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Oculus

Abstract #91550 Published in IGR 21-4

Correlation of histopathology of trabecular meshwork with clinical features in primary congenital glaucoma

Agarwal R; Sen S; Kashyap S; Dada T; Nag TC; Gupta V; Sihota R
British Journal of Ophthalmology 2020; 0:


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 vs 1.00±0.74 cells/mm, 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.

Glaucoma research facility and services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Full article

Classification:

9.1.1 Congenital glaucoma, Buphthalmos (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
2.5.1 Trabecular meshwork (Part of: 2 Anatomical structures in glaucoma > 2.5 Meshwork)
3.1 Microscopy (Part of: 3 Laboratory methods)



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