Visual Field Defects and Retinal Ganglion Cell Losses in Patients With Glaucoma

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Abstract
Glaucoma is a disease that causes progressive loss of vision from the death of retinal ganglion cells,1,2 and it is reasonable that the degree of vision loss would be proportional to the amount of ganglion cell loss.3-9 Traditionally, this relationship between structure and function in glaucoma has been applied in clinical perimetry to establish the clinical stage, or severity, of the disease,10-15 but the quantitative relationship between visual sensitivity and ganglion cell density was established only recently.16 The quantitative structure-function model, which was developed from data on experimental glaucoma in monkeys, was accurate and relatively precise in predicting the retinal ganglion cell density underlying a given sensitivity and location in the visual field. Although based on experimental glaucoma, the model should be applicable to clinical glaucoma because the visual systems in humans and monkeys are essentially identical.17-19 However, direct empirical evidence of the structure-function relationship for clinical glaucoma is an important verification of the scientific basis of interpreting glaucomatous optic neuropathy from visual thresholds.

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