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A neuroglia-based interpretation of glaucomatous neuroretinal rim thinning in the optic nerve head.
Prog Retin Eye Res. 2020 Jan 23 [Online ahead of print]PR

Abstract

Neuroretinal rim thinning (NRR) is a characteristic glaucomatous optic disc change. However, the precise mechanism of the rim thinning has not been completely elucidated. This review focuses on the structural role of the glioarchitecture in the formation of the glaucomatous NRR thinning. The NRR is a glia-framed structure, with honeycomb geometry and mechanically reinforced astrocyte processes along the transverse plane. When neural damage selectively involves the neuron and spares the glia, the gross structure of the tissue is preserved. The disorganization and loss of the glioarchitecture are the two hallmarks of optic nerve head (ONH) remodeling in glaucoma that leads to the thinning of NRR tissue upon axonal loss. This is in contrast to most non-glaucomatous optic neuropathies with optic disc pallor where hypertrophy of the glioarchitecture is associated with the seemingly absent optic disc cupping. Arteritic anterior ischemic optic neuropathy is an exception where pan-necrosis of ONH tissue leads to NRR thinning. Milder ischemia indicates selective neuronal loss that spares glia in non-arteritic anterior ischemic optic neuropathy. The biological reason is the heterogeneous glial response determined by the site, type, and severity of the injury. The neuroglial interpretation explains how the cellular changes underlie the clinical findings. Updated understandings on glial responses illustrate the mechanical, microenvironmental, and microglial modulation of activated astrocytes in glaucoma. Findings relevant to the possible mechanism of the astrocyte death in advanced glaucoma are also emerging. Ultimately, a better understanding of glaucomatous glial response may lead to glia-targeting neuroprotection in the future.

Authors+Show Affiliations

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea.Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, South Korea. Electronic address: ckee@skku.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31982595

Citation

Lee, Eun Jung, et al. "A Neuroglia-based Interpretation of Glaucomatous Neuroretinal Rim Thinning in the Optic Nerve Head." Progress in Retinal and Eye Research, 2020, p. 100840.
Lee EJ, Han JC, Park DY, et al. A neuroglia-based interpretation of glaucomatous neuroretinal rim thinning in the optic nerve head. Prog Retin Eye Res. 2020.
Lee, E. J., Han, J. C., Park, D. Y., & Kee, C. (2020). A neuroglia-based interpretation of glaucomatous neuroretinal rim thinning in the optic nerve head. Progress in Retinal and Eye Research, 100840. https://doi.org/10.1016/j.preteyeres.2020.100840
Lee EJ, et al. A Neuroglia-based Interpretation of Glaucomatous Neuroretinal Rim Thinning in the Optic Nerve Head. Prog Retin Eye Res. 2020 Jan 23;100840. PubMed PMID: 31982595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A neuroglia-based interpretation of glaucomatous neuroretinal rim thinning in the optic nerve head. AU - Lee,Eun Jung, AU - Han,Jong Chul, AU - Park,Do Young, AU - Kee,Changwon, Y1 - 2020/01/23/ PY - 2019/10/07/received PY - 2020/01/02/revised PY - 2020/01/13/accepted PY - 2020/1/27/pubmed PY - 2020/1/27/medline PY - 2020/1/27/entrez KW - Astrocyte loss KW - Glaucomatous cupping KW - Glial disorganization KW - Prelaminar cupping KW - Reactive gliosis KW - Rim thinning SP - 100840 EP - 100840 JF - Progress in retinal and eye research JO - Prog Retin Eye Res N2 - Neuroretinal rim thinning (NRR) is a characteristic glaucomatous optic disc change. However, the precise mechanism of the rim thinning has not been completely elucidated. This review focuses on the structural role of the glioarchitecture in the formation of the glaucomatous NRR thinning. The NRR is a glia-framed structure, with honeycomb geometry and mechanically reinforced astrocyte processes along the transverse plane. When neural damage selectively involves the neuron and spares the glia, the gross structure of the tissue is preserved. The disorganization and loss of the glioarchitecture are the two hallmarks of optic nerve head (ONH) remodeling in glaucoma that leads to the thinning of NRR tissue upon axonal loss. This is in contrast to most non-glaucomatous optic neuropathies with optic disc pallor where hypertrophy of the glioarchitecture is associated with the seemingly absent optic disc cupping. Arteritic anterior ischemic optic neuropathy is an exception where pan-necrosis of ONH tissue leads to NRR thinning. Milder ischemia indicates selective neuronal loss that spares glia in non-arteritic anterior ischemic optic neuropathy. The biological reason is the heterogeneous glial response determined by the site, type, and severity of the injury. The neuroglial interpretation explains how the cellular changes underlie the clinical findings. Updated understandings on glial responses illustrate the mechanical, microenvironmental, and microglial modulation of activated astrocytes in glaucoma. Findings relevant to the possible mechanism of the astrocyte death in advanced glaucoma are also emerging. Ultimately, a better understanding of glaucomatous glial response may lead to glia-targeting neuroprotection in the future. SN - 1873-1635 UR - https://www.unboundmedicine.com/medline/citation/31982595/A_neuroglia-based_interpretation_of_glaucomatous_neuroretinal_rim_thinning_in_the_optic_nerve_head L2 - https://linkinghub.elsevier.com/retrieve/pii/S1350-9462(20)30012-4 DB - PRIME DP - Unbound Medicine ER -
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