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Glaucomatous damage has been described as a slowly progressive neuronal degenerative process along the visual pathway. Decreased cerebral and ocular blood flow as well as impaired vascular autoregulation has been identified in glaucoma and have been shown to correlate with visual field loss. In low-tension glaucoma patients, diffuse cerebral ischemic changes have been detected through magnetic resonance imaging. Given these findings, it seems that for some patients, glaucomatous damage may be the ocular manifestation of a more widespread vascular abnormality involving the brain rather than a separate process isolated only to the eye and its immediate vasculature.
Department of Ophthalmology, Glick Eye Institute, Indiana University Medical Center, Indianapolis, IN, USA.
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