In glaucomatous optic neuropathy recent data suggests that the pinching of the ganglion axons at the lamina cribrosa leads to deprivation of brain derived neurotrophic factor (BDNF) from the lateral geniculate body and ultimately death of the ganglion mitochondrial cells. Hence, the importance of assessing the ganglion cell layer which at present is only detectable by ocular coherence tomography (OCT).
Intraocular pressure is no longer in the glaucoma definition even though the mainstay of glaucoma treatment is lowering of intraocular pressures.
The prevalence of primary open-angle glaucoma (POAG) is estimated to be 2 per cent in Caucasian and 8 per cent in Afro-Caribbean population. In Caucasian study the prevalence rises to 10 per cent in patients over the age of 75. Myopia seems to be high risk for POAG. The prevalence of patients with ocular hypertension has been estimated at 10 per cent in the Caucasian population. Ocular hypertension is defined as open-angle patients having intraocular pressures >21mmHg and no optic neuropathy. Ocular hypertensives need to be closely monitored as 7 per cent of these patients will eventually develop glaucoma.
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