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January 1982, Vol 100, No. 1 >
ARTICLE | January 1982

Optic Nerve Damage in Human Glaucoma: Title and subTitle BreakIII. Quantitative Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy FREE

Harry A. Quigley, MD; W. Richard Green, MD; Earl M. Addicks
[+] Author Affiliations

Accepted for publication March 9, 1981.

Read in part before the Association for Research and Vision in Ophthalmology, Orlando, Fla, April 28, 1981.

Reprint requests to Wilmer Ophthalmological Institute, B-2, The Johns Hopkins Hospital, 506 N Broadway, Baltimore, MD 21205 (Dr Quigley).


Arch Ophthalmol. 1982;100(1):135-146. doi:10.1001/archopht.1982.01030030137016
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• The number and distribution of human optic nerve axons were compared with clinical measurements available in the same eyes, including visual acuity, disc appearance, and visual field studies. Definite loss of axons occurs prior to reproducible visual field defects in some patients suspected of having glaucoma. In glaucoma, the superior and inferior poles of the nerve lose nerve fibers at a selectively greater rate, leading to an hourglass-shaped atrophy. Cavernous degeneration of the retrobulbar optic nerve is rarely observed in chronic glaucoma. The pattern of atrophy in examples of toxic amblyopia, ischemic optic neuropathy, and chronic papilledema differs from that of glaucoma, suggesting different mechanisms of damage in these conditions.

REFERENCES

1 +
Quigley HA, Green WR:  The histology of human glaucoma cupping and nerve damage: Clinicopathologic correlation in 21 eyes . Ophthalmology 1979;;10:1803-1827.
2 +
Hoyt WF, Luis O:  Visual fiber anatomy in the infrageniculate pathway of the primate . Arch Ophthalmol 1962;;68:124-136.
3 +
Quigley HA, Addicks EM:  Regional differences in the structure of the lamina cribrosa and their relation to glaucomatous optic nerve damage . Arch Ophthalmol 1981;;99:137-143.
4 +
Quigley HA, Addicks EM, Green WR, et al:  Optic nerve damage in human glaucoma: II. The site of injury and susceptibility to damage . Arch Ophthalmol 1981;;98:635-649.
5 +
Potts AM, Hodges D, Shelman CB, et al:  Morphology of the primate optic nerve: I. Method and total fiber count . Invest Ophthalmol Vis Sci 1972;;11:980-988.
6 +
Breusch SR, Arey LB:  The number of myelinated and unmyelinated fibers in the optic nerve of vertebrates . J Comp Neurol 1942;;77:631-665.
7 +
Kupfer C, Chumbley L, Downer JC:  Quantitative histology of optic nerve, optic tract, and lateral geniculate nucleus of man . J Anat 1967;;101:393-401.
8 +
Kohn AN, Moss AP, Podos SM:  Relative afferent pupillary defects in glaucoma without characteristic field loss . Arch Ophthalmol 1979;;97:294-296.
9 +
Sommer A, Miller NR, Pollack I, et al:  The nerve fiber layer in the diagnosis of glaucoma . Arch Ophthalmol 1977;;95:2149-2156.
10 +
Quigley HA, Miller NR, George T:  Clinical evaluation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage . Arch Ophthalmol 1980;;98:1564-1571.
11 +
Quigley HA, Addicks EM:  Chronic experimental glaucoma in primates: II. Effect of extended intraocular pressure elevation on optic nerve head and axonal transport . Invest Ophthalmol Vis Sci 1980;;19:137-152.
12 +
Hayreh SS: Anterior Ischemic Optic Neuropathy . Berlin, Springer-Verlag, 1975;.
13 +
Potts AM, Hodges D, Shelman CB, et al:  Morphology of the primate optic nerve: III. Fiber characteristics of the foveal outflow . Invest Ophthalmol Vis Sci 1972;;11:1004-1016.
14 +
Schnabel J:  Das Glaucomatose Sehnervenleiden . Arch Augenheilkd 1892;;24:273-292.
15 +
Zimmerman LE, de Venecia G, Mahasaki DI:  Pathology of the optic nerve in experimental acute glaucoma . Invest Ophthalmol Vis Sci 1967;;6:109-125.
16 +
Brownstein S, Font RL, Zimmerman LE, et al:  Nonglaucomatous cavernous degeneration of the optic nerve: Report of two cases . Arch Ophthalmol 1980;;98:354-358.

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1 +
Quigley HA, Green WR:  The histology of human glaucoma cupping and nerve damage: Clinicopathologic correlation in 21 eyes . Ophthalmology 1979;;10:1803-1827.
2 +
Hoyt WF, Luis O:  Visual fiber anatomy in the infrageniculate pathway of the primate . Arch Ophthalmol 1962;;68:124-136.
3 +
Quigley HA, Addicks EM:  Regional differences in the structure of the lamina cribrosa and their relation to glaucomatous optic nerve damage . Arch Ophthalmol 1981;;99:137-143.
4 +
Quigley HA, Addicks EM, Green WR, et al:  Optic nerve damage in human glaucoma: II. The site of injury and susceptibility to damage . Arch Ophthalmol 1981;;98:635-649.
5 +
Potts AM, Hodges D, Shelman CB, et al:  Morphology of the primate optic nerve: I. Method and total fiber count . Invest Ophthalmol Vis Sci 1972;;11:980-988.
6 +
Breusch SR, Arey LB:  The number of myelinated and unmyelinated fibers in the optic nerve of vertebrates . J Comp Neurol 1942;;77:631-665.
7 +
Kupfer C, Chumbley L, Downer JC:  Quantitative histology of optic nerve, optic tract, and lateral geniculate nucleus of man . J Anat 1967;;101:393-401.
8 +
Kohn AN, Moss AP, Podos SM:  Relative afferent pupillary defects in glaucoma without characteristic field loss . Arch Ophthalmol 1979;;97:294-296.
9 +
Sommer A, Miller NR, Pollack I, et al:  The nerve fiber layer in the diagnosis of glaucoma . Arch Ophthalmol 1977;;95:2149-2156.
10 +
Quigley HA, Miller NR, George T:  Clinical evaluation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage . Arch Ophthalmol 1980;;98:1564-1571.
11 +
Quigley HA, Addicks EM:  Chronic experimental glaucoma in primates: II. Effect of extended intraocular pressure elevation on optic nerve head and axonal transport . Invest Ophthalmol Vis Sci 1980;;19:137-152.
12 +
Hayreh SS: Anterior Ischemic Optic Neuropathy . Berlin, Springer-Verlag, 1975;.
13 +
Potts AM, Hodges D, Shelman CB, et al:  Morphology of the primate optic nerve: III. Fiber characteristics of the foveal outflow . Invest Ophthalmol Vis Sci 1972;;11:1004-1016.
14 +
Schnabel J:  Das Glaucomatose Sehnervenleiden . Arch Augenheilkd 1892;;24:273-292.
15 +
Zimmerman LE, de Venecia G, Mahasaki DI:  Pathology of the optic nerve in experimental acute glaucoma . Invest Ophthalmol Vis Sci 1967;;6:109-125.
16 +
Brownstein S, Font RL, Zimmerman LE, et al:  Nonglaucomatous cavernous degeneration of the optic nerve: Report of two cases . Arch Ophthalmol 1980;;98:354-358.

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