Light and Electron Microscopic Study of the Retina in a Patient with Congenital Glaucoma

Purpose: The morphological observation of the human retinal changes caused by severely elevated intraocular pressure (IOP) in congenital glaucoma.Method: Light and electron microscopy.Subjects: One eye of a 15-year-old boy diagnosed as having congenital glaucoma was obtained after he had suffered from severe visual disturbance and ocular pain because of extensive elevated IOP, corneal leucoma, and exophthalmos.Results: Ganglion cells and nerve fibers in the inner layer were lost and replaced by Müller cell processes. The cellular elements in the outer layer were regularly arranged, but these cytoplasmic organelles were not very well developed. Most of the cellular elements of the whole retina contained many dense bodies. The retinal capillaries in the nerve fiber layer were lost or severly damaged, but some of these in the inner plexiform layer were intact. In the retinal arteries and veins marked thickening of the adventitial tissues was observed. These tissues consisted of remarkably increased and irregularly arranged collagen fibers, and a few elastic fibers scattered in some parts.Conclusion: It appeared that the pathological changes in the inner layer of the retina were caused by ischemia. The retinal vascular abnormality was thought to be the result of protective reaction against the severly elevated IOP.