Abstract
Abstract: :
Purpose: To study the number and appearance of choroidal ganglion cells (CGC) in human donor eyes with glaucoma disease. Methods: The number of CGC was quantified in complete choroidal and scleral whole mounts from 33 normal human eyes aged 25th week of pregnancy to 95 years, stained for NADPH diaphorase. Same technique was used in 13 eyes with glaucoma (donors aged 60-98 years, glaucoma duration 4-20 years). A Quantimed computer system (Leica) was used to measure the size of 100 ganglion cells in each the peripheral and central choroid. Ultrastructure of the CGC and the ciliary nerves at the level of the sclera were evaluated. Results: The number of CGC did not change after birth, but the size increased with increasing age. This was most pronounced in the central choroid. CGC were not surrounded by capillaries and not connected to choroidal elastic fibers or vessels. In all glaucomatous eyes, independent of type, duration, and stage of the disease, the number of CGC was markedly decreased if compared to age-matched controls. The loss of CGC was most pronounced in the central choroid. The remaining CGC showed a shift in their size towards larger cell bodies. The ciliary nerves within and at the inner rim of the sclera were unchanged. Conclusion: In human glaucoma, like in monkey glaucoma model, the number of CGC was decreased. The pathomechanism underlying this CGC degeneration is not known. Our findings show that direct pressure of CGC against connective tissue structures or ascending neuronal degeneration are not involved.