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Correlations of Glaucoma Clinical Findings with Histology from Eye Bank Eyes
Research conducted by the Glaucoma Service was instrumental in pointing out that glaucoma damage was occurring much earlier than had been assumed during the 1970's and early 1980's. This involved counting the number of retinal ganglion cells present in donated eye bank eyes and comparing these counts to the optic disc, nerve fiber layer, and visual field findings in the same eyes during the patient's life. Contributions of chart material from many ophthalmologists outside the Wilmer Institute was instrumental in this work. As a result, the search was intensified for earlier diagnostic methods in glaucoma.
The detailed research in this area further disclosed that one class of ganglion cells, the largest or magnocellular cells, are lost selectively in glaucoma. Tests that target the functions performed by these cells, including night vision and motion detection have been proven to be useful in early glaucoma.
Present research is aimed at correlating the automated visual field findings in more than 20 glaucoma eyes donated to the Glaucoma Service with the number of ganglion cells at various locations in the retina directly underlying test locations in the Humphrey instrument.
Studies of glaucoma damage have detected a change in the elastin molecules of the optic nerve head in human glaucoma that probably translate into the production of a stiffer nerve head. Our research with modern imaging techniques such as the Glaucoma-Scope, has produced methods to use the elasticity of the nerve head as a test of the susceptibility of early glaucoma patients to future damage.