Differences in the trabecular meshwork between Belgian and Congolese patients with open-angle glaucoma

Area of Science:

• Ophthalmology
• Cellular Biology
• Glaucoma Research

Background:

• Open angle glaucoma (OAG) is a leading cause of irreversible blindness worldwide.
• Trabecular meshwork (TM) dysfunction is implicated in the pathogenesis of OAG.
• Racial disparities in OAG prevalence and severity are well-documented.

Purpose of the Study:

• To investigate and compare the histological alterations of the trabecular meshwork in Belgian and Congolese patients diagnosed with open angle glaucoma.
• To elucidate potential cellular and structural differences in the TM that may contribute to observed racial variations in glaucoma.

Main Methods:

• Trabeculectomy specimens were obtained from 27 Belgian and 24 Congolese OAG patients.
• Trabecular tissue was processed, stained, and analyzed using light microscopy.
• Specimens were compared against a control group of 5 non-glaucomatous Belgian eyes.

Main Results:

• Congolese OAG patients exhibited significantly lower mean trabecular cell counts (10 cells/field) compared to Belgian OAG patients (34 cells/field) and Belgian normal controls (69 cells/field).
• Trabecular meshwork collapse and Schlemm's canal closure were observed in eyes with reduced cellularity.
• Increased pigmentation was noted in Congolese TM specimens (79%) versus Belgian TM specimens (35%).

Conclusions:

• Open angle glaucoma is associated with reduced TM cellularity, with a more pronounced effect observed in Congolese individuals.
• These findings suggest that lower TM cellularity and increased pigmentation in Congolese patients may contribute to the higher prevalence and severity of OAG in Black populations.
• The study highlights potential cellular mechanisms underlying racial differences in glaucoma.