PATHOGENETIC MECHANISMS OF GLAUCOMA------RESEARCH PROCESS ON THE DEFORMATION OF LAMINA CRIBROSA

Glaucoma is the first cause of irreversible blinding eye disease in the world. Glaucomatous optic nerve damage is directly associated with the intraocular pressure, and tight control of intraocular pressure is still the only therapeutic approach available for the treatment of glaucoma, while the pathogenesis of glaucoma remains unknown. It has now been confirmed that the primary site of glaucoma is the lamina cribrosa: the pressure difference between the intraocular pressure and intracranial pressure respectively exerted on the anterior and posterior surfaces of lamina cribrosa can cause the change in the structure and morphology of lamina cribrosa, then the deformation of lamina cribrosa squeezes the optic nerves passing through the lamina cribrosa to make their damages; and finally, the damages produce irreversible visual loss. As a result, the pathogenesis of glaucoma is essentially associated with the mechanical properties of lamina cribrosa and mechanical environment surrounding the lamina cribrosa. Since lamina cribrosa was identified as the primary site of glaucomatous optic nerve damage, it has become the hot spot of glaucomatous optic nerve damage research. As an effective method, we can study the deformation of lamina cribrosa under the effect of intraocular pressure and intracranial pressure by developing mechanical model of lamina cribrosa, and analyze the effect of the deformation of lamina cribrosa on the optic nerve damage. This method has helped us to reveal the mechanism of glaucomatous optic nerve damage and the pathogenesis of glaucoma to some extent. This review will introduce the research progress and the present existing problems on the deformation of lamina cribrosa during glaucoma from the related experimental, theoretical, computational and clinical aspects.