Future Novel Imaging Methods

Abstract

Glaucoma is an ocular disease resulting in irreversible vision loss. It is estimated more than 60 million people worldwide have glaucoma and its incidence is anticipated to increase to more than 111 million by 2040. Glaucoma causes damage to the optic nerve head (ONH) and is accompanied by loss of retinal ganglion cells and reduction in the visual field. Although increased intraocular pressure (IOP) is considered the major risk factor for the development of glaucoma, there is supportive evidence for a role of ocular microcirculation in glaucoma pathophysiology. It is thought that increased IOP may cause deformation within the ONH, thus blocking axonal transport and impeding blood flow, which can eventually lead to cell death. Clinically, imaging technologies have played a critical role in visualizing abnormalities in the ONH and retinal cell layers in glaucoma. The advent of novel optical imaging technologies with higher depth resolution, tissue penetration, and image acquisition rate has allowed quantitative evaluation of retinal anatomy and hemodynamics at cellular and capillary levels. Furthermore, the availability of multimodal imaging techniques for assessment of retinal metabolic function offers new insights into glaucoma pathophysiology. Finally, application of artificial intelligence approaches can improve and enable screening, early detection, and progression monitoring of glaucomatous damage. Overall, the application of novel optical imaging and computational techniques shows great promise for enhancing detection of glaucoma and its progression as well as for improving knowledge of glaucoma pathophysiology and development of effective therapeutic interventions to prevent vision loss.