Differences in outflow channels between two eyes of unilateral primary congenital glaucoma.
Gupta Viney, Singh Abhishek, Pandya Ishan, Sofi Rayees, Sen Seema, Somarajan Bindu I, Gupta Shikha, Nag Tapas C
AI Summary
Unilateral PCG fellow eyes often show angle dysgenesis but maintain outflow channels like uveoscleral or direct Schlemm's canal communication, potentially preventing glaucoma development.
Abstract
Purpose
Primary congenital glaucoma (PCG) occurs in only one eye in some patients. We aimed to characterize anatomical features of the angle and Schlemm's canal (SC) in vivo among fellow eyes of patients with unilateral primary congenital glaucoma.
Methods
Both eyes of 33 children with unilateral PCG and 30 healthy, age-matched children, old enough to co-operate were analysed using high-resolution anterior segment spectral domain (SD) OCT. Subgroup analysis was done for the presence/absence of angle dysgenesis as defined by the presence of abnormal tissue/hyper-reflective membrane within angle recess and/or the absence of SC. Other anatomical landmarks differentiating the fellow eyes from eyes with glaucoma were also evaluated and compared with healthy subjects.
Results
The presence of abnormal tissue at the angle and/or a hyper-reflective membranous structure covering the meshwork was seen in all affected PCG eyes (100%) and in 21 (63%) unaffected fellow eyes; p = 0.001. The SC could be seen in 8 (24%) affected in comparison with 29 (88%) fellow unaffected eyes; p = 0.001. The ASOCT scans of 54 (90%) healthy eyes and 3 (9%) fellow PCG eyes revealed a direct communication of anterior portion of the SC with the anterior chamber. Among the fellow eyes, a communication of the supraciliary space with anterior chamber could be discerned in 26 eyes (79%).
Conclusions
Despite angle dysgenesis, outflow channels such as the uveoscleral or a direct communication of SC with the anterior chamber play a role in preventing the development of glaucoma in fellow eyes of unilateral PCG.
MeSH Terms
Shields Classification
Key Concepts5
Abnormal tissue at the angle and/or a hyper-reflective membranous structure covering the meshwork was observed in all affected primary congenital glaucoma (PCG) eyes (100%) and in 21 (63%) unaffected fellow eyes among 33 children with unilateral PCG (p = 0.001).
The Schlemm's canal (SC) was visible in 8 (24%) affected eyes compared to 29 (88%) fellow unaffected eyes in 33 children with unilateral primary congenital glaucoma (p = 0.001).
A direct communication of the anterior portion of the Schlemm's canal (SC) with the anterior chamber was observed in 54 (90%) healthy eyes and 3 (9%) fellow eyes of patients with unilateral primary congenital glaucoma, as analyzed using high-resolution anterior segment spectral domain (SD) OCT.
Among the fellow eyes of 33 children with unilateral primary congenital glaucoma, a communication of the supraciliary space with the anterior chamber was discernible in 26 eyes (79%).
Outflow channels, such as the uveoscleral pathway or a direct communication of Schlemm's canal with the anterior chamber, play a role in preventing the development of glaucoma in fellow eyes of unilateral primary congenital glaucoma, despite the presence of angle dysgenesis.
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