Angle-closure glaucoma associated with endothelial cell loss

Eyes that have had acute or chronic angle-closure glaucoma show a significant decrease in corneal endothelial cell density compared to normal eyes, according to a cross-sectional study. Eyes with acute angle-closure glaucoma also have a significantly greater corneal thickness than normal eyes, the study found.

Ramanjit Sihota, MD, FRCS and colleagues at the All India Institute of Medical Sciences in New Delhi studied 30 patients in each subtype of primary angle closure glaucoma (PACG): subacute, acute and chronic, and they compared these results with 30 age- and refraction-matched controls. Recorded parameters included gonioscopy, optic disc evaluation, applanation tonometry, specular microscopy and central ultrasonic pachymetry.

Patients with subacute PACG had a mean endothelial cell count of 2,396 cells/mm². Those with acute PACG had a mean endothelial cell count of 1,597 cells/mm². Patients with chronic PACG had mean cell counts of 2,229 cells/mm². Eyes in the control group had a mean endothelial cell count of 2,461 cells/mm².

In eyes that experienced an acute attack of angle closure, mean endothelial cells count was 2,106 cells/mm² if the attack lasted less than 72 hours and 759 cells/mm² if the attack lasted more than 72 hours.

The mean central corneal thickness was 531.4 µm in eyes with subacute PACG, 567.9 µm in eyes with acute PACG, 526.4 µm in eyes with chronic PACG and 525 µm in control eyes.

The study is published in the December issue of Clinical & Experimental Ophthalmology.