E Rosenstein Ruth, Belforte Nicolás
Laboratory of Retinal Neurochemistry and Experimental Ophthalmology, Department of Human Biochemistry, School of Medicine, University of Buenos Aires/CEFyBO, CONICET, Buenos Aires, Argentina.
Med Hypothesis Discov Innov Ophthalmol. 2012 Fall;1(3):52-6.
Glaucoma is a leading cause of blindness worldwide, characterised by specific visual field defects due to the degeneration of retinal ganglion cells and damage to the optic nerve head (ONH). Elevated intraocular pressure (IOP) is the most important risk factor for glaucoma development. One of the clinical hallmarks of glaucomatous optic neuropathy is the excavation of the ONH, which consists of a progressive posterior displacement of the ONH surface and excavation of the pre-laminar tissues beneath the anterior-most aspect of the scleral canal, known as the anterior scleral ring. Radial optic neurotomy (RON) is a surgical technique that has been proposed for treating central retinal vein occlusion. While the original rationale of RON was the relief of increased tissue pressure within the optic nerve that results from occlusion of the central retinal vein, recent results are discussed here which suggest that by relaxing of the scleral ring of the prelaminar and laminar regions of the ONH, RON may alleviate the IOP-related connective tissue stress, and in turn, prevent the onset and reduce the progression of glaucomatous neuropathy.
青光眼是全球失明的主要原因，其特征是由于视网膜神经节细胞变性和视神经乳头（ONH）受损而导致特定的视野缺损。眼压升高是青光眼发展的最重要危险因素。青光眼性视神经病变的临床特征之一是视神经乳头凹陷，它包括视神经乳头表面的渐进性后移以及巩膜管最前端下方的层前组织凹陷，即前巩膜环。放射状视神经切开术（RON）是一种已被提出用于治疗视网膜中央静脉阻塞的手术技术。虽然RON最初的原理是缓解因视网膜中央静脉阻塞导致的视神经内组织压力升高，但本文讨论的最新结果表明，通过放松视神经乳头层前和层状区域的巩膜环，RON可能减轻与眼压相关的结缔组织压力，进而预防青光眼性神经病变的发生并减缓其进展。
