Intracellular flow in optic nerve axons: a mechanism for cell death in glaucoma

Glaucoma is characterised by elevated intraocular pressure and a progressive loss of retinal ganglion cells, resulting in optic neuropathy. Although it is evident that the raised intraocular pressure somehow affects the retinal ganglion cells, the exact mechanism of glaucomatous neuropathy remains unclear. We propose a potential mechanism for the death of retinal ganglion cells, whereby elevated intraocular pressure causes fluid to permeate the axonal membranes, creating a passive intracellular fluid flow within the axons of the retinal ganglion cells. We hypothesise that this flow locally depletes the concentration of adensoine triphosphate (ATP) within the axons, disrupting axonal transport and leading to cell death