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Presence of peripapillary chorioretinal atrophy (PPA) is considered one of the risk factors for glaucoma. It can be identified as bright regions in retinal fundus images, and therefore, incorrectly included as the part of the optic disc regions in the automated disc detection scheme. For potential risk assessment and use in improving optic disc segmentation, a computerized detection of PPA was investigated. By using texture analysis, the sensitivity for detecting the moderate to severe PPA regions in the test dataset was 73% with the specificity of 95%. The proposed method may be useful for identifying the cases with the PPA in retinal fundus images.

Background: Three children, ranging in age from 2 to 6 months, had diffuse and homogeneously opaque corneas, clinically consistent with congenital hereditary endothelial dystrophy. Bilateral elevated intraocular pressure (IOP) was a feature in all three children., Methods: Initially, all patients underwent glaucoma surgery to reduce IOP. Subsequently, a penetrating keratoplasty was performed in one eye of each patient to clear the visual axis. The excised corneal button was examined by light microscopy and by transmission and scanning electron microscopy., Results: Postoperatively, all patients maintained clear corneal grafts. Results of histopathologic examination showed an absence of the endothelial cell layer in all patients. The presence of a variably thick collagenous layer posterior to the anterior banded zone of Descemet's membrane and the absence of endothelial cells were noted on transmission electron microscopy. Scanning electron microscopy confirmed absent, or scanty, and abnormal endothelial cells., Conclusion: The authors describe three patients with a clear association between congenital glaucoma and congenital hereditary endothelial dystrophy. This combination should be suspected where persistent and total corneal opacification fails to resolve after normalization of IOP.

A report is given of a case of a unilateral condition of this type in a 30-year-old woman, who was observed and repeatedly photographed for more as 7 years.

A family with posterior polymorphous corneal dystrophy is presented that includes a child with juvenile glaucoma. A review of the literature reveals an increased incidence of juvenile glaucoma associated with this dystrophy. It is of practical importance that the dystrophy be recognized and glaucoma be ruled out as the latter is asymptomatic in the infant.

Posteroir polymorphous dystrophy (PPMD) and Chandler's syndrome are separate ocular diseases with certain clinical features in common. Both may cause endothelial dystrophy, corneal edema, iridocorneal adhesions, and glaucoma. Differences between the two disorders include the morphology of the endothelial dystrophy, hereditary transmission, laterality, and rate of progression. Histopathologic examination of trabeculectomy and iridectomy specimens from two patients with Pmd and one patient with Chandler's syndrome disclosed a common basic pathologic process--endothelialization of the anterior chamber angle. Ectopic corneal endothelium and abnormal Descemet's membrane extended across the trabecular meshwork and onto the anterior surface of the iris. The appearance of the endothelial cells, however, was strikingly different in the two conditions. The endothelial cells in PPMD had ultrastructural characteristics of epithelial cells. Those in Chandler's syndrome were degenerated but retained ultrastructural features of endothelial cells.

Eleven cases of unilateral glaucoma are summarized. The typical presentations of these cases are (1) unilateral; (2) middle-aged women; (3) blurred vision; (4) corneal endothelial guttae (unilateral); (5) corneal edema; (6) stromal iris atrophy; (7) pupil abnormality; (8) peripheral anterior synechias;(9) elevated intraocular pressure; and (10) if previously diagnosed, the diagnosis is likely incorrect. Variations in these may occur. The disease can occur in men. Some patients may have nodular iris nevi. All of them represent the spectrum of Chandler's syndrome. Accurate diagnosis is important particularly in view of the optimistic prognostic implications for the fellow eye.