TUNEL-POSITIVE GANGLION-CELLS IN HUMAN PRIMARY OPEN-ANGLE GLAUCOMA

Objective: To determine whether retinal ganglion cell death in primary open-angle glaucoma occurs by apoptosis. Methods: Eighteen eyes of 17 subjects with documented primary open-angle glaucoma were compared wi th 21 control eyes that were group matched for age, race, and sex. Sta ging of glaucoma severity was performed by histologic optic nerve eval uation. Fixed, paraffin-embedded retinal sections were assayed by the TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine tri phosphate (UTP)-biotin nick end-labeling) method to detect the internu cleosomal DNA fragmentation that is characteristic of apoptosis. Resul ts: A positive TUNEL reaction was observed among ganglion layer cells in 10 of 18 cases with glaucoma, compared with 1 of 11 control cases w ithout confounding systemic disease (5 control eyes were excluded owin g to artifactual staining and 4 eyes had confounding systemic disease) . Sections containing more than 250 000 cells in the ganglion cell lay er were examined in cases and controls. The frequency of TUNEL-positiv e cells in the ganglion cell layer in cases with glaucoma was 1.76 per 10 000, or 15.2 times greater than the control frequency from individ uals without confounding disease (P<.001;95% CI, 2.4-623). Eyes withou t glaucoma from subjects with diabetes and amyotrophic lateral scleros is showed more positive cells than other controls. Conclusion: Apoptos is seems to be a mechanism of cell death, in human eyes with primary o pen-angle glaucoma.