Histopathology of abnormalities of the anterior chamber with glaucoma

Neural crest cells give rise to all connective tissues anterior to the lens epithelium including corneal stromal cells, corneal and trabecular mesothelial cells, iris stromal cells, and iris melanophores. These cells constitute a continuous layer which extends from the corneal mesothelium to trabecular meshwork mesothelium and onto the anterior surface of the iris. Between the seventh and eighth month of gestation in man, the layer of cells loses its continuity. The present case suggests a defective terminal induction of a particular structural component of the angle derived from neural crest resulting in massive congenital adhesions in the anterior chamber angle. The persistence of a layer of abnormal cells lining the anterior chamber structures further reinforces the presence of defective mesothelial cells. Additional cases having such clinicopathologic correlation may provide further insight into this hypothesis.