Expansion of visual receptive fields in experimental glaucoma

Influences of Glaucoma on the Structure and Function of Synapses in the Visual System

Significance: Glaucoma is an age-related neurodegenerative disorder of the visual system associated with sensitivity to intraocular pressure (IOP). It is the leading irreversible cause of vision loss worldwide, and vision loss results from damage and dysfunction of the retinal output neurons known as retinal ganglion cells (RGCs). Recent Advances: Elevated IOP and optic nerve injury triggers pruning of RGC dendrites, altered morphology of excitatory inputs from presynaptic bipolar cells, and disrupted RGC synaptic function. Less is known about RGC outputs, although evidence to date indicates that glaucoma is associated with altered mitochondrial and synaptic structure and function in RGC-projection targets in the brain. These early functional changes likely contribute to vision loss and might be a window into early diagnosis and treatment. Critical Issues: Glaucoma affects different RGC populations to varying extents and along distinct time courses. The influence of glaucoma on RGC synaptic function as well as the mechanisms underlying these effects remain to be determined. Since RGCs are an especially energetically demanding population of neurons, altered intracellular axon transport of mitochondria and mitochondrial function might contribute to RGC synaptic dysfunction in the retina and brain as well as RGC vulnerability in glaucoma. Future Directions: The mechanisms underlying differential RGC vulnerability remain to be determined. Moreover, the timing and mechanisms of RGCs synaptic dysfunction and degeneration will provide valuable insight into the disease process in glaucoma. Future work will be able to capitalize on these findings to better design diagnostic and therapeutic approaches to detect disease and prevent vision loss. Antioxid. Redox Signal. 37, 842-861.

Eye Movement Abnormalities in Glaucoma Patients: A Review

Glaucoma is a common condition that relies on careful clinical assessment to diagnose and determine disease progression. There is growing evidence that glaucoma is associated not only with loss of retinal ganglion cells but also with degeneration of cortical and subcortical brain structures associated with vision and eye movements. The effect of glaucoma pathophysiology on eye movements is not well understood. In this review, we examine the evidence surrounding altered eye movements in glaucoma patients compared to healthy controls, with a focus on quantitative eye tracking studies measuring saccades, fixation, and optokinetic nystagmus in a range of visual tasks. The evidence suggests that glaucoma patients have alterations in several eye movement domains. Patients exhibit longer saccade latencies, which worsen with increasing glaucoma severity. Other saccadic abnormalities include lower saccade amplitude and velocity, and difficulty inhibiting reflexive saccades. Fixation is pathologically altered in glaucoma with reduced stability. Optokinetic nystagmus measures have also been shown to be abnormal. Complex visual tasks (eg reading, driving, and navigating obstacles), integrate these eye movements and result in behavioral adaptations. The review concludes with a summary of the evidence and recommendations for future research in this emerging field.

Binocularly Asymmetric Crowding in Glaucoma and a Lack of Binocular Summation in Crowding

Purpose

Glaucoma is associated with progressive loss of retinal ganglion cells. Here we investigated the impact of glaucomatous damage on monocular and binocular crowding in parafoveal vision. We also examined the binocular summation of crowding to see if crowding is alleviated under binocular viewing.

Methods

The study design included 40 individuals with glaucoma and 24 age-similar normal cohorts. For each subject, the magnitude of crowding was determined by the extent of crowding zone. Crowding zone measurements were made binocularly in parafoveal vision (i.e., at 2° and 4° retinal eccentricities) visual field. For a subgroup of glaucoma subjects (n = 17), crowding zone was also measured monocularly for each eye.

Results

Our results showed that, compared with normal cohorts, individuals with glaucoma exhibited significantly larger crowding—enlargement of crowding zone (an increase by 21%; P < 0.01). Moreover, we also observed a lack of binocular summation (i.e., a binocular ratio of 1): binocular crowding was determined by the better eye. Hence, our results did not provide evidence supporting binocular summation of crowding in glaucomatous vision.

Conclusions

Our findings show that crowding is exacerbated in parafoveal vision in glaucoma and binocularly asymmetric glaucoma seems to induce binocularly asymmetric crowding. Furthermore, the lack of binocular summation for crowding observed in glaucomatous vision combined with the lack of binocular summation reported in a previous study on normal healthy vision support the view that crowding may start in the early stages of visual processing, at least before the process of binocular integration takes place.

Simultaneous changes in visual acuity, cortical population receptive field size, visual field map size, and retinal thickness in healthy human aging

Healthy human aging is associated with a deterioration of visual acuity, retinal thinning, visual field map shrinkage and increasing population receptive field sizes. Here we ask how these changes are related to each other in a cross-sectional sample of fifty healthy adults aged 20-80 years. We hypothesized that age-related loss of macular retinal ganglion cells may lead to decreased visual field map sizes, and both may lead to increased pRF sizes in the cortical central visual field representation. We measured our participants' perceptual corrected visual acuity using standard ophthalmological letter charts. We then measured their early visual field map (V1, V2 and V3) functional population receptive field (pRF) sizes and structural surface areas using fMRI, and their retinal structure using high-definition optical coherence tomography. With increasing age visual acuity decreased, pRF sizes increased, visual field maps surface areas (but not whole-brain surface areas) decreased, and retinal thickness decreased. Among these measures, only functional pRF sizes predicted perceptual visual acuity, and Bayesian statistics support a null relationship between visual acuity and cortical or retinal structure. However, pRF sizes were in turn predicted by cortical structure only (visual field map surface areas), which were only predicted by retinal structure (thickness). These results suggest that simultaneous disruptions of neural structure and function throughout the early visual system may underlie the deterioration of perceptual visual acuity in healthy aging.

Limited Spatial Spread Explains the Dependence of Visual Response Adaptation on Stimulus Size in Rat Superior Colliculus Neurons

Although adaptation to light occurs in the eye and mainly preserves the full dynamic range of neuronal responses during changing background illumination, it affects the entire visual system and helps to optimize visual information processing. We have shown recently that in rat superior colliculus (SC) neurons adaptation to light acts as a local low-pass filter because, in contrast to the primate SC, in rat collicular neurons adaptation to small stimuli is largely limited to the vicinity of the adaptor stimulus. However, it was unclear whether large visual stimuli would induce the same spatially limited adaptation. We addressed this question by evaluating the effects of 1.8°, 6.2° and 20.8° wide adaptor stimuli on test stimuli of variable size. Single unit recordings in the adult rat SC were employed to estimate the response amplitude. Small, 1.8° and 6.2° adaptors habituated visual responses only to stimuli smaller than the adaptive stimuli. However, the 20.8° adaptor dramatically reduced responses even to test stimuli >3 times wider than the adaptor (up to 70° wide). The latter result may be explained by a nearly complete occlusion by a large adaptor of the neuron's receptive field (RF). All these results are consistent with the idea of a limited spatial spread of adaptation in rat SC neurons that is the consequence of high convergence of retinal inputs, in which small RFs limit the spatial spread of adaptation. It is concluded that, in this limited spatial spread of adaptation, rodent SC resembles higher visual system areas in primates and indicates potential differences in visual information processing between rodents and primates.

High Correlation between Glaucoma Treatment with Topical Prostaglandin Analogs and BDNF Immunoreactivity in Human Retina

PURPOSE

To examine the expression of brain-derived neurotrophic factor (BDNF) and its high-affinity receptor, tropomyosin-related kinase receptor-B (TrkB), in normal and glaucomatous human retinas.

METHODS

Human retinas were collected from 8 donors who had been clinically diagnosed and treated for glaucoma, and from 9 control donors. Immunohistochemical analysis for BDNF and TrkB was performed. The percent of each retina expressing BDNF and TrkB was quantified for the total retinal thickness, and separately for the retinal ganglion cell (RGC) complex + retinal nerve fiber layer (RNFL). The expression of each protein was correlated with clinical outcomes obtained from the subject's ocular histories.

RESULTS

There was no significant difference in BDNF or TrkB expression when comparing glaucomatous and control retinas. Correlation analysis revealed a significant relationship between BDNF expression and the use of prostaglandin analogs. TrkB expression was highly correlated with the last-measured intraocular pressure (IOP), the use of carbonic anhydrase inhibitors, the use of beta blockers, and the total number of drugs used for the treatment of glaucoma.

CONCLUSION

Topical drugs used to treat glaucoma were associated with an increase in retinal BDNF and TrkB expression in human retina, independent of IOP, which may represent molecular evidence of neuroprotective pathway activation.

Visual Crowding in Glaucoma

Purpose

Crowding refers to the phenomenon in which objects that can be recognized when viewed in isolation are unrecognizable in clutter. Crowding sets a fundamental limit to the capabilities of the peripheral vision and is essential in explaining performance in a broad array of daily tasks. Due to the effects of glaucoma on peripheral vision, we hypothesized that neural loss in the disease would lead to stronger effects of visual crowding.

Methods

Subjects were asked to discriminate the orientation of a target letter when presented with surrounding flankers. The critical spacing value (scritical), which was required for correct discrimination of letter orientation, was obtained for each quadrant of the visual field. scritical values were correlated with standard automated perimetry (SAP) mean sensitivity (MS) and optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness measurements.

Results

The study involved 13 subjects with mild glaucomatous visual field loss and 13 healthy controls. Glaucomatous eyes had significantly greater (worse) scritical than controls (170.4 ± 27.1 vs. 145.8 ± 28.0 minimum of visual angle, respectively; P = 0.007). scritical measurements were significantly associated with RNFL thickness measurements (R2 = 26%; P < 0.001) but not with SAP MS (P = 0.947).

Conclusions

In glaucoma patients, a pronounced visual crowding effect is observed, even in the presence of mild visual field loss on standard perimetry. scritical was associated with the amount of neural loss quantified by OCT. These results may have implications for understanding how glaucoma patients are affected in daily tasks where crowding effects may be significant.

Linkage between retinal ganglion cell density and the nonuniform spatial integration across the visual field

The integration of visual information over space is critical to human pattern vision. For either luminance detection or object recognition, the position of the target in the visual field governs the size of a window within which visual information is integrated. Here we analyze the relationship between the topographic distribution of ganglion cell density and the nonuniform spatial integration across the visual field. We find that the variation in the retinal ganglion cell (RGC) density across the human retina is closely matched to the variation in the extent of spatial integration. Our study suggests that a fixed number of RGCs subserves spatial integration of visual input, independent of the visual-field location.

The ability to integrate visual information over space is a fundamental component of human pattern vision. Regardless of whether it is for detecting luminance contrast or for recognizing objects in a cluttered scene, the position of the target in the visual field governs the size of a window within which visual information is integrated. Here we analyze the relationship between the topographic distribution of ganglion cell density and the nonuniform spatial integration across the visual field. The extent of spatial integration for luminance detection (Ricco’s area) and object recognition (crowding zone) are measured at various target locations. The number of retinal ganglion cells (RGCs) underlying Ricco’s area or crowding zone is estimated by computing the product of Ricco’s area (or crowding zone) and RGC density for a given target location. We find a quantitative agreement between the behavioral data and the RGC density: The variation in the sampling density of RGCs across the human retina is closely matched to the variation in the extent of spatial integration required for either luminance detection or object recognition. Our empirical data combined with the simulation results of computational models suggest that a fixed number of RGCs subserves spatial integration of visual input, independent of the visual-field location.

An Electrophysiological Comparison of Contrast Response Functions in Younger and Older Adults, and Those With Glaucoma

Purpose

Aging and glaucoma both result in contrast processing deficits. However, it is unclear the extent to which these functional deficits arise from retinal or post-retinal neuronal changes. This study aims to disentangle the effects of healthy human aging and glaucoma on retinal and post-retinal contrast processing using visual electrophysiology.

Methods

Steady-state pattern electroretinograms (PERG) and pattern visual evoked potentials (PVEP) were simultaneously recorded across a range of contrasts (0%, 4%, 9%, 18%, 39%, 73%, 97%; 0.8° diameter checks, 31° diameter checkerboard) in 13 glaucoma patients (67 ± 6 years), 15 older (63 ± 8 years) and 14 younger adults (27 ± 3 years). PERG and PVEP contrast response functions were fit with a linear and saturating hyperbolic model, respectively. PERG and PVEP magnitude, timing (phase), and model fit parameters (slope, semi-saturation constant) were compared between groups.

Results

PERG responses were reduced and delayed in older adults relative to younger adults, and further reduced and delayed in glaucoma patients across all contrasts. PVEP signals were also reduced and delayed in glaucoma patients, relative to age-similar (older) controls. However, despite having reduced PERG magnitudes, older adults did not demonstrate reduced PVEP magnitudes.

Conclusions

Older adults with healthy vision demonstrate reduced magnitude and delayed timing in the PERG that is not reflected in the PVEP. In contrast, glaucoma produces functional deficits in both PERG and PVEP contrast response functions. Our results suggest that glaucomatous effects on contrast processing are not a simple extension of those that arise as part of the aging process.

Slow Reading in Glaucoma: Is it due to the Shrinking Visual Span in Central Vision?

Purpose

Glaucoma is a leading cause of blindness worldwide, characterized by progressive loss of retinal ganglion cells. Patients with bilateral glaucoma read slower than normal cohorts. Here we examined the factors that may underlie slow reading in glaucoma and determined the best predictor of reading speed in glaucoma.

Methods

A total of 38 subjects participated in this study: 17 patients with primary open-angle glaucoma (mean age = 64.71 years) and 21 age-similar normal controls (58.24 years). For each subject, we measured binocular visual acuity (BVA); binocular contrast sensitivity (BCS); stereoacuity; visual field mean deviation (MD); and the visual span (i.e., the number of letters recognizable at one glance) known to limit reading speed. The visual span was measured with a trigram letter-recognition task in which subjects identify trigrams flashed at varying letter positions left and right of the fixation. Oral reading speed was measured with short blocks of text.

Results

Even after controlling for age, glaucoma patients showed significantly slower reading speed (by 19%, P < 0.05) and smaller visual span (by 11 bits, P < 0.001) compared to normal controls. While their BVA was relatively normal (20/20 Snellen equivalent), their BCS (P < 0.001); stereoacuity (P < 0.001); and visual field MD (P < 0.001) showed pronounced deficits. Multiple regression analysis further revealed that reading speed in glaucoma was best predicted by the visual span.

Conclusions

Our results showed that slower reading speed in glaucoma was closely related to the shrinkage of the visual span. Our findings further support the view that the visual span plays a limiting role in reading speed.

Age-related changes in crowding and reading speed

Crowding, the inability to recognize objects in clutter, is known to play a role in developmental changes in reading speed. Here, we investigated whether crowding also plays a role in age-related changes in reading speed. We recruited 18 young (mean age: 22.6 ± 3.5; range: 18~31) and 21 older adults (mean age: 58.2 ± 7.0; range: 50~73) with normal vision. Reading speed was measured with short blocks of text. The degree of crowding was determined by measuring crowding zone (the distance between a target and flankers required to yield a criterion recognition accuracy) and the size of the visual span (an uncrowded window in the visual field within which letters can be recognizable reliably). Measurements were made across the central 16-degree visual field using letter-recognition tasks. Our results showed that, compared to young adults, older adults exhibited significantly slower reading speed (a decrease by 30%) and larger crowding: an enlargement of crowding zone (an increase by 31%) and shrinkage of the visual span (a decrease by 6.25 bits). We also observed significant correlations between reading speed and each of the crowding measures. Our results suggest that crowding increases with age. Age-related changes in crowding may in part explain slower reading in older adults.

Progressive degeneration of retinal and superior collicular functions in mice with sustained ocular hypertension

PURPOSE

We investigated the progressive degeneration of retinal and superior collicular functions in a mouse model of sustained ocular hypertension.

METHODS

Focal laser illumination and injection of polystyrene microbeads were used to induce chronic ocular hypertension. Retinal ganglion cell (RGC) loss was characterized by in vivo optical coherence tomography (OCT) and immunohistochemistry. Retinal dysfunction was also monitored by the full-field ERG. Retinal ganglion cell light responses were recorded using a 256-channel multielectrode array (MEA), and RGC subtypes were characterized by noncentered spike-triggered covariance (STC-NC) analysis. Single-unit extracellular recordings from superficial layers of the superior colliculus (SC) were performed to examine the receptive field (RF) properties of SC neurons.

RESULTS

The elevation of intraocular pressure (IOP) lasted 4 months in mice treated with a combination of laser photocoagulation and microbead injection. Progressive RGC loss and functional degeneration were confirmed in ocular hypertensive (OHT) mice. These mice had fewer visually responsive RGCs than controls. Using the STC-NC analysis, we classified RGCs into ON, OFF, and ON-OFF functional subtypes. We showed that ON and OFF RGCs were more susceptible to the IOP elevation than ON-OFF RGCs. Furthermore, SC neurons of OHT mice had weakened responses to visual stimulation and exhibited mismatched ON and OFF subfields and irregular RF structure.

CONCLUSIONS

We demonstrated that the functional degeneration of RGCs is subtype-dependent and that the ON and OFF pathways from the retina to the SC were disrupted. Our study provides a foundation to investigate the mechanisms underlying the progressive vision loss in experimental glaucoma.

Ocular hypertension results in retinotopic alterations in the visual cortex of adult mice

PURPOSE

Glaucoma is a group of optic neuropathies characterized by the loss of retinal ganglion cells (RGCs). Since ocular hypertension (OHT) is a main risk factor, current therapies are predominantly based on lowering eye pressure. However, a subset of treated patients continues to lose vision. More research into pathological mechanisms underlying glaucoma is therefore warranted in order to develop novel therapeutic strategies. In this study we investigated the impact of OHT from eye to brain in mice.

METHODS

Monocular hypertension (mOHT) was induced in CD-1 mice by laser photocoagulation (LP) of the perilimbal and episcleral veins. The impact on the retina and its main direct target area, the superficial superior colliculus (sSC), was examined via immunostainings for Brn3a, VGluT2 and GFAP. Alterations in neuronal activity in V1 and extrastriate areas V2L and V2M were assessed using in situ hybridization for the activity reporter gene zif268.

RESULTS

Transient mOHT resulted in diffuse and sectorial RGC degeneration. In the sSC contralateral to the OHT eye, a decrease in VGluT2 immunopositive synaptic connections was detected one week post LP, which appeared to be retinotopically linked to the sectorial RGC degeneration patterns. In parallel, hypoactivity was discerned in contralateral retinotopic projection zones in V1 and V2. Despite complete cortical reactivation 4 weeks post LP, in the sSC no evidence for recovery of RGC synapse density was found and also the concomitant inflammation was not completely resolved. Nevertheless, sSC neurons appeared healthy upon histological inspection and subsequent analysis of cell density revealed no differences between the ipsi- and contralateral sSC.

CONCLUSION

In addition to RGC death, OHT induces loss of synaptic connections and neuronal activity in the visual pathway and is accompanied by an extensive immune response. Our findings stress the importance of looking beyond the eye and including the whole visual system in glaucoma research.

Retinal ganglion cell dendritic atrophy in DBA/2J glaucoma

Glaucoma is a complex disease affecting an estimated 70 million people worldwide, characterised by the progressive degeneration of retinal ganglion cells and accompanying visual field loss. The common site of damage to retinal ganglion cells is thought to be at the optic nerve head, however evidence from other optic neuropathies and neurodegenerative disorders suggests that dendritic structures undergo a prolonged period of atrophy that may accompany or even precede soma loss and neuronal cell death. Using the DBA/2J mouse model of glaucoma this investigation aims to elucidate the impact of increasing intraocular pressure on retinal ganglion cell dendrites using DBA/2J mice that express YFP throughout the retinal ganglion cells driven by Thy1 (DBA/2J.Thy1(YFP)) and DiOlistically labelled retinal ganglion cells in DBA/2J mice. Here we show retinal ganglion cell dendritic degeneration in DiOlistically labelled DBA/2J retinal ganglion cells but not in the DBA/2J.Thy1(YFP) retinal ganglion cells suggesting that a potential downregulation of Thy1 allows only ‘healthy’ retinal ganglion cells to express YFP. These data may highlight alternative pathways to retinal ganglion cell loss in DBA/2J glaucoma.

Critical pathogenic events underlying progression of neurodegeneration in glaucoma

Glaucoma is a common optic neuropathy with a complex etiology often linked to sensitivity to intraocular pressure. Though the precise mechanisms that mediate or transduce this sensitivity are not clear, the axon of the retinal ganglion cell appears to be vulnerable to disease-relevant stressors early in progression. One reason may be because the axon is generally thin for both its unmyelinated and myelinated segment and much longer than the thicker unmyelinated axons of other excitatory retinal neurons. This difference may predispose the axon to metabolic and oxidative injury, especially at distal sites where pre-synaptic terminals form connections in the brain. This idea is consistent with observations of early loss of anterograde transport at central targets and other signs of distal axonopathy that accompany physiological indicators of progression. Outright degeneration of the optic projection ensues after a critical period and, at least in animal models, is highly sensitive to cumulative exposure to elevated pressure in the eye. Stress emanating from the optic nerve head can induce not only distal axonopathy with aspects of dying back neuropathy, but also Wallerian degeneration of the optic nerve and tract and a proximal program involving synaptic and dendritic pruning in the retina. Balance between progressive and acute mechanisms likely varies with the level of stress placed on the unmyelinated axon as it traverses the nerve head, with more acute insult pushing the system toward quicker disassembly. A constellation of signaling factors likely contribute to the transduction of stress to the axon, so that degenerative events along the length of the optic projection progress in retinotopic fashion. This pattern leads to well-defined sectors of functional depletion, even at distal-most sites in the pathway. While ganglion cell somatic drop-out is later in progression, some evidence suggests that synaptic and dendritic pruning in the retina may be a more dynamic process. Structural persistence both in the retina and in central projection sites offers the possibility that intrinsic self-repair pathways counter pathogenic mechanisms to delay as long as possible outright loss of tissue.

Changes in the modulation of retinocollicular transmission through group III mGluRs long after an increase in intraocular pressure in a rat model of glaucoma

Metabotropic glutamate receptors (mGluRs) have been shown to be involved in the modulation of retinocollicular neurotransmission. In glaucoma, retinal ganglion cells (RGCs) degenerate, which may have an implication on this transmission as the superior colliculus is their major central target in the much-used rodent models of the disease. We have investigated this using an in vitro slice preparation of the superior colliculus by eliciting field excitatory postsynaptic potentials (fEPSPs) through optic tract stimulation in a rat ocular hypertension model of glaucoma. Application of the group III mGluR agonist L-AP4 reduced the peak amplitude of the fEPSP in superior colliculus slices through presynaptic mechanisms as previously shown in our lab. At 3 and 16 weeks after surgery, there were no significant differences in the effect of L-AP4 on fEPSP peak amplitude in the superior colliculus slices receiving input from the glaucomatous eyes [elevated intraocular pressure (IOP)] compared to those with input from the unoperated eyes (normal IOP). However, at 32 weeks, the fEPSP peak amplitude was reduced to a significantly greater degree during L-AP4 application in the elevated IOP slices compared to normal IOP slices. At all time points, there were no significant changes in the baseline amplitudes of fEPSPs or the stimulus intensities required to evoke fEPSPs. These results suggest that the modulation of synaptic transmission through group III mGluRs on RGC terminals to the superior colliculus is changed at later stages due to RGC degeneration through IOP elevation. These changes may be compensatory changes possibly through plasticity in the RGC terminals of surviving cells, which may be due to increases in the numbers of group III mGluRs. This result may have implications on further treatment studies carried out using these models of glaucoma as changes in the central visual system may need to be considered along with the retinal changes that occur.

Determining mechanisms of visual loss in glaucoma using Rarebit perimetry

PURPOSE

Evidence for ganglion cell visual dysfunction in human glaucoma is often indirect, being either measured at the cellular level in animal models or being inferred from the pooled responses of a large number of ganglion cells in human observers. Rarebit perimetry (RBP) uses repeated, intense (150 cd/m2) stimuli-whose size is close to the spatial scale of a ganglion cell-to search for small retinal areas with zero sensitivity. Decreasing the stimulus luminance to 64 cd/m2 in normal observers does not alter the percentage of RBP stimuli detected [the mean hit rate (MHR)], and so we hypothesized that a similar response robustness should occur in glaucoma if the elements detecting the RBP target show no signs of visual dysfunction.

METHODS

Nineteen glaucoma subjects and 19 age-matched controls were tested with a customized RBP test at 13 stimulus luminances (10 to 150 cd/m2, 0.14 log unit intervals). A four-parameter (threshold, spread, false positive proportion, and miss rate) cumulative Gaussian psychometric function was fitted to the response rate data from a glaucoma-affected region (glaucoma subjects; MHR >50% and <80%) and from the corresponding region in an age-matched normal control. Our hypothesis would predict that only the miss rates should differ between groups.

RESULTS

Glaucoma subjects showed significantly higher miss rates (0.18 vs. 0.04, p < 0.001), lower false positive proportions (0.009 vs. 0.025, p = 0.004), greater spreads (0.30 vs. 0.19, p = 0.002), and elevated thresholds [1.57 log(cd/m2) vs. 1.13 log(cd/m2), p < 0.001].

CONCLUSIONS

Responses to RBP stimuli are not robust to decreasing luminances in glaucoma. Our results more directly imply the presence of ganglion cell visual dysfunction in human glaucoma than studies using larger targets where contrast sensitivity losses could result through ganglion cell death alone. Such dysfunction may not be detected by Rarebit's MHR given that dysfunctional elements may still respond to the very intense RBP stimulus.

Neurodegeneration in glaucoma: progression and calcium-dependent intracellular mechanisms

Glaucoma is an age-related optic neuropathy involving sensitivity to ocular pressure. The disease is now seen increasingly as one of the central nervous system, as powerful new approaches highlight an increasing number of similarities with other age-related neurodegenerations such as Alzheimer's and Parkinson's. While the etiologies of these diseases are diverse, they involve many important common elements including compartmentalized programs of degeneration targeting axons, dendrites and finally cell bodies. Most age-related degenerations display early functional deficits that precede actual loss of neuronal substrate. These are linked to several specific neurochemical cascades that can be linked back to dysregulation of Ca(2+)-dependent processes. We are now in the midst of identifying similar cascades in glaucoma. Here we review recent evidence on the pathological progression of neurodegeneration in glaucoma and some of the Ca(2+)-dependent mechanisms that could underlie these changes. These mechanisms present clear implications for efforts to develop interventions targeting neuronal loss directly and make glaucoma an attractive model for both interrogating and informing other neurodegenerative diseases.

Changes in NMDA receptor contribution to synaptic transmission in the brain in a rat model of glaucoma

In the age-related, blinding disease glaucoma, retinal ganglion cells (RGCs) degenerate, possibly affecting glutamatergic retinofugal transmission to the brain. The superior colliculus (SC) is a major central target of retinofugal axons in the rodent, a much used disease model. We investigated the contribution of NMDA-type glutamate receptors to retinocollicular transmission in a rat glaucoma model, using a SC brain slice preparation to determine the sensitivity of synaptic responses to the NMDAR antagonist D-AP5. At 32 weeks after induction of experimental glaucoma, but not earlier, there was an increase in NMDAR contribution to SC synaptic responses in slices receiving input from glaucomatous eyes. This suggests that there are changes in NMDAR function after RGC degeneration in experimental glaucoma, which may represent functional SC compensation through plasticity via NMDARs. This has implications for studies carried out using rodent glaucoma models, especially those evaluating potential treatment strategies, as it suggests that functional changes in the central visual system need to be considered in addition to those in the eye. Furthermore, the data underline the need for early therapeutic intervention in order to pre-empt subsequent central functional changes.

Changes of central visual receptive fields in experimental glaucoma

Retinal ganglion cell apoptotic death in experimental glaucoma is protracted over several months and it leads to the visual dysfunction. In the rat with increased intraocular pressure (IOP), the lack of visual scotoma was observed where visual field was determined electrophysiologically on the contralateral optic tectum in the early stages of the disease. Increases in the sizes of receptive fields on the periphery represented early stage of glaucomatous dysfunction. The relationship of duration and magnitude of IOP elevation had a significant correlation between percentages of receptive field sizes in the tectum. Large increases in receptive field sizes noted in the glaucomatous retinal terminal areas suggest the ability of the remaining retinal axons to compete and compensate for the loss of retinal axons. This compensatory adaptation leads to the degradation of the visual acuity and visual thresholds when measured psychophysically.