Corneal Endothelium and Central Corneal Thickness Changes in Patients with Primary Open Angle Glaucoma
Author(s): Amira Elagamy, Manal Tawashi, Mohamed Berika
Purpose: The purpose of this study was to compare corneal endothelial morphometric changes and central corneal thickness (CCT) in patients with primary open-angle glaucoma (POAG) with age-matched, non-glaucomatous control subjects using CEM-530 NIDEK indirect specular microscope. In addition, the associations between endothelial changes and IOP; glaucoma duration and topical anti-glaucoma medications were performed.
Methods: The study included 44 patients (44 eyes) with POAG and 50 control (non-glaucomatous) subjects (50 eyes). Corneal endothelial changes and CCT were measured for all patients using CEM-530 NIDEK indirect specular microscope.
Results: This study demonstrated a high statistically significant difference in endothelial cell density (ECD), average cell area, maximum cell area and standard deviation of cell area between the 2 groups (P=0.000). However, the study showed no statistically significant differences in coefficient of variation (CV), hexagonality and CCT between the 2 groups. Pearson correlation analysis showed that POAG group had a statistically weak positive correlation between IOP and maximum cell area (r=0.323 & P=0.033) and hexagonality (r=0.313 & P=0.038). Moreover, POAG group had a statistically weak negative correlation between age and CCT (r= -0.303 & P=0.046).
Conclusion: This study documented lower ECD and larger average endothelial cell area in POAG patients. Therefore, it is mandatory to use all precautions to protect the corneal endothelial cells from further impairment during any anterior segment operations. In addition, the study confirmed a positive correlation between IOP and maximum cell area in glaucomatous eyes. On the other hand, endothelial parameters and CCT showed no significant correlations with the number of medications and duration of glaucoma. Therefore, further studies using a longitudinal large population-based prospective design are recommended to verify the extent of endothelial damage caused by POAG and to determine factors prognostic of enhanced endothelial damage.