functional data.[19,20,21,22,23,24]
Key words used in search strategy consisted of primary open-angle glaucoma, ethnicity, diabetes, gender, obesity, body-mass index, age, intraocular pressure, risk factors, glaucomatous progression, treatment, mathematical model, optic-head morphology, visual acuity, ocular perfusion pressure and capillary blood flow
Summary
Glaucoma is the second leading cause of blindness.[1,2,3] Primary open-angle glaucoma (POAG) is characterized by progressive retinal ganglion cell death and irreversible visual field loss. The vessels of the retina represent the only ones in the whole body that can be observed directly and non-invasively by the physician, which can be used to ascertain systemic vessel health In this sense, the diagnosis and follow up of important systemic conditions, such as diabetes and hypertension, is realized by the periodical examination of the fundus oculi at the slit lamp. Optic neuritis is frequently the initial sign of multiple sclerosis Other neurological diseases, such as brain tumors or cerebral ischemia, can be diagnosed with visual field examination, another noninvasive tool that ophthalmologist use in their clinical practice. We will demonstrate the necessity of comprehensive mathematical modeling capable of predicting the natural course of disease progression, which holds the promise for individualized patient care by incorporating specific characteristics lacking in current models to date
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