Clinical and ocular histopathological findings in a patient with normal-pressure glaucoma.
OBJECTIVE
To study the histopathological changes of eyes from a patient with normal-pressure glaucoma whose clinical and laboratory findings were well documented.


METHODS
Postmortem histopathological findings in a patient with normal-pressure glaucoma who had monoclonal gammopathy and serum immunoreactivity to retinal proteins were examined in comparison with those of an age-matched control subject. Clinicopathological correlations to laboratory findings were examined.


RESULTS
Clinical and histopathological findings of the patient, including cavernous degeneration of optic nerve and characteristic optic nerve cupping, were similar to those in patients with glaucoma who had high intraocular pressure. In addition, we found immunoglobulin G and immonuglobulin. A deposition in the ganglion cells, inner and outer nuclear layers of the retina, and evidence of apoptotic retinal cell death using terminal deoxynucleotidyltransferase-mediated deoxyuridine triphosphate nick end labeling technique.


CONCLUSIONS
Serum antibodies to retinal proteins and retinal immunoglobulin deposition constitute novel findings in a patient with normal-pressure glaucoma and may contribute to better understanding of the mechanisms underlying glaucomatous optic neuropathy in this disorder.
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, Mo., USA. wax@am.seer.wustl.edu
M B
MB
Wax
G
G
Tezel
P D
PD
Edward
D000368:Aged; D017209:Apoptosis; D001323:Autoantibodies / Q000032:analysis; D005136:Eye Proteins / Q000276:immunology; D005260:Female; D005451:Fluorescein Angiography; D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007072:Immunoglobulin D / Q000032:analysis; D007208:Indocyanine Green; D007429:Intraocular Pressure; D009898:Optic Disk / Q000473:pathology; D009901:Optic Nerve Diseases / Q000473:pathology*; D010265:Paraproteinemias / Q000473:pathology; D012160:Retina / Q000276:immunology / Q000473:pathology; D012165:Retinal Ganglion Cells / Q000276:immunology; D014794:Visual Fields
D001323:Autoantibodies; D005136:Eye Proteins; D007070:Immunoglobulin A; D007072:Immunoglobulin D; D007208:Indocyanine Green