Li, Y;
Li, D;
Ying, X;
Khaw, PT;
Raisman, G;
(2015)
An energy theory of glaucoma.
Glia
, 63
(9)
pp. 1537-1552.
10.1002/glia.22825.
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Abstract
A radial array of fortified astrocytes (FASTs) is the load bearing structure of the rat optic nerve head (ONH). At the retinal end the ONH is suspended on a fluid filled extracellular space occupied by modified pigment cells which generate a glomerular-like formation of villi. We propose that regulation of fluid in and out of this space may contribute to buffering the normal fluctuations of intraocular pressure. The energy requirement for the fluid transfer process is provided by the dense vascularity of the ONH and is reflected in the giant mitochondria of the FASTs. We propose that glaucoma occurs when a maintained rise in pressure overwhelms the capacity of this regulatory system. Under these circumstances the FAST array becomes detached from its anchorage in the surrounding ONH sheath. Progressively driven backwards by the pressure, the FASTs degenerate. We propose that the degeneration of the FASTs is associated with ischemic damage caused by the backward stretching of their blood supply. Retraction of the FAST processes deprives the retinal ganglion cell axons of their energy support, resulting in axotomy. We consider that our previously observed rescue of axons and FASTs by transplantation of olfactory ensheathing cells is due to replacement of this lost energy source.
| Type: | Article |
|---|---|
| Title: | An energy theory of glaucoma |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/glia.22825 |
| Publisher version: | http://dx.doi.org/10.1002/glia.22825 |
| Language: | English |
| Additional information: | This is the peer reviewed version of the following article: Li, Y; Li, D; Ying, X; Khaw, PT; Raisman, G; (2015) An energy theory of glaucoma. Glia , 63 (9) pp. 1537-1552, which has been published in final form at http://dx.doi.org/10.1002/glia.22825. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html#terms). |
| Keywords: | glia, intraocular pressure, olfactory ensheathing cells, optic nerve head, posterior ciliary artery, Animals, Astrocytes, Axons, Disease Models, Animal, Female, Glaucoma, Intraocular Pressure, Models, Biological, Neovascularization, Pathologic, Optic Nerve, Rats, Retina, Retinal Degeneration, Transplantation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1464909 |
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