Pathological changes of the central part of the visual analyzer in glaucoma
Egorov E.A.¹, Alekseev V.N.², Gazizova I.R.², Martynova E.B.<sup>2

1</sup> N.I. Pirogov Russian National Research Medical University, Moscow
² I.I. Mechnikov Northwestern State Medical University, St. Petersburg

Aim. To study morphological abnormalities of the central part of the visual analyzer in glaucoma.
Patients and methods. Pathological study was performed in two persons those death was not associated with central nervous system disorders. Advanced glaucoma was diagnosed and verified vitally. Pathological and morphological studies as well as immunohistochemistry (which included morphometry of optic nerve, chiasma, lateral geniculate nucleus, and visual cortex cells) were performed.
Results. Macroscopy revealed significant optic atrophy with significant loss of axons and neurons of lateral geniculate nucleus. Microscopy revealed the thinning of visual cortex at athe cellular level, decrease in neuron radius and corrugation of their nuclei, clumpy granular cytoplasm, and large amount of lipofuscin. These abnormalities indicated atrophy. In both died patients who suffered from glaucoma during the life, neurodegenerative processes were discovered. Degeneration involved all levels of the central part of visual analyzer, in particular, visual cortex near the calcarine sulcus. Amyloid plaques and bodies were identified in the optic nerve and layers IV-V of brain cortex.
Conclusions. Degenerative changes in primary open-angle glaucoma affect both retinal ganglion cells and optic nerve fibers and conduction pathways of the visual analyzer right up to the brain cortex. These findings indicate neurodegenerative nature of primary open-angle glaucoma which is confirmed by the presence of recognized neurodegeneration criteria, i.e., astrogliosis and accumulation of beta amyloid in the brain cortex and optic nerve. This condition is similar to other neurodegenerative disorders (Alzheimer's disease, Parkinson’s disease etc.).

Key words: open-angle glaucoma, neurodegeneration, optic nerve, chiasma, lateral geniculate nucleus, visual cortex, astrogliosis, beta amyloid, Alzheimer's disease.

For citation: Egorov E.A., Alekseev V.N., Gazizova I.R., Martynova E.B. Pathological changes of the central part of the visual analyzer in glaucoma // RMJ. Clinical ophthalmology. 2017. № 1. P. 1–3.