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Ординатура / Офтальмология / Английские материалы / Glaucoma An Open Window to Neurodegeneration and Neuroprotection_Nucci, Cerulli, Osborne_2008.pdf
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low-tension glaucoma cases (Heijl et al., 2002; Leske et al., 2007). However, a significant proportion of glaucoma patients continue to lose sight in spite of IOP-lowering treatment (Heijl et al., 2002; Leske et al., 2007), and in this context, novel adjuvant strategies to prevent RGC loss/injury continue to be an area of intense investigation. This article will critically review our current understanding of neural degeneration in glaucoma, its spread within central visual pathways, and its relevance to understanding transsynaptic degeneration in neurodegenerative disease.

Retinal ganglion cells, retino-geniculate neurons

The RGC is the principal cell type injured in glaucoma. Its cell body, dendrites, and unmyelinated axon component are located within the eye. There are more than 10 RGC types in nonhuman primates (Dacey et al., 2003). The myelinated axon component of the RGC lies outside of the globe, forming the intraorbital, intracanalicular, and intracranial components of the optic nerve, optic

chiasm, and optic tract (Fig. 1). The majority of RGC terminals convey visual information to the lateral geniculate nucleus (LGN), a nucleus in the thalamus (Perry et al., 1984). The remaining 10% of RGCs target structures that include superior colliculus responsible for eye movements, pretectum for pupillary reflex/eye movements, accessory optic system nuclei for optokinetic nystagmus, and suprachiasmatic nucleus for circadian rhythm retinal input (Goebel et al., 2004). RGC axons exiting the eye convey visual information to these centers while maintaining bidirectional axoplasmic transport of molecules and organelles critical to the function of RGCs and targets neurons.

Lateral geniculate nucleus

The LGN is the major relay station between the retina and the primary visual cortex in humans and nonhuman primates. This structure is composed of neuronal cell bodies arranged into six anatomically segregated layers. The two most ventral layers called magnocellular layers receive input from M RGCs conveying motion information. Four dorsal

Fig. 1. Principal visual stations of the brain are apparent. Retinal ganglion cell axons measure approximately 93 mm spanning intraorbital, intracanalicular, and intracranial portions of the visual pathways including optic nerve, optic chiasm, and optic tract.