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. 2012 Jan 4;96(4):597–603. doi: 10.1136/bjophthalmol-2011-300831

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© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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Spontaneous glaucomatous optic neuropathy. (A) Nissle staining of lateral geniculate nucleus reveals a normal, layered configuration. (B) Sagittal histology of wide-open uveo-corneal angle and normal trabecular meshwork stained with Gomori's aldehyde-fuchsin. (C) Fundus photograph shows the optic disc with temporal pallor and excavation and a dark halo around the temporal subretina, demonstrating a nerve fibre layer defect. The macula is normal (black arrow). (D) Double labelling of SMI-31 (green) and glial fibrillary acidic protein (red). Marked gliosis with a few bundles can be seen in the temporal half. (E) Sagittal section of optic nerve head and lamina cribrosa stained with Gomori's aldehyde-fuchsin. (a) Nerve bundles are almost completely absent and replaced by glial proliferation in the temporal half of a broad region from pre- to post-lamina cribrosa (Ea), despite a normal lateral geniculate nucleus configuration. By contrast, demarcated bundles are oriented normally in the nasal half. Superficial nerve bundles in the temporal half of the disc head are not atrophic (white arrow), presumably due to the presence of nerves from the peripheral retina. (b) High-magnification view of the boxed area in (a) reveals the details of glial proliferation (black arrow) and massive collagenous tissue (green) ingrowth (white arrow) with elastic tissue remnants of atrophied vessel wall (purple, white arrow).