TUNEL-positive ganglion cells in human primary open-angle glaucoma.
OBJECTIVE
To determine whether retinal ganglion cell death in primary open-angle glaucoma occurs by apoptosis.


METHODS
Eighteen eyes of 17 subjects with documented primary open-angle glaucoma were compared with 21 control eyes that were group matched for age, race, and sex. Staging of glaucoma severity was performed by histologic optic nerve evaluation. Fixed, paraffin-embedded retinal sections were assayed by the TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate (UTP)-biotin nick end-labeling) method to detect the internucleosomal DNA fragmentation that is characteristic of apoptosis.


RESULTS
A positive TUNEL reaction was observed among ganglion layer cells in 10 of 18 cases with glaucoma, compared with 1 of 11 control cases without confounding systemic disease (5 control eyes were excluded owing to artifactual staining and 4 eyes had confounding systemic disease). Sections containing more than 250,000 cells in the ganglion cell layer were examined in cases and controls. The frequency of TUNEL-positive cells in the ganglion cell layer in cases with glaucoma was 1.76 per 10,000, or 15.2 times greater than the control frequency from individuals without confounding disease (P < .001; 95% CI, 2.46-623). Eyes without glaucoma from subjects with diabetes and amyotrophic lateral sclerosis showed more positive cells than other controls.


CONCLUSIONS
Apoptosis seems to be a mechanism of cell death in human eyes with primary open-angle glaucoma.
Kerrigan
L A
LA
Department of Ophthalmology, Wilmer Eye Institute, Baltimore, Md, USA.
Zack
D J
DJ
Quigley
H A
HA
Smith
S D
SD
Pease
M E
ME
D000368:Aged; D017209:Apoptosis; D016923:Cell Death; D004247:DNA / Q000032:analysis; D053938:DNA Fragmentation; D005260:Female; D005902:Glaucoma, Open-Angle / Q000473:pathology*; D006801:Humans; D008297:Male; D009713:Nucleotidyltransferases; D012160:Retina / Q000473:pathology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D014544:Uridine Triphosphate
D004247:DNA; D009713:Nucleotidyltransferases; D014544:Uridine Triphosphate