Swelling and loss of photoreceptors in chronic human and experimental glaucomas.

James Verhoeve // Matthew Davis // Michael Nork // Nickells Lab // Publications // Feb 01 2000

PubMed ID: 10676789

Author(s): Nork TM, Ver Hoeve JN, Poulsen GL, Nickells RW, Davis MD, Weber AJ, Vaegan, Sarks SH, Lemley HL, Millecchia LL. Swelling and loss of photoreceptors in chronic human and experimental glaucomas. Arch Ophthalmol. 2000 Feb;118(2):235-45. PMID 10676789

Journal: Archives Of Ophthalmology (Chicago, Ill. : 1960), Volume 118, Issue 2, Feb 2000

OBJECTIVE To determine whether outer retinal changes occur in chronic, presumed primary open-angle glaucoma (POAG).

METHODS The outer retinas from 128 human eyes with a diagnosis of chronic glaucoma (presumably POAG in most cases) and 90 control eyes were examined histologically by 3 masked observers for photoreceptor swelling and loss. Retinas from 9 rhesus monkeys with glaucoma induced experimentally by laser trabecular destruction were compared with 7 fellow (control) eyes. The mean pressure elevations in the eyes with laser trabecular destruction ranged from 26.6 to 53.6 mm Hg with durations varying from 7 to 33 weeks.

RESULTS Swelling of the red- and green-sensitive cones was observed in a statistically significantly greater proportion of human eyes with presumed POAG compared with the control eyes. Patchy loss of red/green cones and rods was also found in some of the glaucomatous retinas. In a subset of the human eyes with end-stage disease, cone swelling was a variable finding. Although no photoreceptor loss was found in the 9 monkey eyes with experimental glaucoma, 8 had swelling of their red/green cones that was remarkably similar to that seen in the human eyes. Swelling was not present in any of the control monkey eyes.

CONCLUSIONS The photoreceptors are affected by chronically elevated intraocular pressure.

CLINICAL RELEVANCE These findings may explain some of the abnormalities of color vision and the electrophysiological effects that have been observed in patients with POAG.