Comparison of Schlemm's Canal Morphology Parameters Between Propensity Score-Matched Primary Open-Angle Glaucoma and Exfoliation Glaucoma.
Tsutsui Aika, Hamanaka Teruhiko, Kaidzu Sachiko, Kobayashi Kanae, Ishida Nobuo, Kumasaka Toshio, Tanito Masaki
AI Summary
This study found exfoliation glaucoma (EXG) exhibits greater Schlemm's canal endothelial cell loss than primary open-angle glaucoma (POAG), even after matching for age and medication, suggesting a more critical impact on IOP in EXG.
Abstract
Purpose
This study aimed to histologically compare the status of Schlemm's canal (SC) and Schlemm's canal endothelial (SCE) cells between trabeculectomy specimens from patients with primary open-angle glaucoma (POAG) and exfoliation glaucoma (EXG).
Methods
A total of 182 eyes from 152 patients with POAG and 138 eyes from 116 patients with EXG underwent immunohistochemical staining for thrombomodulin. Equal numbers of cases were selected from both groups using propensity score matching. The following parameters were evaluated: total SC length, staining positive and negative SC length (PSC and NSC, respectively), opened and closed SC length, staining positive and opened SC length, staining positive and closed SC length, staining negative and opened SC length (NOSC), and staining negative and closed SC length.
Results
After matching for age and gender, 87 cases were selected in each group. The EXG group had significantly higher preoperative IOP and medication scores. PSC was significantly longer in the POAG group, while NSC and NOSC were longer in the EXG group. Multiple regression analysis of these 174 cases revealed that PSC was significantly shorter in the EXG group. After matching for age, gender, preoperative IOP, and medication score, 64 cases were selected in each group, and NOSC was significantly longer in the EXG group.
Conclusions
These findings suggest that in EXG, SCE loss occurs independently of background factors such as aging and medication use. The loss of SCE may have a more critical impact on IOP elevation in EXG compared to POAG.
MeSH Terms
Shields Classification
Key Concepts6
After propensity score matching for age and gender, 87 cases of primary open-angle glaucoma (POAG) and 87 cases of exfoliation glaucoma (EXG) were selected. The EXG group had significantly higher preoperative intraocular pressure (IOP) and medication scores.
After propensity score matching for age and gender (87 cases in each group), the staining positive Schlemm's canal length (PSC) was significantly longer in the primary open-angle glaucoma (POAG) group, while the staining negative SC length (NSC) and staining negative and opened SC length (NOSC) were longer in the exfoliation glaucoma (EXG) group.
Multiple regression analysis of 174 cases (87 POAG, 87 EXG) revealed that staining positive Schlemm's canal length (PSC) was significantly shorter in the exfoliation glaucoma (EXG) group.
After propensity score matching for age, gender, preoperative intraocular pressure (IOP), and medication score, 64 cases were selected in each group (primary open-angle glaucoma and exfoliation glaucoma), and the staining negative and opened Schlemm's canal length (NOSC) was significantly longer in the exfoliation glaucoma (EXG) group.
These findings suggest that Schlemm's canal endothelial (SCE) loss occurs independently of background factors such as aging and medication use in exfoliation glaucoma (EXG), and that the loss of SCE may have a more critical impact on intraocular pressure (IOP) elevation in EXG compared to primary open-angle glaucoma (POAG).
A histological comparison of Schlemm's canal (SC) and Schlemm's canal endothelial (SCE) cells was conducted between trabeculectomy specimens from patients with primary open-angle glaucoma (POAG) and exfoliation glaucoma (EXG).
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