Endothelial cells in the glaucomato-cyclitic crisis

Area of Science:

• Ophthalmology
• Corneal Science
• Glaucoma Research

Background:

• Glaucomatocyclitic crisis, also known as Posner-Schlossman syndrome (P-S), is characterized by recurrent episodes of unilateral ocular inflammation and elevated intraocular pressure.
• The long-term effects of P-S on corneal health, particularly endothelial cell density, are not fully understood.

Purpose of the Study:

• To investigate the relationship between Posner-Schlossman syndrome attacks and central corneal endothelial cell density.
• To determine if recurrent elevated intraocular pressure or initial inflammatory events are the primary cause of endothelial cell loss in P-S.

Main Methods:

• Specular microscopy was used to photograph the central corneal endothelium in 21 patients with unilateral Posner-Schlossman syndrome.
• Endothelial cell density was quantified in both the affected and the contralateral healthy eyes of each patient.

Main Results:

• Patients with multiple P-S attacks showed significantly lower endothelial cell density in the affected eye compared to the healthy eye (16 out of 21 cases).
• Endothelial cell density was similar between affected and healthy eyes after the first attack (4 patients) and after the second attack (1 out of 3 patients).

Conclusions:

• Recurrent episodes of elevated intraocular pressure in Posner-Schlossman syndrome are the primary cause of endothelial cell loss.
• The findings suggest that cumulative damage from repeated pressure spikes, rather than initial inflammatory changes like keratic precipitates, leads to endothelial dysfunction in P-S.