Glaucoma, More than Meets the Eye: Patterns of Demyelination Revealed in Human Postmortem Glaucomatous Optic Nerve

Aging Dis. 2024 Oct 1;15(5):2301-2314. doi: 10.14336/AD.2024.0336-1.

Abstract

Glaucoma is a neurodegenerative disease affecting millions worldwide, characterised by retinal ganglion cell (RGC) degeneration which leads to blindness in more advanced cases. Although the pathogenesis and underlying mechanisms of glaucoma are not fully understood, there are theories that hint at demyelination playing a role in the disease process. Demyelination, or the degeneration of the myelin sheath surrounding axons, has been found in previous studies using animal models of glaucoma and clinical assessments of glaucoma patients. However, this has not been fully realised or quantified in glaucoma patients. Utilising postmortem optic nerve samples from glaucoma and healthy subjects, various immunohistochemical and morphological assessments were performed to determine the extent, if any, of demyelination in glaucomatous optic nerves. Our findings revealed that alongside nerve shrinkage and degeneration of nerve tissue fascicles, there were significantly less myelin proteins, specifically myelin basic protein (MBP), in glaucoma optic nerves. Additionally, the loss of MBP was correlated with decreased oligodendrocyte (OLG) precursors and increasing glial activity. This further supports previous evidence that demyelination may be a secondary degenerative process associated with glaucoma disease progression. Not only do these results provide evidence for potential disease mechanisms, but this is also the first study to quantify optic nerve demyelination in glaucoma postmortem tissue.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Autopsy
  • Demyelinating Diseases* / pathology
  • Female
  • Glaucoma* / metabolism
  • Glaucoma* / pathology
  • Humans
  • Male
  • Middle Aged
  • Myelin Basic Protein / metabolism
  • Myelin Sheath / pathology
  • Optic Nerve* / pathology
  • Retinal Ganglion Cells* / pathology

Substances

  • Myelin Basic Protein

Grants and funding

This work is supported by the National Multiple Sclerosis Society (NMSS), USA; Macquarie University, Australia; and by an Australian Government Research Training Program (RTP) Scholarship. Parts of the figures were exported from GraphPad Prism version 10.1.2 (GraphPad Software, Boston, Massachusetts, www.graphpad.com). Icons within figures (e.g. arrows and other graphics) are supplied by Microsoft PowerPoint 365.