Few studies have evaluated correlations between corneal cell morphology and differing anterior chamber structures. Given the importance of anterior chamber indices in the assessment of ocular disorders and for therapeutic purposes, Greek researchers investigated potential relationships between the two. They found that corneal volume, mean anterior chamber angle and white-to-white distance were associated with the morphology of the corneal endothelium in healthy adults.

Associations between corneal and anterior chamber morphological parameters on anterior segment imaging in healthy individuals helps reveal potential threats of myopia on endothelial cells. Photo: Bhawan Minhas, OD. Click image to enlarge.

Greater pleomorphism and polymegethism of the endothelial cells was observed in healthy patients with wider mean anterior chamber angle. This has left the researchers to worry that deepening of the anterior chamber as myopia progresses could render the corneal endothelium more fragile and susceptible to mechanical stress. Their findings were published last week in Cornea.

Endothelial cell density (ECD), coefficient of variation and hexagonal cell appearance ratio were measured with specular microscopy in 136 participants. Central corneal thickness, anterior chamber depth, corneal depth, white-to-white distance and the angle width of 12 points were taken by the Pentacam HR Scheimpflug anterior segment imaging. The arithmetical mean of the 12 points was considered the mean anterior chamber angle.

According to the results, corneal volume, mean anterior chamber angle and white-to-white distance were associated with the morphology of the corneal endothelium in healthy adults. The researchers concluded that the corneal endothelial morphology is negatively correlated with the width of the mean anterior chamber angle. Even if ECD was not significantly correlated with the angle measurement, corneal polymegethism and pleomorphism was greater when it was wider.

“Myopic corneas may be more fragile and more susceptible to mechanical stress, but the exact mechanism by which myopia causes corneal endothelial morphology alterations needs to be further studied,” the researchers wrote in their paper. “The circulation of the aqueous humor can also differ in eyes with wider mean anterior chamber angle and greater white-to-white distance, which may result in a different flow in the anterior chamber affecting the distribution of oxygen in the anterior chamber and the corneal endothelium.”

The team also warned that increased awareness of the potential risk in endothelium could be needed when performing intraocular operations in such eyes.