Myopia and Diabetes Mellitus as Modific...Aucomatous Optic Neuropathy - Springer

7/23/2019 Myopia and Diabetes Mellitus as Modific...Aucomatous Optic Neuropathy - Springer

1/13

eview

panese Journal of Ophthalmology

nuary 2014, Volume 58, Issue 1, pp 16-25

rst online: 15 August 2013

Myopia and diabetes mellitus as modificatory factors of

glaucomatous optic neuropathy

Etsuo Chihara

bstract

yopic deformation of the eye and metabolic alterations of the nerve tissue of patients with diabetes may modify

aucomatous optic neuropathy (GON). Blockage of axonal transport of neurotrophic factors (NTFs) is the event crucial to

nderstanding the factors that affect GON. The primary, but not sole, blockage site is at the lamina cribrosa (LC). Other

an this primary site of damage at the LC, 7 other factors may explain atypical nerve fiber layer (NFL) defects and the

lnerability of the nerve fibers in eyes with high myopia and glaucoma: a second point of blockage at the edge of the

sterior scleral foramen; ectatic strain on the NFL; ectasia and distortion of the LC; association of a hypoplastic optic disc;

in and weak collagen fibers; peripapillary chorioretinal atrophy; and myopic neuropathy. Among diabetic patients,

abetic neuropathy in the retinal NFL is present initially, and increased resistance to aqueous outflow leads to ocular

pertension. Superimposition of GON on diabetic neuropathy and ocular hypertension in patients with diabetes may

hance their susceptibility to nerve damage. Results of a meta-analysis study suggested a positive association between

abetes mellitus and glaucoma whereas other reports suggested that leakage of vascular endothelial growth factor, a

rvival mechanism of ischemic neural tissue, and enhanced stiffness of the LC as a result of diabetic glycation may protect

urons from apoptosis. Thus, modification of GON as a result of diabetes remains controversial.

eywords

yopia Diabetes mellitus Diabetic neuropathy Glaucoma Optic disc

art of this review article was presented as the Suda Memorial Lecture at the Japanese Glaucoma Society Meeting in

anazawa on September 30, 2012.

myopia tilted disc syndrome

optic disc size rnfl defect

ocular hypertension

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bout this Article

tle

Myopia and diabetes mellitus as modificatory factors of glaucomatous optic neuropathy

urnal

Japanese Journal of Ophthalmology

Volume 58, Issue 1 , pp 16-25

over Date

2014-01

OI

10.1007/s10384-013-0267-3

int ISSN

0021-5155

nline ISSN

1613-2246

ublisherSpringer Japan

dditional Links

Register for Journal Updates

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About This Journal

Manuscript Submission

opics

Ophthalmology

eywords

Myopia

Diabetes mellitus

Diabetic neuropathy


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Glaucoma

Optic disc

dustry Sectors

Biotechnology

Pharma

uthors

Etsuo Chihara(1)

uthor Affiliations

1. Sensho-Kai Eye Institute, Minamiyama 50-1, Iseda, Uji, Kyoto, 611-0043, Japan

Myopia and Diabetes Mellitus as Modific...Aucomatous Optic Neuropathy - Springer

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