A Comparison of Corneal Endothelial Cell Density Between a Group of Black South Africans with Glaucoma and a Group of Black South African Healthy Controls

Abstract

Background: The endothelial layer of the cornea is crucial to corneal clarity and function and the cell density of this layer gradually decreases with age and due to disease processes. Primary open angle glaucoma, a subtype of glaucoma, has been shown to be associated with reduced corneal endothelial cell density in various populations. Methods: This cross-sectional, descriptive, observational study assessed the corneal endothelial density of a group of black South Africans with primary open angle glaucoma on topical medical management only and compared it to a control group from the same population. Results: 112 participants were included in the study with an equal number in each group. The baseline characteristics of the two groups were similar. Corneal endothelial cell density in cells per square millimetre was found to be significantly lower in the group of participants with primary open angle glaucoma compared to the group of control participants with healthy corneas – mean endothelial cell density overall was 2323 (SD 331, 95% CI 2261-2385) with the glaucoma group having a mean of 2213 (SD 365, 95% CI 2115-2311) and the control group having a mean of 2433 (SD 251, 95% CI 2365-2500). Conclusion: The corneal endothelial cell density of a group of black South Africans with primary open angle glaucoma only being managed with topical mediation was found to be significantly lower than a control group from the same population. The clinical significance of this difference is not certain.