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Analysis of corneal endothelium and corneal densitometry in primary open-angle glaucoma, pseudoexfoliation glaucoma, and myopic and diabetic glaucomatous patients

Poster Details

First Author: R.Spinetta ITALY

Co Author(s):    T. Rolle   E. Malgieri   R. Carroll   A. Kolomeyer   R. Nuzzi   A. Fea     

Abstract Details


Corneal densitometry measurements provide objective and quantitative assessment of corneal clarity and transparency . Both the corneal endothelial and stromal layers are required to have excellent function and arrangement for corneal clarity. Aim of this study was to analyze and compare corneal endothelium density and morphology and corneal densitometry(COD) in primary open angle glaucoma(POAG), pseudoexfoliation glaucoma(PEG) and in myopic (MG) and diabetic without diabetic retinopathy glaucomatous patients (DG) and to investigate whether corneal densitometry may be used as an indicator of the health of corneal endothelium in glaucoma patients.


Department of Surgical Sciences, Eye Clinic, Citta'della Salute, University of Turin, Turin, Italy


212 eyes (56 POAG,39 PEG,43 MY, 42 DG and 32 healthy eyes) were analyzed in this prospective cross sectional study. Endothelial cell density(CD), average cell area(AVE), standard deviation(SD) and coefficient of variation(CV) of the cell area, coefficient of hexagonality(HEX) and central corneal thickness(CCT) were measured by a specular microscope. COD was assessed with the densitometry software of PentacamHR-Scheimpflug corneal topography over a 12-mm diameter of the cornea subdivided for densitometry analysis into 4 concentric radial zones and also into anterior, central, and posterior layers based on corneal depth. COD measurements were expressed in gray scale unit.


All glaucomatous groups presented a lower CD and HEX but a higher AVE than controls(p<0.05). In the comparison between glaucoma groups CCT was higher in DG than MG and PEG,CD was lower whereas CV and SD were higher in DG vs POAG(p<0.05).COD of PEG was higher than in controls in all sectors considered(p<0.05). PEG presented higher COD in some of the sectors analyzed respect to the other glaucomatous groups(p<0.05). CD and HEX in PEG were inversely correlated with COD whereas AVE was positively correlated in all layers and concentric annuli except for the apical zone(p<0.05).


All glaucomatous groups show an impaired endothelium. COD in diabetic and myopic glaucomatous patients and in POAG patients is similar to that of healthy control subjects suggesting a good corneal transparency. COD in PEG eyes is higher than in controls and it inversely correlates with endothelium density: the decreased corneal transparency in PEG eyes may be due not only to pseudoexfoliatio material but also to the reduced endothelium density and related pump-fluid and barrier functions. COD might be used as an indicator of the health of corneal endothelium in PEG eyes.

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