Despite our armada of technological and pharmaceutical tools, many questions remain unanswered regarding the origins of glaucoma. The vascular theory vs. the neuronal destruction process is still a chicken-and-egg-type question. New research helps us determine what technology to invest in and gives some insight on how to utilize it most effectively.
Which systems are best for earliest disease detection, and which can accurately detect progression in more advanced cases? The need for ganglion cell analysis in concert with 10-2 visual fields in early detection has become clearer. Macular microvascular analysis with OCTA is of emerging importance, although it remains unclear what advantage it holds over GCC analysis.
This study suggests that structural damage precedes microvascular changes more often than not. This does not exclude the possibility that microvascular changes will be of greater significance in certain glaucoma populations, as one-third of the cases showed a greater percent loss in vessel density than in GCC thickness.
Ultimately, both technologies will likely play a role, but further studies are needed and may hopefully also shed light on the origins of the disease.
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