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Zmiany w drogach wzrokowych w przebiegu jaskry
Changes in the Optic Pathways in the Glaucoma Course
Piotr Polit, Ewa Kosior-Jarecka, Andrzej Sawicki, Iwona Żarnowska, Tomasz Żarnowski
Klinika Diagnostyki i Mikrochirurgii Jaskry Uniwersytetu Medycznego w Lublinie
Kierownik: prof. dr hab. n. med. Tomasz Żarnowski
Summary: Glaucoma is one of the leading causes of irreversible blindness worldwide. It causes death of retinal ganglion cells, which leads to visual field loss and visual acuity deterioration. The main focus of glaucoma therapy is on lowering the intraocular pressure, which is the main risk factor. Most of the retinal ganglion cell axon is situated extraocular and that suggests the need for examining the whole optic pathway in patients suffering from glaucoma. The development of magnetic resonance technology allows for better visualisation of the optic pathway structures and studying glaucomatous damage in them. Research on animal models led to creation of axonal transport damage theory in retinal ganglion cells, which can be one of the reasons of their death and atrophy. In studies cited in the article there was thinning in the optic nerve observed, especially in the apex of the orbit and lowering of the optic chiasm height compared to control groups. These changes had correlation with typically performed measurements like visual field defect and retinal nerve fiber layer thickness in optical coherence tomography. Lateral geniculate nucleus also showed decreased volume in patients with glaucoma. It is a difficult part of the brain to objectively measure due to its localization and volume. Researchers found thinning of some regions of the visual cortex is also present in glaucoma. Studies using functional magnetic resonance showed lower activity of this part of the brain in patients with glaucoma compared to healthy individuals. Higher magnetic resonance imaging resolution and easier access to this method of examination allow in vivo studying and assessing changes in the central nervous system in the course of glaucoma. Further study is needed to search for potential unknown glaucomatous damage mechanisms.
Słowa kluczowe: rezonans magnetyczny (MRI), jaskra, droga wzrokowa.
Keywords: Magnetic Resonance Imaging (MRI), glaucoma, optic pathway.