Evaluation of Corneal Endothelium in Adolescents with Juvenile Glaucoma

Urban, Beata; Bakunowicz-Łazarczyk, Alina; Michalczuk, Marta; Krętowska, Małgorzata

doi:10.1155/2015/895428

Cited by 15 publications

(12 citation statements)

References 33 publications

(48 reference statements)

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“…This finding is in keeping with the theory that elevated intraocular pressure stresses and damages the corneal endothelium in pediatric glaucoma, 25 and further provides direct evidence to support glaucomatous EC damage in pediatric eyes after cataract removal. Given that all study eyes with glaucoma or glaucoma suspect also had cataract removal, it is possible that the reduction in EC density in these eyes is multifactorial.…”

Section: Discussionsupporting

confidence: 87%

Corneal Changes in Children after Unilateral Cataract Surgery in the Infant Aphakia Treatment Study

et al. 2015

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Purpose We report endothelial cell (EC) characteristics and central corneal thickness (CCT) from Infant Aphakia treatment Study (IATS) patients at the 5-year exam. Design Randomized, controlled trial of the treatment of unilateral cataract with aphakic contact lens (CL) versus primary intraocular lens implant (IOL). Subjects 114 infants with unilateral cataract. Methods EC density, coefficient of variation (CV), and percent hexagonal cells were measured by non-contact specular microscopy. Central corneal thickness (CCT) was measured using contact pachymetry. Fellow eyes served as controls. Main outcome measures Mean differences between treated and fellow eyes of CL and IOL groups were compared with a paired t test. A one-way analysis of variance model and the Tukey-Kramer multiple comparison procedure were used to assess the effect of a diagnosis of glaucoma or glaucoma suspect. Results 105 (52 CL, 53 IOL) had either specular microscopy or corneal thickness data recorded. Mean EC densities were higher in the aphakic eyes compared to fellow eyes (3921 and 3495 cells/mm2, p < 0.0001). Mean CV was higher in aphakic eyes (27 vs 24, p=0.0002), and mean percent hexagonal cells was lower (72% vs 76%, p=0.002). Mean CCT of aphakic eyes was higher than controls (637 vs 563 μm, p < 0.0001). There was no difference in EC densisty in eyes treated with IOL compared to fellow eyes (3445 and 3487 cells/mm2, p=0.68). Means for CV (25 vs 24, p=0.07) and percent hexagonal cells (74 vs 76%, p=0.27) were also not significantly different. Mean CCT was higher in eyes with IOL (605 vs 571 μm, p < 0.0001) compared to fellow eyes. Compared to treated eyes without glaucoma or glaucoma suspect, treated eyes with glaucoma had lower EC density (3289 vs 3783 cells/mm2, p = 0.03) and treated eyes with glaucoma suspect had greater mean corneal thickness (660 vs 612 μm, p = 0.0036). Conclusion Cataract extraction during infancy with IOL implantation was not associated with a reduced EC count in treated compared to fellow eyes, although CCT was increased. Extended wear aphakic CL may cause corneal polymegathism with increased EC density and CCT. Glaucoma diagnosis was associated with reduced EC counts and increased CCT.

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Section: Discussionsupporting

confidence: 87%

Corneal Changes in Children after Unilateral Cataract Surgery in the Infant Aphakia Treatment Study

et al. 2015

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“…The mean CCT values of glaucoma patients were found to be significantly lower than those of normal subjects in our study. Urban et al 11 investigated the CCT and endothelial cell density in adult patients with JOAG under topical anti-glaucoma treatment and compared them with ocular hypertension patients without glaucoma therapy. They found significantly lower endothelial cell density in JOAG patients but no significant differences in CCT.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Refractive Status and Anterior Segment Parameters of Juvenile Open-Angle Glaucoma and Normal Subjects

Elgin¹,

Şen²,

Üzel³

et al. 2018

tjo

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Objectives:Our aim was to compare the refractive status and anterior segment parameters of patients with juvenile open-angle glaucoma (JOAG) and normal subjects.Materials and Methods:Twenty-five recently diagnosed cases of JOAG and 24 normal subjects were included in this prospective controlled clinical trial. Central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), K1 and K2 keratometry, and white-to-white distance (WTW) measurements were performed with optical biometry (LenStar LS 900, Haag Streit Diagnostics). Spherical equivalent (SE) values and anterior segment parameters were statistically compared by chi-square, Kolmogorov- Smirnov, and independent samples t-tests.Results:The mean age of the 15 male and 10 female JOAG patients was 11.8±2.78 (8-18) years and the mean age of the 14 male and 10 female normal subjects was 11.58±3.04 (7-16) years (age: p=0.51; sex: p=0.18). Mean intraocular pressure in the JOAG group before treatment was 30.08±4.3 mmHg. The mean SE values of the JOAG and the control group were -1.94±1.86 (+2.35/-5.5) and -0.76±2.03 (+2.25/-4.85) diopters, respectively (p=0.048). JOAG patients had lower mean CCT values (p=0.016) and higher mean AL and ACD values (p=0.049 and p=0.016). There were no significant differences between the groups for LT, WTW, K1, or K2 (p=0.61; p=0.52; p=0.95; p=0.31 respectively).Conclusion:JOAG patients were found to be more myopic and have lower CCT and greater AL and ACD values than normal subjects. These anterior segment changes may be associated with myopia, which is common in JOAG.

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“…Corneal endothelial cells (CECs) have limited proliferative capacity in vivo [1,2], thus damage to the corneal endothelium is irreversible. Loss of CECs occurs as a consequence of intraocular surgery, trauma or diseases such as diabetes and glaucoma[3-8]. At the early stage of endothelial damage, neighboring cells spread and/or migrate to compensate for the cell loss, which results in an increase in cell size and/or alteration of cell shape.…”

Section: Introductionmentioning

confidence: 99%

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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Evaluation of Corneal Endothelium in Adolescents with Juvenile Glaucoma

Cited by 15 publications

References 33 publications

Corneal Changes in Children after Unilateral Cataract Surgery in the Infant Aphakia Treatment Study

Corneal Changes in Children after Unilateral Cataract Surgery in the Infant Aphakia Treatment Study

Comparison of Refractive Status and Anterior Segment Parameters of Juvenile Open-Angle Glaucoma and Normal Subjects

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

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