The Role of Ocular Perfusion Pressure in the Pathogenesis of Glaucoma

Although many risk factors, such as elevated intraocular pressure (IOP), have been implicated in the pathogenesis of open-angle glaucoma (OAG), the exact mechanisms remain unclear. There are 2 theories that have gained the most traction over time: the mechanical theory suggests that IOP directly damages the lamina cribrosa and retinal ganglion cell axons, whereas the vascular theory hypothesizes that insufficient ocular blood flow predisposes the optic nerve to damage, especially in the setting of increased IOP. ^{1, 2} While these 2 theories are presented as distinct, they are not mutually exclusive, and in many clinical scenarios, both mechanisms may be at play.

Duke Scholars

Author Sanjay Girdhari Asrani Ophthalmology, Glaucoma