D - Glaucoma Histopath 2 - Week 2 Flashcards
How does lens cell death differ in angle-closure glaucoma compared to open angle? Explain why this occurs and how it presents visually
Angle closure results in an acute rise to very high IOP levels. This leads to necrosis of the lens epithelium, which appears as “Glaukomflecken” (grey-white lens epithelial and anterior cortical lens opacities; beneath anterior lens capsule)
(cf open angle, which is apoptosis)
What percentage of aqueous drains through the uveoscleral route? What about via trabecular meshwork?
Uveoscleral: 85-95%
Trabecular: 5-15%
What feature of the trabecular meshwork allows for fine control of aqueous outflow?
giant vacuoles on the endothelial surface of schlem’s canal
What is the role of trabecular cells (2) and where are they found?
In the cribriform region of the trabecular meshwork, there are trabecular cells that:
- Produce a gel to fill in holes + stick to debris
- phagocytose debris to clean TM
List 2 trabecular mechanisms for angle compromise
Congenital/juvenile (formation problems)
Mechanical blockage (e.g. pigment, debris, vacuole dysfunction)
What does posterior trabecular dysfunction lead to? (2)
Reduced venous drainage
Increased venous backpressure
List 2 anatomical causes for angle closure
Anterior membrane overgrowth (Irido Corneal Endothelial “ICE” syndrome)
Occlusion of PTM by iris (iris “push” or “pull”)
continue later
yeah