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Grace Shih, Dilshad Contractor, Bibiana Jin Reiser; Corneal Endothelium and Iridocorneal Angle Biometrics in Pediatric Glaucomatous Eyes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1901.
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© ARVO (1962-2015); The Authors (2016-present)
Pediatric glaucoma patients are managed with a myriad of topical eyedrops and surgical interventions. However, as glaucoma is chronic and progressive, it is important for these young patients to maintain relatively healthy corneas and iridocorneal angles to maximize successful visual outcomes. Herein, we evaluated the endothelial cell morphology and density, and iridocorneal angle biometrics in glaucomatous and non-glaucomatous pediatric eyes.
90 glaucomatous eyes and 39 control eyes from 80 pediatric subjects aged 0-18 years at Children’s Hospital Los Angeles were evaluated and imaged with specular microscopy (Konan NSP-9900, Konan Medical) and anterior segment optical coherence tomography (AS-OCT) (iVue, Optovue, Inc.) . Specular images were manually counted to evaluate endothelial cell density and morphology. AS-OCT images of open angles were analyzed for angle opening distance at Schwalbe’s line (AOD-SL) and the trabecular iris space area 500 µm posterior to Schwalbe’s line (TISA-SL).
The average age of glaucoma patients and control subjects was 9 was and 6 years, respectively. Glaucomatous eyes demonstrated an average cell density of 2763.84/mm2, compared to control eyes with a cell density of 3318.46/mm2 (p=0.002). Of the cells counted, normal eyes averaged 71.69% hexagonality, whereas glaucomatous eyes averaged 62.89% hexagonal cells (p=0.0001). The average pachymetry for glaucomatous eyes was 590.35µm, whereas normal eyes averaged 587.47µm corneal thickness (p=0.044). Average AOD-SL was 0.689 and 0.740 mm for glaucomatous and control eyes, respectively. Average TISA-SL was 0.245 and 0.248 mm2 for glaucomatous and control eyes, respectively.
On average, glaucomatous pediatric eyes appeared to exhibit lower endothelial cell density and percentage of hexagonal cells than age-matched controls. Pachymetry measurements were comparable between glaucomatous and control eyes. Iridocorneal angle biometrics do not appear to be different between groups. Although our findings suggest a disparity in the density and morphology of corneal endothelial cells in glaucomatous eyes compared to normal controls, further studies are required to elucidate the etiology of these changes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Normal corneal endothelium in a pediatric control eye.
Endothelial cell loss in a pediatric glaucomatous eye.
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