Following the latest research balance between IOP and ICP plays a role in neurodegeneration of ganglion cells at the level of lamina cribrosa

The latest paper on the matter available fro ResearchGate

Tortuous Pore Path Through the Glaucomatous Lamina Cribrosa

• December 2018
• Scientific Reports 8(1)
• DOI
• 10.1038/s41598-018-25645-9

The lamina cribrosa is a primary site of damage in glaucoma. While mechanical distortion is hypothesized to cause reduction of axoplasmic flow, little is known about how the pores, which contains the retinal ganglion cell axons, traverse the lamina cribrosa. We investigated lamina cribrosa pore paths in vivo to quantify differences in tortuosity of pore paths between healthy and glaucomatous eyes. We imaged 16 healthy, 23 glaucoma suspect and 48 glaucomatous eyes from 70 subjects using a swept source optical coherence tomography system. The lamina cribrosa pores were automatically segmented using a previously described segmentation algorithm. Individual pore paths were automatically tracked through the depth of the lamina cribrosa using custom software. Pore path convergence to the optic nerve center and tortuosity was quantified for each eye. We found that lamina cribrosa pore pathways traverse the lamina cribrosa closer to the optic nerve center along the depth of the lamina cribrosa regardless of disease severity or diagnostic category. In addition, pores of glaucoma eyes take a more tortuous path through the lamina cribrosa compared to those of healthy eyes, suggesting a potential mechanism for reduction of axoplasmic flow in glaucoma.

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I agree with Marianne answer

The pathophysiological explanation is quite clear, what can be done to limit nerve damage at the lamina cribrosa area? Are some patients are more prone genetically to this problem ?