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. 2022 Jan 1;48(1):27-32.
doi: 10.1097/ICL.0000000000000844.

Corneal Structural Changes in Congenital Glaucoma

Jennifer Drechsler  1 , Adrianna Lee, Snehaa Maripudi, Laura Kueny, Moran R Levin, Osamah J Saeedi, Marlet Bazemore, Bethany Karwoski, Richard Birdsong, Camilo Martinez, Mohamad S Jaafar, Sairah Yousaf, Zubair M Ahmed, William P Madigan, Janet Leath Alexander
Affiliations

Corneal Structural Changes in Congenital Glaucoma

Jennifer Drechsler et al. Eye Contact Lens. .

Abstract

Objective: To identify corneal structure differences on quantitative high-frequency ultrasound biomicroscopy (UBM) among subjects with congenital glaucoma compared with controls.

Methods: This prospective case-control study evaluated 180 UBM images from 44 eyes of 30 subjects (18 control and 12 glaucoma, mean age 5.2±8.0 years, range 0.2-25.8 years) enrolled in the Pediatric Anterior Segment Imaging and Innovation Study (PASIIS). ImageJ was used to quantify a comprehensive set of corneal structures according to 21 quantitative parameters. Statistical analysis compared corneal measurements in glaucoma subtypes and age-matched controls with significance testing and mixed effects models.

Results: Significant differences between congenital glaucoma cases and controls were identified in 16 of 21 measured parameters including angle-to-angle, central and peripheral corneal thicknesses, scleral integrated pixel density, anterior corneal radius of curvature, and posterior corneal radius of curvature. Eight parameters differed significantly between primary congenital glaucoma and glaucoma following congenital cataract surgery.

Conclusion: Multiple measurable corneal structural differences exist between congenital glaucoma and control eyes, and between primary and secondary congenital glaucoma, including but not limited to corneal width and thickness. The structural differences can be quantified from UBM image analysis. Further studies are needed to determine whether corneal features associated with glaucoma can be used to diagnose or monitor progression of congenital glaucoma.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose. O.J. Saeedi has received research grants from Vasoptic, Inc and research support from Heidelberg Engineering and declares no relevant conflict of interest. J. Drechsler and A. Lee received funding support from the Proposed Research Initiated by Students and Mentors (PRISM) Program, University of Maryland, Baltimore, MD (UMB). J.L. Alexander has received research grants in collaboration with Vasoptic, Inc and declares no relevant conflict of interest. J.L. Alexander received funding support from the Knights Templar Eye Foundation Career Starter Grant, and the UBM ICTR/Clinical Science and Translational Science KL2 Award 1KL2TR003099-01.

Figures

Figure 1.
Figure 1.
Sample UBM image measurement technique. (A) Location of landmarks for measurement of angle to scleral spur distance [A-SS-D], scleral spur to ciliary body distance [SS-CB-D], scleral spur to mid-iris insertion distance [SS-MI-D]. (B) Location of measurement for anterior reflective layer, including the epithelium [Epi-T], posterior reflective layer, including the endothelium [Endo-T], central corneal thickness [CC-T], 3-millimeter paracentral corneal thickness [3mm-T], 6-millimeter paracentral corneal thickness [6mm-T], corneal thickness 1-millimeter from angle [1.0mm-T], corneal thickness 0.5-millimeter from angle [0.5mm-T]. (C) Central corneal integrated pixel density [CCPD], peripheral corneal integrated pixel density [PCPD], scleral integrated pixel density [SPD]. Measured by drawing a 0.25 mm x 0.25 mm square in the region of the central cornea, peripheral cornea (1 mm anterior from the angle), and sclera, respectively.
See this image and copyright information in PMC

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