What Is Glaucoma?Pathogenesis, Symptoms, & Diagnostic Tests
GLAUCOMA: DEFINITION1,2
The different forms of glaucoma are a group of progressive optic neuropathies that are MULTIFACTORIAL and have a common progressive loss of retinal ganglion cells and their axons resulting in characteristic morphological alterations of the optic papilla and nerve fibres associated with corresponding visual field alterations.
In all of this, the ocular tone
- Disappears from the definition criteria of glaucomatous disease
- And it is one of the risk factors for its progression
In this definition from 2021, the concept expressed in the first definition of glaucoma disappears, according to which for the diagnosis of the disease a high ocular tone, the excavation of the optic papilla and damage to the visual field must be detectable.
Worldwide glaucoma no. of cases expected
risk factors glaucoma3
Intraocular pressure (IOP) elevation is only a risk factor but currently the most relevant to treat in order to reduce the glaucoma damage progression.
But it’s not THE TREATMENT of the disease, because glaucoma progression may occur also with compensated IOP
iop
NEURODEGENERATION
neurodegeneration3
Group of multifactorial diseases (primary o secondary) with
(RGC) and peripapillary nerve fiber layer (RNFL)
Progression of glaucomatous optic nerve damage
Normal optic disc
Moderate glaucoma
Advanced glaucoma, with increasing cup/disc ratio and progressive loss of neuroretinal rim and nerve fibre layer
neurodegeneration5
CLINICAL MANAGEMENT OF GLAUCOMA
On the
reduction of IOP
LOP CAN BE REDUCED WITH PHARMACOLOGICAL TREATMENT, LASER OR SURGERY
on
Neuroprotection
The supplementation with antioxidants and neurotrophic agents exerts a neuroprotective activity
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References:
1. EGS Guidelines 6th ED 2025
2. Tezel G. Multifactorial pathogenic processes of retinal ganglion cell degeneration in glaucoma towards multi-target strategies. Cells. 2021;10(6):1372.
3. European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition 2021
4. Report: World Health Organization 2022
5. Adapted from Melecchi A., et al., Restored retinal physiology after administration of niacin with citicoline in a mouse model of hypertensive glaucoma. Frontiers in medicine, 10, 1230941 (2023);
6. Terminology and Guidelines for Glaucoma (5th edition) – 2020