Evaluation and correlation of corneal endothelium parameters with the severity of primary glaucoma

Abstract

Purpose: To evaluate and correlate corneal endothelium parameters with the severity of primary glaucoma. Methods: This prospective case-control study was conducted on 150 eyes of 80 newly diagnosed primary open-angle glaucoma (POAG), chronic primary angle-closure glaucoma (cPACG), and normal-tension glaucoma (NTG) patients in a tertiary care center. Endothelial parameters including endothelial cell count (ECC), percentage of hexagonal cells, and coefficient of variation of cell size were analyzed. Glaucoma cases were further sub-grouped into early, moderate, and severe glaucoma and compared for endothelial parameters. Chi-square, Fischer’s exact test, independent sample t -test, and analysis of variance were performed using IBM ® SPSS ® Statistics version 28. Results: The ECC was markedly reduced in cases (2281 cells/mm 2 ) versus controls (2611 cells/mm 2 ) ( P < 0.001). The POAG (2251 cells/mm 2 ) and cPACG (2287 cells/mm 2 ) eyes had significantly a lower ECC compared to healthy controls ( P < 0.001), whereas NTG eyes had a lower mean ECC (2538 cells/mm 2 ), but it was not statistically significant ( P > 0.05) when compared with controls. The ECC decreased with an increase in severity as patients with early glaucoma had an ECC of 2284 cells/mm 2 , moderate 2261 cells/mm 2 , and severe 2086 cells/mm 2 , and the difference was statistically significant. Conclusion: A significant decrease in corneal ECC was observed in POAG and cPACG patients when compared with healthy controls of the same age group. Mechanical damage following an elevated intra-ocular pressure for a longer duration may be attributed to morphological and consequent functional damage to endothelial cells.

Particular Anatomy of the Hyperopic Eye and Potential Clinical Implications

“…As stated previously, hyperopia is a significant PACG risk factor, and several studies have found lower CD in PACG compared to open-angle glaucoma [ 38 ] or compared to healthy controls [ 35 ]. Both in emmetropes and in hyperopes we have found a correlation between CD, CV and ACD—a shallower anterior chamber is correlated with a decrease in endothelial cell density and increase in variability, which may have important repercussions over the patient’s lifetime.…”

“…The corneal endothelium is the innermost layer of the cornea, consisting of tightly interconnected cells, with an essential role in maintaining proper corneal hydration and transparency [ 34 ]. It is a single-cell layer, with limited capacity for regeneration [ 35 ]. In normal eyes, the annual rate of cell loss is 0.6%, and there are several systemic and ocular conditions which may increase this rate during the course of the patient’s life [ 34 , 36 ].…”

Corneal endothelial cells survival rate in primary open angle glaucoma eyes after cataract surgery. (Review)

“…Кроме того, в 2022 году D. Kang и соавт. [38] опубликовали результаты исследования о взаимосвязи параметров эндотелия роговицы с тяжестью первичной глаукомы. Количество эндотелиальных клеток роговицы снижалось с увеличением тяжести, поскольку у пациентов с ранней глаукомой плотность эндотелиальных клеток составляла 2284 кл./мм 2 , при умеренной -2261 кл./мм 2 , при тяжёлой -2086 кл./мм 2 , и разница была статистически значимой.…”