Abstract
Introduction: The corneal endothelium is a single layer of polygonal cells covering the posterior surface of Descemet's membrane. The endothelial cells have the lowest mitotic activity. The corneal endothelium regulates hydration of cornea through ATP and biocarbonate-dependent pump and thereby providing transparency. In the adult, the average cell density is 2600 - 3000 cells/mm2.1 Glaucoma is an optic neuropathy characterized by progressive loss of retinal ganglion cells, thinning of the neuroretinal rim and the retinal nerve fiber layer (RNFL), with associated deterioration of the visual field.3 It can cause defects to the corneal endothelial cells either by direct or indirect mechanisms.
Aim: The aim was to compare corneal endothelial cell changes among Primary open angle glaucoma patients and normal control group and to correlate endothelial changes with duration of disease and severity of field defects.
Methods: It is a cross sectional comparative study comprised of 200 eyes, each of POAG patients and of normal individuals of similar age group who attended the outpatient department. Corneal endothelial cells were examined using noncontact specular microscope.
Results: The mean endothelial cell density (ECD) in POAG patients were significantly lower (2211.13 ± 171.49cells/mm2 in right eye, 2198.20± 154.39cells/mm2 in left eye) compared to control group ( 2417.43 ± 116.92 in right eye and 2390.18 ±101.31 cells/mm2 in left eye, p value <.001). Hexagonality in POAG patients also were significantly less. (43.79 ±5.77, 43.58± 6.82 in right and left eye respectively as to control group 48.25± 2.82, 48.71± 2.89 ,p value <.001). Coefficient of variation in POAG patients was significantly higher than control group.
Conclusion: Corneal Endothelial cell density and percentage of hexagonal cells were significantly lower among Primary open angle glaucoma patients. Evaluation of corneal endothelium is necessary for proceeding to intraocular procedures in glaucoma patients.
Keywords: Open angle glaucoma, endothelial cell density, Hexogonality, coefficient of variation.
References
1. Zavala J, López Jaime GR, Rodríguez Barrientos CA, Valdez-Garcia J. Corneal endothelium: developmental strategies for regeneration. Eye (Lond). 2013 May;27(5):579-88.
2. Wali UK, Al-Mujaini AS, Al-Kharusi NS, Bialasiewicz AA, Rizvi SG. Quantitative and qualitative corneal endothelial morphology of omani patients with pseudoexfoliation syndrome. Sultan Qaboos Univ Med J. 2008Nov;8(3):300-5.
3. Kita Y, Soutome N, Horie D, Kita R, Hollό G. Circumpapillary ganglion cell complex thickness to diagnose glaucoma: A pilot study. Indian J Ophthalmol. 2017 Jan;65(1):41-47.
4. Weinreb RN, Leung CK, Crowston JG, Medeiros FA, Friedman DS, Wiggs JL, Martin KR. Primary open-angle glaucoma. Nat Rev Dis Primers. 2016 Sep 22;2:16067.
5. Iutaka NA, Grochowski RA, Kasahara N. Correlation between Visual Field Index and Other Functional and Structural Measures in Glaucoma Patients and Suspects. J Ophthalmic Vis Res. 2017 Jan-Mar;12(1):53-57.
6. Harwerth RS, Wheat JL, Fredette MJ, Anderson DR. Linking structure and function in glaucoma. Prog Retin Eye Res. 2010;29:249–271.
7. Quaranta L, Riva I, Gerardi C, Oddone F, Floriano I, Konstas AG. Quality of Life in Glaucoma: A Review of the Literature. Adv Ther. 2016 Jun;33(6):959-81.
8. Cho SW, Kim JM, Choi CY, Park KH. Changes in corneal endothelial cell density in patients with normal-tension glaucoma. Jpn J Ophthalmol. 2009Nov;53(6):569-73.
9. Gagnon MM, Boisjoly HM, Brunette I, Charest M, Amyot M. Corneal endothelial cell density in glaucoma. Cornea. 1997 May;16(3):314-8.
10. Sihota R, Lakshmaiah NC, Titiyal JS, Dada T, Agarwal HC. Corneal endothelial status in the subtypes of primary angle closure glaucoma. Clin Exp Ophthalmol.2003 Dec;31(6):492-5.
11. Urban B, Bakunowicz-Łazarczyk A, Michalczuk M, Krętowska M. Evaluation of corneal endothelium in adolescents with juvenile glaucoma. J Ophthalmol. 2015;2015:895428.
12. Gatzioufas Z, Labiris G, Stachs O, Hovakimyan M, Schnaidt A, Viestenz A, Käsmann-Kellner B, Seitz B. Biomechanical profile of the cornea in primary congenital glaucoma. Acta Ophthalmol. 2013 Feb;91(1):e29-34.
13. Wang M, Sun W, Ying L, Dong XG. Corneal endothelial cell density and morphology in Chinese patients with pseudoexfoliation syndrome. Int J Ophthalmol. 2012;5(2):186-9.
14. Bozkurt B, Güzel H, Kamış Ü, Gedik Ş, Okudan S. Characteristics of theAnterior Segment Biometry and Corneal Endothelium in Eyes with Pseudoexfoliation Syndrome and Senile Cataract. Turk J Ophthalmol. 2015 Oct;45(5):188-192.
15. Vannas A, Setälä K, Ruusuvaara P. Endothelial cells in capsular glaucoma. Acta Ophthalmol (Copenh). 1977 Dec;55(6):951-8.
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.173
