[Cell-to-cell interactions between iris and trabecular meshwork in primary open-angle glaucoma]

Pathomorphological study of the ocular draining system in the presence of an ischemic iris was carried out in patients with primary open-angle glaucoma (POAG). A total of 173 biopsy specimens of the sclera and iris were collected during anti-glaucoma operations in 115 patients aged 32-90 years. The specimens were stained for amyloid with Congo red, thioflavin, and toluidine blue at pH 4.6 and 5.8 for detecting glycosaminoglycanes. The specimens were examined by histochemical and electron microscopic methods. Morphological changes in the trabecular system in POAG are due to abnormalities in the iridal microcirculatory bed. The status of the trabecular system during the initial and advanced stages of glaucoma depends on the severity of involvement of iridal arterioles, capillaries, and venules, modulating the biochemical processes in the anterior segment of the eye. Endotheliocyte and collagen matrix pathology and subsequent degradation of the trabecular system are closely related to dystrophic processes in the iris (release of plasma protein from the vessels and melanin granules into anterior chamber humor, cytotoxic effects of degradation products on adjacent tissues). The detected changes imply the use of drugs improving blood supply to the eye at the microcirculatory level and antihypoxants and antioxidants in local and total-systems therapy of patients with POAG.