摘要青光眼是一种以眼压为主要危险因素的视神经疾病.近年来,随着对青光眼和视觉科学的深入研究以及眼科神经科交叉学科的发展,同时借助于神经影像技术的不断提高,关于青光眼本质的一些新问题随即产生,即青光眼仅仅是一种眼部疾病吗?它是原发于眼部但累及全视路的疾病吗?或者它是某种特殊中枢神经系统疾病在眼部的表现?这些问题在眼科界引起了争论.已有许多证据表明青光眼不仅仅累及视神经,而且引起外侧膝状体、视放射和视觉中枢的损伤,它是整个视路多层次损害的综合征群,其机制复杂.我们认为青光眼是一种中枢神经系统疾病.最近,有学者通过实验发现青光眼的首发损害在中枢神经系统而非眼部.将青光眼归为一种中枢神经系统疾病对认识青光眼的发病机制、建立系统全面的治疗策略、挽救患者视力具有一定意义.

abstractsGlaucoma is a typical optic neuropathy mainly caused by elevated intraocular pressure (IOP). In recent years, with the advances in understanding of glaucoma and visual sciences, and the development of a neurological cross-discipline and neuroimaging technology, the question about the nature of glaucoma has been raised. Is glaucoma merely an ocular disease? Is it a disease that begins from the eye,and then involves the whole visual pathway? Or is it a particular central nervous disease, which manifests itself in the eye? The answers to these questions are controversial. Growing evidences have showed that glaucoma is a disease with multi-level, multi-factor damage to the entire visual pathway which involved from optic nerve to the lateral geniculate body, optic radiation and visual cortex. Its mechanisms are complex. We believe that glaucoma is a central nervous system neurodegenerative disease. Recent study showed that the primary damage of glaucoma occurred in central nervous system rather than in the eye. The new generation of concept steps forward in the knowledge of the pathogenesis of glaucoma, and may illuminate the potential of neuroprotection in glaucoma management.