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August 1997

TUNEL-Positive Ganglion Cells in Human Primary Open-angle Glaucoma

Author Affiliations

From the Department of Ophthalmology, Wilmer Eye Institute (Mss Kerrigan and Pease and Drs Zack, Quigley, and Smith), and the Departments of Molecular Biology and Genetics and Neuroscience (Dr Zack), The Johns Hopkins University School of Medicine, Baltimore, Md.

Arch Ophthalmol. 1997;115(8):1031-1035. 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.