Morphological features of the corneal endothelium in patients with pseudoexfoliative glaucoma

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Abstract

Purpose. To study the main morphological features of the corneal endothelium in patients with pseudoexfoliative glaucoma (PEG).

Methods. We included 193 subjects aged from 55 to 75 years. The main study group (PEG) included 96 patients (192 eyes), the primary open angle glaucoma (POAG) group included 36 patients (72 eyes) with POAG, the PEX group included 31 patients (62 eyes) with pseudoexfoliation syndrome without glaucoma. The control group consisted of 30 healthy subjects (60 eyes). Main corneal endothelium parameters were evaluated using a non-contact endothelial microscope EM-935 (Haag Streit, Switzerland). Data were analyzed by STATISTICA 9 software for Windows.

Results. The patients with PEG had lower endothelial cell density (ECD) in comparison to the control group (p < 0.01), and PEX group (p < 0.05). The polymegatism level in patients with PEG and POAG was higher than in the control group (p < 0.001, and p < 0.01, correspondingly). In patients with moderate and advanced PEG, the ECD was significantly lower (p < 0.01), and the polymegatism level was significantly higher (p < 0.01) than the same parameters in patients with early PEG. The lowest ECD and the highest polymegatism percentage were observed in PEG patients with more pronounced PEX manifestations, p < 0.05. No effect of IOP-lowering eye drops on the corneal endothelium parameters was revealed, p < 0.05.

Conclusions. Significant morphological changes of the corneal endothelium (decreased endothelial cell density, increased polymegatism percentage) were revealed in patients with PEG. It was established that the severity of these changes is associated with the PEG and PEX severity. No effect of IOP-lowering eye drops on the corneal endothelium parameters was detected.

About the authors

Inessa S. Beletskaya

Academician I.P. Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: glaziki@list.ru

Ophthalmologist, Ophthalmology Department

Russian Federation, Saint Petersburg

Sergey Yu. Astakhov

Academician I.P. Pavlov First Saint Petersburg State Medical University

Email: astakhov73@mail.ru

MD, PhD, Professor, Head of the Department, Ophthalmology Department

Russian Federation, Saint Petersburg

Natalya V. Tkachenko

Academician I.P. Pavlov First Saint Petersburg State Medical University

Email: natalyatkachenko@yandex.ru

MD, PhD, Assistant, Ophthalmology Department

Russian Federation, Saint Petersburg

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2. Fig. 1. Pseudoexfoliation material on the anterior segment structures (a); results of non-contact endothelial microscopy (EM-935, Haag Streit) in 72 years old female patient diagnosed with moderate pseudoexfoliative glaucoma (b)

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3. Fig. 2. Corneal endothelial edema intensity in patients with pseudoexfoliative glaucoma, primary open angle glaucoma, pseudoexfoliation syndrome, and in the control group

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4. Fig. 3. Type of the iridocorneal angle pigmentation in patients with pseudoexfoliative glaucoma, primary open angle glaucoma, pseudoexfoliation syndrome, and in the control group

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5. Fig. 4. Pigmentation intensity of the iridocorneal angle in patients with pseudoexfoliative glaucoma, primary open angle glaucoma, pseudoexfoliation syndrome

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Copyright (c) 2018 Beletskaya I.S., Astakhov S.Y., Tkachenko N.V.

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