A clinicopathologic study of four cases of primary open-angle glaucoma compared to normal eyes

Eight eyes obtained at autopsy from four patient who had chronic open-angle glaucoma were compared to eyes with normal aging changes. Three cases were characterized by early and pronounced abnormalities in the uveal portion of the drainage angle. The findings consisted of formation of an exaggerated scleral spur upon the scleral roll by accretion and compaction of the overlying uveal meshwork, hyalinization and atrophy of the adjacent ciliary muscle, and atrophy of the iris root. The fourth case showed widespread proliferation of endothelium into the lumen of Schlemm's canal. We concluded that the predominant histologic findings in eyes with open-angle glaucoma consists of an exaggeration of normal aging processes, ranging in a spectrum from excessive involvement of the uveal pathway to excessive involvement of the canal of Schlemm pathway.