MITOCHONDRIAL EXTRUSION HYPOTHESIS OF GLAUCOMA

The mitochondrial extrusion hypothesis of glaucoma was proposed in 197 6 to explain the mechanism of damage that occurs in this disease. it i s based upon the author's observation that the axoplasm (containing mi tochondria) is blocked at the lamina cribrosa by intraocular pressure (IOP) elevation. This hypothesis suggests that the obstruction of mito chondria by IOP at the lamina cribrosa is central to damage.(1) The ad enosine triphosphate (ATP) produced by the mitochondria is no longer a vailable to the axonal membranes at the sites just beyond the blockage , which leads to cell death. The mitochondrial extrusion hypothesis of glaucoma offers a clear link between IOP elevation, mitochondrial sta sis, and the unusual pattern of visual field loss seen in chronic open -angle glaucoma. Evidence to support this hypothesis is offered.