The histologic differences in Schlemm's canal (SC) and trabecular meshwork (TM), obtained from the trabeculectomy specimens of different age-group glaucoma patients, were compared. This study involved 44 trabeculectomy specimens of 37 juvenile-onset open-angle glaucoma (JOAG) patients (Group A) and 24 trabeculectomy specimens of 24 elderly-onset primary OAG (POAG) patients (age range: 70–79 years, Group B) with no familial history of POAG. Clinical parameters of gender, maximum intraocular pressure (IOP), and the number of glaucoma medications used prior to trabeculectomy were investigated and compared between the two groups. From light microscopy photographs of hematoxylin-eosin, and immunohistochemical staining of markers for SC endothelium (SCE), the total SC length (TSC), comprised of the opened-SC length (OSC) and the closed-SC length (CSC), the percentage of CSC in TSC (%CSC), the percentage of positive SCE marker in CSC (%PinCSC), and the percentage of negative SCE marker in OSC (%NinOSC) were analyzed. Moreover, podoplanin staining patterns in the TM were investigated and compared between the two groups. Among the clinical parameters, the mean maximum IOP in Group A (33.41 ± 9.24 mmHg) was the only significant parameter when compared to that in Group B (22.96 ± 7.17 mmHg, P = 0.000003). TSC in Group A was significantly shorter than that in Group B (P = 0.00092), and %CSC (P = 0.00004) and %PinCSC (P = 0.00342) in Group B were significantly higher than those in Group A. No statistically significant difference in %NinOSC was found between Group A and Group B (P = 0.76060). Juxtacanalicular tissue (JCT) in Group A showed compact and weak staining with podoplanin, while the JCT and closed-SC area in Group B showed intense staining. In the Group A subjects, TSC (P = 0.04819) and OSC (P = 0.02867) were significantly shorter in the non-familial cases than in the familial cases. Platelet coagulations 10–37 μm in size at the defect of the SCE in the inner wall of the SC were observed in 8 eyes (18%) and 4 eyes (17%) in Group A and Group B, respectively. The platelets appeared to repair the SCE damage for maintaining the blood aqueous barrier in both groups of POAG eyes. Smaller SC diameters and accompanying TM abnormality were features observed in the young-onset JOAG patients, thus suggesting developmental abnormalities in the outflow routes. The collapse of SC lumen, presumably due to aging, was the feature observed in the elderly-onset POAG patients. In Group A, the significantly higher IOP, despite of no significant number of topical medications used prior to trabeculectomy, also suggested that JOAG eyes can be categorized as a distinct type of POAG from the eyes of elder-aged POAG patients. The SCE drop out observed in the glaucomatous eyes of the different age groups suggested that worsening of IOP control may possibly occur equally in both groups.

比较了从不同年龄组青光眼患者的小梁切除术标本中获得的施累姆氏管 (SC) 和小梁网 (TM) 的组织学差异。本研究涉及 37 名青少年开角型青光眼 (JOAG) 患者 (A 组) 的 44 个小梁切除术标本和 24 名老年原发性 OAG (POAG) 患者 (年龄范围：70-79 岁，B 组) 的 24 个小梁切除术标本无 POAG 家族史。调查并比较两组的性别、最大眼内压 (IOP) 和小梁切除术前使用的青光眼药物数量的临床参数。从苏木精-伊红的光学显微镜照片和 SC 内皮标记物 (SCE) 的免疫组织化学染色，总 SC 长度 (TSC)，由开放 SC 长度 (OSC) 和闭合 SC 长度 (CSC)、TSC 中 CSC 的百分比 (%CSC)、CSC 中正 SCE 标记的百分比 (%PinCSC) 和负 SCE 的百分比组成分析了 OSC (%NinOSC) 中的标记物。此外，研究并比较了两组之间的 TM 中的 podoplanin 染色模式。在临床参数中，A组的平均最大眼压（33.41±9.24 mmHg）是与B组（22.96±7.17 mmHg，P  = 0.000003）。A组TSC明显短于B组（P  =0.00092），B组%CSC（P  =0.00004）和%PinCSC（P  =0.00342）均显着高于A组，差异无统计学意义在 %NinOSC 中发现 A 组和 B 组之间（P  = 0.76060）。A组近小管组织（JCT）呈致密且弱的podoplanin染色，而B组的JCT和闭合SC区呈强染色。在 A 组受试者中，TSC ( P  = 0.04819) 和 OSC ( P = 0.02867) 在非家族性病例中明显短于家族性病例。在 A 组和 B 组中分别在 8 只眼（18%）和 4 只眼（17%）中观察到 SC 内壁 SCE 缺损处大小为 10-37 μm 的血小板凝固。血小板似乎修复了 SCE 损伤，以维持两组 POAG 眼中的血水屏障。较小的 SC 直径和伴随的 TM 异常是在年轻发病的 JOAG 患者中观察到的特征，因此表明流出路线的发育异常。SC 管腔的塌陷，可能是由于衰老，是在老年 POAG 患者中观察到的特征。在 A 组中，尽管在小梁切除术前没有使用大量局部药物，但眼压明显较高，还建议 JOAG 眼可归类为与老年 POAG 患者眼睛不同的 POAG 类型。在不同年龄组的青光眼中观察到的 SCE 下降表明，IOP 控制的恶化可能在两组中同样发生。