The development of the trabecular meshwork and its abnormality in primary infantile glaucoma.

Douglas Anderson

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Tissue from ten eyes with infantile glaucoma and from 40 normal eyes of fetuses and infants without glaucoma were examined by light and electron microscopy. In normal development, the corneoscleral coat grows faster than the uveal tract during the last trimester, leading to a posterior migration of the ciliary body attachment from Schwalbe's line (5th month) to the scleral spur (9th month), and then to a location behind the scleral spur (postnatally). In infantile glaucoma, the insertion of the anterior ciliary body and iris overlaps the trabecular meshwork, similar to the late fetal position. The trabecular sheets are perforated, and there is no membrane over the surface of the trabecular meshwork. The trabecular beams are thicker than in normal infant eyes. There is both histologic and clinical evidence of traction on the iris root exerted by the thickened trabecular beams. These findings suggest that in congenital glaucoma the thickened beams had prevented the normal posterior migration of the ciliary body and iris root. This traction may compact the thickened trabecular beams, obstructing aqueous humor outflow. Release of the traction by an incision (goniotomy or trabeculotomy) of the thickened meshwork may relieve the obstruction. Of uncertain pathological significance is that there are no vacuoles in the endothelium of Schlemm's canal and there is a broad layer of collagen and amorphous material in the juxtacanalicular connective tissue. The ciliary processes are elongated inward, as if they were pulled by zonular traction (perhaps created by an enlarging diameter of the limbus with a fixed lens diameter).

Original languageEnglish
Pages (from-to)458-485
Number of pages28
JournalTransactions of the American Ophthalmological Society
Volume79
StatePublished - Dec 1 1981
Externally publishedYes

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Trabecular Meshwork
Traction
Glaucoma
Ciliary Body
Iris
Trabeculectomy
Aqueous Humor
Third Pregnancy Trimester
Vacuoles
Connective Tissue
Lenses
Endothelium
Electron Microscopy
Fetus
Collagen
Light
Membranes

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The development of the trabecular meshwork and its abnormality in primary infantile glaucoma. / Anderson, Douglas.

In: Transactions of the American Ophthalmological Society, Vol. 79, 01.12.1981, p. 458-485.

Research output: Contribution to journalArticle

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