Glaucoma Perspective: From Back to Future

Abstract

Glaucoma diagnosis represents a dilemma that cannot be addressed by relying on a single diagnostic tool or evaluation of a solitary marker. Conventional, subjective methods including nerve fiber layer photography and visual field analysis were associated with inconsistency in diagnosis. The advent of optical coherence tomography (OCT) enabled objective evaluation of numerous relevant structures including peripapillary retinal nerve fiber layer (RNFL), neural rim area, optic disc margin, and ganglion cell complex. The newly introduced OCT angiography enabled detection and evaluation of perfusion, blood flow, and vessel density at different vascular beds. The recent application of artificial intelligence (AI) and genome-wide association studies (GWAS) made it possible to optimize glaucoma care at an earlier stage with deeper insight.