TUNEL-positive ganglion cells in human primary open-angle glaucoma

Arch Ophthalmol. 1997 Aug;115(8):1031-5. doi: 10.1001/archopht.1997.01100160201010.


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 with 21 control eyes that were group matched for age, race, and sex. Staging of glaucoma severity was performed by histologic optic nerve evaluation. Fixed, paraffin-embedded retinal sections were assayed by the TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate (UTP)-biotin nick end-labeling) method to detect the internucleosomal DNA fragmentation that is characteristic of apoptosis.

Results: A positive TUNEL reaction was observed among ganglion layer cells in 10 of 18 cases with glaucoma, compared with 1 of 11 control cases without confounding systemic disease (5 control eyes were excluded owing to artifactual staining and 4 eyes had confounding systemic disease). Sections containing more than 250,000 cells in the ganglion cell layer were examined in cases and controls. The frequency of TUNEL-positive 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 individuals without confounding disease (P < .001; 95% CI, 2.46-623). Eyes without glaucoma from subjects with diabetes and amyotrophic lateral sclerosis showed more positive cells than other controls.

Conclusion: Apoptosis seems to be a mechanism of cell death in human eyes with primary open-angle glaucoma.

Publication types

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

MeSH terms

  • Aged
  • Apoptosis*
  • Cell Death
  • DNA / analysis
  • DNA Fragmentation
  • Female
  • Glaucoma, Open-Angle / pathology*
  • Humans
  • Male
  • Nucleotidyltransferases
  • Retina / pathology
  • Retinal Ganglion Cells / pathology*
  • Uridine Triphosphate


  • DNA
  • Nucleotidyltransferases
  • Uridine Triphosphate