Documenta Ophthalmologica

, Volume 26, Issue 1, pp 516–525 | Cite as

The role of the astroglial cells in glaucomatous disc cupping

  • Robert N. Shaffer


Two paradoxical findings are explained by the Astroglial Hypothesis of Disc Cupping. First, the early cupping of the optic disc in young glaucoma patients is not accompanied by field changes at first. Second, after normalization of intraocular pressure the size of the optic cup decreased dramatically in size. Such findings can only be explained by atrophy and later regeneration of the astrocytes rather than the neurons. Support for the theory is derived from the analogy with internal hydrocephalus and from the clinical course of primary optic atrophy.


Glaucoma Intraocular Pressure ASTROGLIAL Cell Congenital Glaucoma Peripapillary Area 
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L'hypothèse astrogliale de l'excavation glaucomateuse permet d'expliquer deux observations paradoxales: 1. le fait que l'excavation précoce des jeunes glaucomateux n'est au début pas accompagnée d'anomalies du champ visuel; 2. que la normalisation de la pression peut faire diminuer l'importance de l'excavation. Seule l'atrophie et la régéneration ultérieure des astrocytes permet de comprendre ces constatations, une régénération des neurones étant impossible.

Cette théorie peut aussi s'appuyer sur une certaine analogie avec ce qui se passe dans l'hydrocephalie interne et sur l'évolution opposée dans l'atrophie optique primitive.


Die astrogliale Hypothese der glaukomatösen Sehnervenexkavation erlaubt es zwei paradoxe Beobachtungen zu erklären: 1. daß die schnell auftretende Exkavation des jungen Glaukompatienten am Anfang nicht von Gesichtsfelddefekten begleitet ist; 2. daß die Normalisierung des Augendruckes eine Abnahme der Exkavation hervorrufen kann. Nur die Atrophie und die nachherige Regeneration der Astrozyten erlaubt es diese Tatsachen befriedigend zu erklären, da ja eine Regeneration von Neuronen unmöglich ist. Diese Theorie kann sich auch auf gewisse Feststellungen bei Hydrocephalus internus und bei primärer Optikusatrophie stützen.


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Copyright information

© Dr. W. Junk N.V. 1969

Authors and Affiliations

  • Robert N. Shaffer
    • 1
  1. 1.Department of OphthalmologyUniversity of California Medical CenterUSA

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