In addition, some of the studies cited by Dr Quigley have been questioned. Our point was that we should not stress only tests of magnocellular function at this early stage of our evolving knowledge of structural-functional damage in glaucoma. No one approach or technique will answer the question of selective ganglion cell loss in glaucoma. Multidisciplinary approaches are needed to solve the issue. However, the evidence from psychophysics is strong that early functional deficits in patients with ocular hypertension, which precede the diagnosis of glaucoma and which are not processed in the magnocellular pathways, can be predictive of the later development of the disease.
All methods suffer from limitations.
Continued longitudinal studies of glaucoma suspects, including patients with ocular hypertension, with various functional tests, coupled with measures of structural integrity in eyes in which glaucoma later develops, clearly are important. This information can then be viewed in light of histological and anatomical studies to better help us understand the disease. Pamela A. Sample, PhD Charles F. Bosworth Robert N. Weinreb, MD La Jolla, Calif 1. Short-wavelength automated perimetry and motion automated perimetry in patients with glaucoma. Martin P, White A, Goodchild A, Wilder H, Sefton A. Evidence that blue-on cells are part of the third geniculocortical pathway in primates.