Update on the structure-function relationship in glaucoma

Area of Science:

• Ophthalmology and Vision Science
• Biomedical Engineering
• Artificial Intelligence in Medicine

Background:

• The structure-function relationship is crucial for glaucoma assessment, monitoring, and prognosis.
• Current understanding emphasizes the link between retinal microstructure and visual function.

Purpose of the Study:

• To synthesize current knowledge on the glaucoma structure-function relationship.
• To highlight recent advances in imaging, analytical methods, and AI-driven modeling.
• To discuss emerging frameworks for personalized glaucoma management.

Main Methods:

• Review of emerging evidence from optical coherence tomography (OCT) and OCT angiography (OCTA).
• Integration of imaging data with functional measures like standard automated perimetry (SAP).
• Evaluation of classical, mechanistic, statistical, and AI-based models.

Main Results:

• The relationship is predominantly nonlinear, with stage-dependent correlations and divergences.
• Emerging frameworks like multimodal fusion and deep learning enhance accuracy.
• Data quality and anatomical variability are key limitations.

Conclusions:

• Integrating multimodal imaging and AI advances structure-function relationship modeling.
• Developments promise earlier detection, precise monitoring, and individualized glaucoma management.
• A deeper mechanistic understanding will improve neurovascular and neurofunctional health assessment.