Corneal Endothelium in Dysgenetic Juvenile Open-angle Glaucoma with Myopia magna
Jünemann A., Schlötzer-Schrehardt U.
Department of Ophthalmology, University Erlangen-Nuremberg, Erlangen
Purpose: The histopathologic alterations of the corneal endothelium in dysgenetic juvenile open-angle glaucoma with myopia magna are demonstrated.
Method: A 27-year old female patient presented with a dysgenetic juvenile open-angle glaucoma (pseudophacia with posterior chamber lens implantation, state after three-fold cyclocryocoagulation, secondary divergent strabism) with secondary macropapilla and myopic fundus degenerations in myopia magna. Due to painful absolute glaucoma with non-regulated intraocular-pressure an enucleation of the eye with orbital implant was performed. Light microscopic and electron microscopic alterations of the corneal endothelium were examined.
Results: Light microscopy revealed vacuolic degeneration of corneal endothelium. Descemet's membrane showed a diffuse thickening, as well as peripheral breaks. Electronmicroscopically, the corneal endothelium showed insufficient differentiation and partial multilayering by interdigitating cellular processes and intercellular vacuoles. Descemet's membrane revealed breaks and ridge formations in the mid-periphery, a marked variation in thickness (1.5-15 µm), and an abnormal ultrastructure.
Conclusions: The neuralcrest-derived corneal endothelium is involved in the dysgenesis of the anterior segment in dysgenetic juvenile open-angle glaucoma. The ridges of Descemet' membrane may be considered as Pseudo-Ha
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