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

Lisa A. Kerrigan, Donald J. Zack, Harry A. Quigley, Scott D. Smith, Mary E. Pease

Research output: Contribution to journalArticlepeer-review

404 Scopus citations


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 internuleosomal DNA fragmentation that is characteristic of apoptosis. Result: 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.

Original languageEnglish (US)
Pages (from-to)1031-1035
Number of pages5
JournalArchives of ophthalmology
Issue number8
StatePublished - 1997

ASJC Scopus subject areas

  • Ophthalmology


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