Title: Corneal Endothelial Cell Changes in POAG & Its Relation with Severity of Field Defect
Authors: Dr Prasannakumary.C, Dr Ragi. T K, Dr Raju K V
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.173
Abstract
Introduction: The corneal endothelium is a single layer of polygonal cells covering the posterior surface of Descemet's membrane. The endothelial cells have the lowest mitotic activity. The corneal endothelium regulates hydration of cornea through ATP and biocarbonate-dependent pump and thereby providing transparency. In the adult, the average cell density is 2600 - 3000 cells/mm2.1 Glaucoma is an optic neuropathy characterized by progressive loss of retinal ganglion cells, thinning of the neuroretinal rim and the retinal nerve fiber layer (RNFL), with associated deterioration of the visual field.3 It can cause defects to the corneal endothelial cells either by direct or indirect mechanisms.
Aim: The aim was to compare corneal endothelial cell changes among Primary open angle glaucoma patients and normal control group and to correlate endothelial changes with duration of disease and severity of field defects.
Methods: It is a cross sectional comparative study comprised of 200 eyes, each of POAG patients and of normal individuals of similar age group who attended the outpatient department. Corneal endothelial cells were examined using noncontact specular microscope.
Results: The mean endothelial cell density (ECD) in POAG patients were significantly lower (2211.13 ± 171.49cells/mm2 in right eye, 2198.20± 154.39cells/mm2 in left eye) compared to control group ( 2417.43 ± 116.92 in right eye and 2390.18 ±101.31 cells/mm2 in left eye, p value <.001). Hexagonality in POAG patients also were significantly less. (43.79 ±5.77, 43.58± 6.82 in right and left eye respectively as to control group 48.25± 2.82, 48.71± 2.89 ,p value <.001). Coefficient of variation in POAG patients was significantly higher than control group.
Conclusion: Corneal Endothelial cell density and percentage of hexagonal cells were significantly lower among Primary open angle glaucoma patients. Evaluation of corneal endothelium is necessary for proceeding to intraocular procedures in glaucoma patients.
Keywords: Open angle glaucoma, endothelial cell density, Hexogonality, coefficient of variation.
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