Conjunctival modifications in ocular hypertension and primary open angle glaucoma: an in vivo confocal microscopy study.
OBJECTIVE
The study was conducted to analyze, by in vivo confocal microscopy (IVCM), the conjunctival epithelial characteristics in untreated ocular hypertension (OH) and in topically treated primary open-angle glaucoma (POAG).


METHODS
The study included 30 eyes affected with untreated OH, 96 eyes with POAG receiving medical therapy, and 15 healthy control eyes. The main outcome measures were the mean density and the mean area of conjunctival epithelium microcysts. The relations among the microscopic parameters intraocular pressure (IOP), and age in both hypertensive and glaucomatous eyes and between mean defect (MD) of visual fields and the time on therapy in patients with glaucoma were analyzed.


RESULTS
There was no evidence of conjunctival microcysts in any of the healthy eyes examined; conversely, conjunctival microcysts were found in all ocular hypertensive eyes (mean microcyst density of 19.7 +/- 3.5 cysts/mm(2) and mean total microcyst area of 4063.6 +/- 921.2 mum(2)). All patients with POAG showed conjunctival microcysts (mean density of 28.7 +/- 2.7 cysts/mm(2) and a mean total microcyst area of 6564.2 +/- 671.4 mum(2)). No significant differences were found between OH and POAG subjects for microcyst parameters and no significant relations were found in either OH or POAG eyes for microcyst density, area, IOP, MD, and time on therapy.


CONCLUSIONS
The results of the study show that conjunctival microcysts are features present in all hypertensive and glaucomatous eyes. Based on these findings, conjunctiva could be an additional potential target tissue available for the investigation by a noninvasive in vivo approach of glaucoma-induced pathologic modifications.
Ciancaglini
Marco
M
Department of Medicine and Ageing Science, Ophthalmic Clinic, University of Chieti-Pescara, Pescara, Italy. m.ciancaglini@unich.it
Carpineto
Paolo
P
Agnifili
Luca
L
Nubile
Mario
M
Fasanella
Vincenzo
V
Mastropasqua
Leonardo
L
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000209:etiology* / Q000473:pathology; D003560:Cysts / Q000209:etiology* / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications* / Q000473:pathology; D011453:Prostaglandins / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D011453:Prostaglandins