Swelling and loss of photoreceptors in chronic human and experimental glaucomas

Arch Ophthalmol. 2000 Feb;118(2):235-45. doi: 10.1001/archopht.118.2.235.


Objective: To determine whether outer retinal changes occur in chronic, presumed primary open-angle glaucoma (POAG).

Methods: The outer retinas from 128 human eyes with a diagnosis of chronic glaucoma (presumably POAG in most cases) and 90 control eyes were examined histologically by 3 masked observers for photoreceptor swelling and loss. Retinas from 9 rhesus monkeys with glaucoma induced experimentally by laser trabecular destruction were compared with 7 fellow (control) eyes. The mean pressure elevations in the eyes with laser trabecular destruction ranged from 26.6 to 53.6 mm Hg with durations varying from 7 to 33 weeks.

Results: Swelling of the red- and green-sensitive cones was observed in a statistically significantly greater proportion of human eyes with presumed POAG compared with the control eyes. Patchy loss of red/green cones and rods was also found in some of the glaucomatous retinas. In a subset of the human eyes with end-stage disease, cone swelling was a variable finding. Although no photoreceptor loss was found in the 9 monkey eyes with experimental glaucoma, 8 had swelling of their red/green cones that was remarkably similar to that seen in the human eyes. Swelling was not present in any of the control monkey eyes.

Conclusions: The photoreceptors are affected by chronically elevated intraocular pressure.

Clinical relevance: These findings may explain some of the abnormalities of color vision and the electrophysiological effects that have been observed in patients with POAG.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Animals
  • Cell Death
  • Chronic Disease
  • Color Vision Defects / etiology
  • Disease Models, Animal
  • Edema / etiology*
  • Edema / pathology
  • Female
  • Glaucoma, Open-Angle / complications*
  • Humans
  • Intraocular Pressure
  • Macaca mulatta
  • Male
  • Photoreceptor Cells, Vertebrate / pathology*
  • Retinal Diseases / etiology*
  • Retinal Diseases / pathology
  • Retinal Ganglion Cells / pathology