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Sahar Bedrood, Dilshad Contractor, Xuejuan Jiang, Bibiana Jin Reiser; Comparison of corneal specular microscopy features in pediatric glaucomatous eyes versus non-glaucomatous eyes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1159.
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In order to understand the pathophysiology of glaucoma in pediatric patients, features of the ocular anatomy and the cornea need to be better understood. Specular microscopy is a non-invasive technique to assess the structure and function of the corneal endothelium. The aims of this study were to study the specular microscopy features of pediatric eyes with glaucoma and compare them to normal pediatric eyes.
We performed a cross-sectional study of 47 patients (76 eyes) between the ages of 0-18 years with a diagnosis of glaucoma in at least one eye. The exclusion criteria was corneal pathology and narrow angle glaucoma. Specular microscopy was performed either in clinic or under EUA as apropriate. The endothelial cell density, hexagonality of the cells, corneal thickness and variability of the cell density were compared. The endothelial cell density analysis was performed manually using the center to center technique with the Konan Specular Microscope (Konan Medical USA., Torrance, CA) along with the KSS-300 analysis software. The comparisons between glaucomatous and normal eyes were tested using generalized estimating equations adjusting for participant’s age and between-eye correlation.
The average subject age was 9 years and 56% were male. 51 eyes had glaucoma and 26 eyes were non-glaucomatous. Endothelial cell density was significantly lower in glaucomatous eyes (2691 cells/mm2) than normal eyes (3188 cells/mm2) (P=0.005). The percentage of hexagonal cells was marginally significantly lower in glaucomatous eyes (67.2%) than normal eyes (71.8%) (P=0.080). The corneal thickness shows no significant difference between normal eyes (577 +/- 10) and glaucomatous eyes (570+/-11). However, the coefficient of variation of the cells was found to decrease with age (p=0.046) and the total number cells increased with age (p=0.024).
The corneal endothelial cell density of pediatric patients with glaucoma is lower than in patients with non-glaucomatous eyes. However, the hexagonality of the cells and the corneal thickness do not differ significantly between the two groups. While causality can not be implied from this study, these results indicate an anatomical difference between the corneas of the two groups and provide information regarding the anatomical differences of the cornea in pediatric patients with glaucoma.
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