Glaucoma is a multifactorial neurodegenerative disease of the optic nerve currently considered a severe health problem because of its high prevalence, being the primary cause of irreversible blindness worldwide. The most common type corresponds to Primary Open-Angle Glaucoma (POAG). Glaucoma produces, among other alterations, a progressive loss of Retinal Ganglion Cells (RGC) and its axons, key to generate the action potential that reaches the visual cortex to create the visual image. It indicates a Visual Field (VF) loss whose main feature is to be painless, and this makes early detection difficult, causing a late diagnosis and delaying a timely treatment indication that slows down its progression. Intrinsically photosensitive Retinal Ganglion Cells (ipRGCs), which represent a subgroup of RGCs being sensitive to damage, are characterized by reacting to short-wave light stimulation close to 480 nm and among their non-visual function, the role in the generation of the pupillary reflex stands out. Currently, the sensitivity of clinical trials correlates to RGC damage, however the need for an early damage biomarker is still relevant. It is an urgent task to create new diagnostic approaches to detect an early stage of glaucoma in a prompt, quick, and economical manner. We suggest evaluating the pupillary response to chromatic light as a potential biomarker of disease, its diagnostic benefit, and its cost-effectiveness in clinical practice to reduce irreversible damage caused by glaucoma.
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