Correlation of histopathology of trabecular meshwork with clinical features in primary congenital glaucoma.
Agarwal Rinky, Sen Seema, Kashyap Seema, Dada Tanuj, Nag Tapas Chandra, Gupta Viney, Sihota Ramanjit
AI Summary
This study linked trabecular meshwork histopathology in congenital glaucoma to clinical features. Key findings showed specific TM changes correlated with IOP, suggesting microscopic analysis may help predict prognosis.
Abstract
Purpose
To correlate histopathological changes of trabecular meshwork (TM) with clinical features in primary congenital glaucoma (PCG).
Methods
This was a prospective interventional study including 66 eyes of 39 PCG children aged ≤12 months at diagnosis. Corneal clarity, corneal diameter (CD), intraocular pressure (IOP) and cup disc ratio (C:D ratio) were assessed at baseline and at 1-year follow-up. The trabecular meshwork (TM) specimens obtained during primary combined trabeculectomy and trabeculotomy augmented with Mitomycin-C were evaluated on light microscopy to look for eosinophilic membrane (EM), status of trabecular beams and trabecular endothelial cells (TEC), presence of intervening spaces, TM thickness and TEC count which were then correlated with clinical features.
Results
At 1-year follow-up, IOP reduced from 27.96±10.2 to 11.88±5.63 mm Hg, p<0.001, C:D ratio decreased from 0.65±0.34 to 0.49±0.06, p=0.036, and the bleb had a significant tendency to change from well formed (59-46) to flat type (3-6) or thin, cystic type (4-14) (p=0.014). Presence of EM on the cameral surface was associated with a lower baseline IOP. Fused trabecular beams were associated with higher baseline IOP. The TM was significantly thicker in eyes with IOP >20 mm Hg at presentation (1.86±0.7 mm vs 1.3±0.47 mm, p=0.0356). Eyes with IOP ≤14 mm Hg at final follow-up had lower TEC count than eyes with IOP >14 mm Hg (0.92±0.45 cells/mm 2 vs 1.00±0.74 cells/mm 2 , p=0.0028).
Conclusion
A light microscopic analysis of surgical specimens may guide prognosis of PCG. However, larger studies are required to validate these results.
MeSH Terms
Shields Classification
Key Concepts6
In a prospective interventional study of 66 eyes of 39 primary congenital glaucoma (PCG) children aged ≤12 months at diagnosis, intraocular pressure (IOP) reduced from 27.96±10.2 to 11.88±5.63 mm Hg (p<0.001) at 1-year follow-up after primary combined trabeculectomy and trabeculotomy augmented with Mitomycin-C.
In a prospective interventional study of 66 eyes of 39 primary congenital glaucoma (PCG) children aged ≤12 months at diagnosis, the cup-to-disc (C:D) ratio decreased from 0.65±0.34 to 0.49±0.06 (p=0.036) at 1-year follow-up after primary combined trabeculectomy and trabeculotomy augmented with Mitomycin-C.
In a prospective interventional study of 66 eyes of 39 primary congenital glaucoma (PCG) children aged ≤12 months at diagnosis, the presence of an eosinophilic membrane (EM) on the cameral surface of the trabecular meshwork (TM) was associated with a lower baseline intraocular pressure (IOP).
In a prospective interventional study of 66 eyes of 39 primary congenital glaucoma (PCG) children aged ≤12 months at diagnosis, fused trabecular beams in the trabecular meshwork (TM) were associated with higher baseline intraocular pressure (IOP).
In a prospective interventional study of 66 eyes of 39 primary congenital glaucoma (PCG) children aged ≤12 months at diagnosis, the trabecular meshwork (TM) was significantly thicker in eyes with intraocular pressure (IOP) >20 mm Hg at presentation (1.86±0.7 mm) compared to eyes with IOP ≤20 mm Hg (1.3±0.47 mm, p=0.0356).
In a prospective interventional study of 66 eyes of 39 primary congenital glaucoma (PCG) children aged ≤12 months at diagnosis, eyes with intraocular pressure (IOP) ≤14 mm Hg at final follow-up had a lower trabecular endothelial cell (TEC) count (0.92±0.45 cells/mm²) than eyes with IOP >14 mm Hg (1.00±0.74 cells/mm², p=0.0028).
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