Objective quantification of trabecular meshwork pigmentation and correlation to primary open-angle glaucoma disease...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Biomarker Discovery

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Early detection of POAG is crucial for preventing vision loss.
• Trabecular meshwork (TM) pigmentation is a potential early indicator of glaucomatous changes.

Purpose of the Study:

• To evaluate the association between TM pigmentation asymmetry and visual field loss in a larger cohort of POAG patients.
• To validate a novel early biomarker for glaucoma severity.

Main Methods:

• Retrospective analysis of 335 Black and Afro-Latino POAG patients.
• TM imaging using the GS-1 gonioscope.
• Quantification of superior-inferior TM pigmentation ratio (SIR) using ImageJ software and comparison with visual field mean deviation.

Main Results:

• A positive correlation was observed between the SIR and visual field loss in 529 eyes.
• Greater pigmentation asymmetry (higher SIR) correlated with more severe visual field deterioration.
• The SIR also showed a positive correlation with patient age.

Conclusions:

• The SIR is a reliable indicator of visual field worsening in POAG patients.
• Further research is needed to assess normal, suspect, and glaucoma populations.
• Automated TM imaging and AI-based pigment density assessment could enhance early glaucoma detection and clinical correlation.