Histopathology of retinal ganglion cell death and diagnosis and monitoring of glaucoma progression
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Abstract
Results of the recent experimental studies related to the microscopic damage of the different elements of retinal ganglion cells will be correlated with the possibilities and limitations of different diagnostic methods in glaucoma. The paper discusses the following imaging tests: conventional static perimetry and non-conventional perimetry tests, GDx laser polarimetry, HRT (Heidelberg Retinal Tomograph) scanning laser ophthalmoscopy as well as the RNFL (retinal nerve fibre layer), ONH (optical nerve head) and GCC (ganglion cell complex) analyses on OCT (optical coherence tomography). The individual diagnostic methods reveal glaucoma-induced damage to the different elements of retinal ganglion cells at different stages of the disease. Glaucoma diagnostics should thus be based on those different available methods. Their choice depends on the elements of ganglion cells and other parts of the eye that we wish to examine, and on whether we wish to assess early damage, advanced disease or progression of the pathological process. Combining several diagnostic methods enhances the sensitivity and specificity of glaucoma diagnosis, and improves the reliability of the follow-up process.
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