'Structure-function relationship' in glaucoma: past thinking and current concepts

• Published in: Clinical & experimental ophthalmology Vol. 40; no. 4; pp. 369 - 380
• Main Authors: Malik, Rizwan, Swanson, William H, Garway-Heath, David F
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.05.2012; Wiley Subscription Services, Inc
• Subjects: Animals; Axons - pathology; function; Glaucoma; Glaucoma - diagnosis; Glaucoma - physiopathology; Humans; Mathematical models; Models, Theoretical; Mutation; Optic Disk - pathology; Optic Nerve Diseases - diagnosis; Optic Nerve Diseases - physiopathology; Prescription drugs; Retinal Ganglion Cells - pathology; structure; Visual Fields - physiology
• ISSN: 1442-6404; 1442-9071
• DOI: 10.1111/j.1442-9071.2012.02770.x

An understanding of the relationship between functional and structural measures in primary open‐angle glaucoma is necessary for both grading the severity of disease and for understanding the natural history of the condition. This article outlines the current evidence for the nature of this relationship and highlights the current mathematical models linking structure and function. Large clinical trials demonstrate that both structural and functional change are apparent in advanced stages of disease, and at an individual level, detectable structural abnormality may precede functional abnormality in some patients, whereas the converse is true in other patients. Although the exact nature of the ‘structure–function’ relationship in primary open‐angle glaucoma is still the topic of scientific debate and the subject of continuing research, this article aims to provide the clinician with an understanding of the past concepts and contemporary thinking in relation to the structure–function relationship in primary open‐angle glaucoma.