Characteristics of the Corneal Endothelium Across the Primary Angle Closure Disease Spectrum

Verma, Sushma; Nongpiur, Monisha E.; Husain, Rahat; Wong, Tina; Boey, Pui Yi; Quek, Desmond; Perera, Shamira; Aung, Tin

doi:10.1167/iovs.18-24939

Cited by 14 publications

(20 citation statements)

References 28 publications

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“…Gagnon et al[13] showed that corneal ECD is inversely proportional to mean IOP. Some researchers hypothesized that CEC changes are not associated with high IOP[26-27]. Our data showed that the glaucoma and normal control groups had significant differences in corneal ECD, consistent with Gagnon et al’s[13] research.…”

Section: Discussionsupporting

confidence: 91%

Changes in corneal endothelial cell density in patients with primary open-angle glaucoma

Zhou

Wu²

2019

WJCC

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BACKGROUND Glaucoma is a group of diseases characterized by a specific pattern of optic nerve neuropathy and retinopathy. Increasing evidence demonstrates glaucoma associated corneal endothelium loss. Direct-compression mechanism due to elevated intraocular pressure (IOP), cell toxicity after long term exposure to preservatives and glaucoma surgery have been reported to be the possible mechanism. Herein, we compare the specular endothelial microscopy in primary open-angle glaucoma (POAG) patients and healthy controls of the same age group to observe the corneal endothelium changes and the correlations to the mean IOP in a Chinese case control study. AIM To investigate corneal endothelial cell density in Chinese patients with POAG. METHODS A case control study was performed on 60 eyes of 60 patients with POAG. Exclusion criteria included history of corneal diseases, intraocular diseases, contact lens use, ocular trauma or surgery (including intraocular surgery and laser treatment), congenital abnormalities or systemic diseases such as diabetes. Intraocular pressure was measured using Goldmann tonometry. Indirect specular microscopy (TOPCON SP-2000P) was performed on central corneas and endothelial images were acquired. Endothelial cell density, area and cell counts were analyzed. RESULTS Endothelial cell density was 2959 ± 236 cells/mm 2 in healthy controls and 2757 ± 262 cells/mm 2 in patients with POAG. The POAG eyes had significantly lower endothelial cell density compared to healthy control eyes ( P < 0.001). In the POAG group, endothelial cell density was 2686 ± 233 cells/mm 2 in the patients receiving medication and 2856 ± 272 cells/mm 2 in the untreated subgroup. The eyes receiving medication had significantly lower endothelial cell density compared to untreated eyes. There was a negative correlation between cell density and mean IOP ( r = −0.286, P = 0.004), positive correlation between the average cell area and mean IOP ( r = 0.228, P = 0.022), maximum cell area and mean IOP ( r = 0.218, P = 0.029) and minimum cell area and mean IOP ( r = 0.290, P = 0.003). The percentage of hexagonal cells was not correlated with mean IOP. CONCLUSION Patients with POAG have lower corneal endothelial cell density than healthy controls of the same age. This may be attributed to mechanical damage from elevated IOP and toxicity of glaucoma medications.

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Section: Discussionsupporting

confidence: 91%

Changes in corneal endothelial cell density in patients with primary open-angle glaucoma

Zhou

Wu²

2019

WJCC

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“…At the same time, there are conflicting studies. Varadaraj et al and Verma et al studied endothelial changes in the PAC disease spectrum, including eyes with a history of acute angle closure attack and found no significant difference in all groups [52,53]. Interestingly, a recent study of a rat model showed eyes with acute angle closure had lower ECD at first, but showed a gradual resolution once IOP stabilized to normal levels [54].…”

Section: Discussionmentioning

confidence: 99%

Rate of central corneal thickness changes in primary angle closure eyes: long-term follow-up results

et al. 2021

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Background Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle-closure (PAC). Additionally, we aimed to analyze events that could affect CCT. Methods In this retrospective study, 26 patients with PAC who had a follow-up period of more than 5 years were analyzed. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle-closure attack was analyzed using the repeated linear mixed model analysis. Results A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 μm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 μm/yr (P = 0.034) and that of the surgical trabeculectomy group was − 1.32 ± 0.43 μm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle-closure attack was − 0.81 ± 0.31 μm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 μm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001). Conclusions We found a significant reduction in CCT over a long observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle-closure attacks. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.

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“…Varadaraj et al and Verma et al studied endothelial changes in the PAC disease spectrum, including eyes with a history of acute angle closure attack and found no signi cant difference in all groups. [24,25] Interestingly, a recent study of a rat model showed eyes with acute angle closure had lower ECD at rst, but showed a gradual resolution once IOP stabilized to normal levels. [26] It may be more useful to assess endothelial changes since CCT does not re ect the overall corneal status.…”

Section: Discussionmentioning

confidence: 99%

Rate of Central Corneal Thickness Changes in Primary Angle Closure Eyes: Long-term Follow-up Results

Park

Choi

Lee

et al. 2020

Preprint

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Background Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle closure (PAC). Additionally, we aimed to analyze events that could affect CCT.Methods In this retrospective study, 27 patients with PAC who had a follow-up period of more than five years were evaluated. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle closure attack was analyzed using the repeated linear mixed model analysis.Results A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 µm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 µm/yr (P = 0.034), that of the surgical trabeculectomy group was − 1.32 ± 0.43 µm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle closure attack was − 0.81 ± 0.31 µm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 µm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001).Conclusions We found a significant reduction in CCT over a long-time observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle closure attack. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.

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Characteristics of the Corneal Endothelium Across the Primary Angle Closure Disease Spectrum

Cited by 14 publications

References 28 publications

Changes in corneal endothelial cell density in patients with primary open-angle glaucoma

Changes in corneal endothelial cell density in patients with primary open-angle glaucoma

Rate of central corneal thickness changes in primary angle closure eyes: long-term follow-up results

Rate of Central Corneal Thickness Changes in Primary Angle Closure Eyes: Long-term Follow-up Results

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