Artikel
Morphological changes of the retrobulbar optic nerve and its meningeal sheaths in glaucoma
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Autoren
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M. Pache
- Augenklinik, Universitätsklinikum Freiburg; Universitäts-Augenklinik Basel, Schweiz
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P. Meyer
- Universitäts-Augenklinik Basel, Schweiz; Institut für Pathologie der Universitätsklinik Basel, Schweiz
| Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
To focuss on possible remodelling of the retrobulbar portion of the optic nerve and its meningeal sheaths.
Methods
The bulbar segment of the orbital optic nerve portion from 25 donors with glaucoma (M:F=8:17; mean age 85±11 years) and 28 controls (M:F=14:14; mean age 79±8 years) were formalin-fixed, paraffin-embedded and sectioned in series. Sections were stained with PAS and Masson trichrome and histopathological examined by two blinded observers. The following parameters were evaluated: 1. Diameter of the optic nerve, 2. Thickness of the pia mater, 3. Distance between dura mater and pia mater, 4. Occurrence and amount of meningothelial cell nests in the subarachnoidal space, 5. Presence and number of corpora arenacea.
Results
The mean diameter of the optic nerve was decreased in glaucoma (2.9 vs 3.4 mm; p<0.003), whereas thickness of the pia mater was increased (0.1 vs. 0.08 mm, p<0.02). Distance between dura mater and pia mater tended to be enlarged in glaucoma, this finding, however, was not significant (0.37 vs. 0.29 mm, p=0.3). Occurrence and amount of meningothelial cell nests was increased in glaucoma (p<0.02). Presence and number of corpora arenacea did not differ between the groups.
Conclusions
As expected, the diameter of the optic nerve was reduced in glaucomatous eyes, and thickness of the pia mater was consecutively increased. Corpora arenacea are concretions composed of calcium and magnesium salts. The degree of calcification was thought to be associated to various diseases of the CNS. However, more recent studies suggest that the presence of corpora arenacea does not reflect a specific pathological state. We could find no association between glaucoma and number of corpora arenacea. Our most interesting finding was that occurrence and amount of meningothelial cell nests was increased in glaucoma. They present a focal compact cell proliferation comparable with a reactive process. In how far this reaction is pathogenetically related to glaucoma is not yet clear.
