On-going retinal neuronal degeneration despite clinical stability in glaucoma.

Adaptive optics–optical coherence tomography (AO-OCT) detected faster retinal ganglion cell density decline in glaucoma—4.16 to 6.86% per year versus 0.27% in healthy volunteers.

• Why it matters: Early detection of retinal ganglion cell neurodegeneration is needed because standard clinical tests often identify glaucoma only after substantial damage has accumulated.
• What they did: In a preliminary 3–5 year longitudinal study, AO-OCT tracked individual retinal ganglion cells in glaucoma patients and healthy volunteers to quantify annual cell density change and timing of progression.
• The result: Cell loss was detected 0.74 years earlier than conventional OCT and 1.49 years earlier than visual field testing, enabling more sensitive monitoring of glaucomatous damage.

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