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Cox RA, Read SA, Hopkins S, Alonso-Caneiro D, Wood JM. Optical Coherence Tomography-Derived Measurements of the Optic Nerve Head Structure of Aboriginal and Torres Strait Islander Children. J Glaucoma 2024; 33:101-109. [PMID: 37523634 DOI: 10.1097/ijg.0000000000002277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/16/2023] [Indexed: 08/02/2023]
Abstract
PRCIS This study demonstrated significant differences in optic nerve head characteristics in Aboriginal and Torres Strait Islander children compared with non-Indigenous children, which has implications for glaucoma risk and diagnosis in Aboriginal and Torres Strait Islander populations. PURPOSE The purpose of this study was to examine the optic nerve head (ONH) characteristics of visually normal Aboriginal and Torres Strait Islander children and non-Indigenous Australian children. MATERIALS AND METHODS Spectral domain optical coherence tomography imaging was performed on the right eye of 95 Aboriginal and Torres Strait Islander children and 149 non-Indigenous Australian children (5-18 years). Horizontal and vertical line scans, centered on the ONH, were analyzed to determine the dimensions of the ONH (Bruch membrane opening diameter), optic cup diameter, Bruch membrane opening minimum rim width, and the peripapillary retinal nerve fiber layer thickness. RESULTS The vertical but not horizontal Bruch membrane opening diameter of Aboriginal and Torres Strait Islander children was significantly larger than non-Indigenous children (mean difference: 0.09 mm, P = 0.001). The horizontal (mean difference: 0.12 mm, P = 0.003) and vertical cup diameter (mean difference: 0.16 mm, P < 0.001) were also significantly larger in Aboriginal and Torres Strait Islander children, as were the horizontal and vertical cup-to-disc ratios (both P < 0.01). Aboriginal and Torres Strait Islander children also had a significantly thinner Bruch membrane opening minimum rim width in the superior, nasal, and temporal meridians (all P < 0.001). Peripapillary retinal nerve fiber layer thickness did not differ between groups. CONCLUSIONS Differences exist in the ONH structure between Aboriginal and Torres Strait Islander children and non-Indigenous children, which may have implications for the detection and monitoring of ocular disease in this population and highlights the need to extend this research to the adult population.
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Affiliation(s)
- Rebecca A Cox
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
| | - Scott A Read
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
| | - Shelley Hopkins
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
| | - David Alonso-Caneiro
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
- School of Science Technology and Engineering, University of Sunshine Coast, Queensland, Australia
| | - Joanne M Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology (QUT), Kelvin Grove, Queensland, Australia
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Macedo M, Hatanaka M, Barboza WL, Mingione GM, Ambrósio R, Susanna R. The influence of topical anesthetic and fluorescein on non-contact tonometry measurements using ultra-high-speed dynamic Scheimpflug. Sci Rep 2023; 13:17864. [PMID: 37857798 PMCID: PMC10587345 DOI: 10.1038/s41598-023-45165-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/17/2023] [Indexed: 10/21/2023] Open
Abstract
This study aimed to investigate the effects of topical anesthetic and fluorescein drops on intraocular pressure (IOP), central corneal thickness (CCT) and biomechanical properties as measured by Corvis ST (CST-Oculus; Wezlar, Germany) in healthy eyes. A cross-sectional observational study was conducted on 46 healthy patients. The CST measurements were obtained before and immediately after the instillation of topical anesthetic and fluorescein drops. Pre-post instillation data were statistically analyzed. IOP measurements were compared to Goldmann's Applanation Tonometry (GAT), which was also performed after drops instillation. Biomechanical parameters analyzed included applanation 1 velocity, applanation 2 velocity, applanation 1 time, applanation 2 time, whole eye movement, deflection amplitude, and stiffness parameter at first applanation. A statistically significant difference in IOP, both for non-corrected IOP (IOPnct) and biomechanically corrected IOP (bIOP), was observed before and after the instillation of eyedrops. Despite this statistical significance, the observed difference lacked clinical relevance. The IOPnct demonstrated a significant difference pre and post-anesthetic and fluorescein instillation compared to GAT (14.99 ± 2.27 mmHg pre-instillation and 14.62 ± 2.50 mmHg post-instillation, versus 13.98 ± 2.04 mmHg, with p-values of 0.0014 and 0.0490, respectively). Comparable findings were noted when justaposing bIOP to GAT (14.53 ± 2.10 mmHg pre-instillation and 13.15 ± 2.25 mmHg post-instillation, against 13.98 ± 2.04 mmHg, with p-values of 0.0391 and 0.0022, respectively). Additionally, CCT measurements revealed a statistically significant elevation following the administration of topical anesthetic and fluorescein drops (from 544.64 ± 39.85 µm to 586.74 ± 41.71 µm, p < 0.01. None of the analyzed biomechanical parameters showed statistically significant differences after drops instillation. While the administration of topical anesthetic and fluorescein drops induced a statistically significant alteration in both IOPnct and bIOP readings, these changes were not clinically consequential. Furthermore, a notable statistical rise was observed in CCT measurements post-drops instillation, as determined by CST. Yet, corneal biomechanical parameters remained unaffected.
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Affiliation(s)
- Marcelo Macedo
- Department of Ophthalmology, University of São Paulo, São Paulo, Brazil.
| | - Marcelo Hatanaka
- Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
| | | | | | - Renato Ambrósio
- Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Remo Susanna
- Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
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Fieß A, Grabitz SD, Mildenberger E, Urschitz MS, Fauer A, Hampel U, Wasielica-Poslednik J, Zepp F, Pfeiffer N, Schuster AK. A lower birth weight percentile is associated with central corneal thickness thinning: Results from the Gutenberg Prematurity Eye Study (GPES). JOURNAL OF OPTOMETRY 2023; 16:143-150. [PMID: 36182657 PMCID: PMC10104790 DOI: 10.1016/j.optom.2022.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Prematurity, prenatal growth restriction, and retinopathy of prematurity (ROP) are associated with altered ocular geometry, such as a steeper corneal shape in childhood, but it is unclear whether perinatal history affects corneal thickness development, so this study investigated whether corneal thickness in adulthood is affected by perinatal history. MARTERIALS AND METHODS The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. The corneal thickness was measured by Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany), and the relationship between perinatal parameters respective birth weight percentile and corneal thickness at different locations was assessed using uni- and multivariable linear regression models. Covariates included age, sex, mean corneal radius, white-to-white distance, gestational age, birth weight percentile, ROP occurrence, and treatment. The main outcome measures were corneal thickness at the apex, the pupil center, and the corneal periphery. RESULTS The corneal thickness was measured in 390 participants (754 eyes, mean age 29.7+/-8.7 years, 224 females). In multivariable analyses, a lower birth weight percentile was associated with a lower corneal thickness at the apex (B = 0.20, p = 0.003) and the pupil (B = 0.19, p = 0.007). These effects diminished towards the corneal periphery and were not observed beyond the 4-mm diameter circle around the thinnest corneal position. Neither gestational age, ROP occurrence, or ROP treatment affected the corneal thickness. CONCLUSION A lower birth weight percentile in subjects born preterm as a proxy for restricted fetal growth is associated with corneal thickness thinning in adults aged 18 to 52 years, indicating that corneal thickness development, particularly in the corneal center, may originate in the fetal stage.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Stephanie D Grabitz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Agnes Fauer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ulrike Hampel
- Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany
| | - Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Brazuna R, Salomão M, Esporcatte B, Macedo M, Esporcatte L, Colombini GNUI, Ambrósio R. Corneal biomechanics and glaucoma beyond the bidirectional impact of intraocular pressure and corneal deformation response. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hoffmann EM, Aghayeva F, Wagner FM, Fiess A, Nagler M, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Lackner KJ, Pfeiffer N, Schuster AK. Intraocular Pressure and Its Relation to Ocular Geometry: Results From the Gutenberg Health Study. Invest Ophthalmol Vis Sci 2022; 63:40. [PMID: 35089330 PMCID: PMC8802016 DOI: 10.1167/iovs.63.1.40] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to investigate the association between intraocular pressure (IOP) and ocular geometry. Methods The Gutenberg Health Study is a population-based cohort study in Mainz, Germany. Study participants underwent a comprehensive ophthalmologic examination including noncontact tonometry, objective refraction, optical biometry, and Scheimpflug imaging of the anterior segment at the first 5-year follow-up examination (in 2012–2017). Multivariable linear regression analysis was carried out to determine associations of IOP and geometric parameter of the human phakic eye, namely central corneal thickness (CCT), corneal curvature, anterior chamber depth (ACD), lens thickness, and axial length. In addition, the relationship of IOP and the anterior chamber angle (ACA) width was analyzed. Results There were 6640 participants with phakia (age 57.3 ± 10.2 years, 49.1% women) that were included in this cross-sectional analysis. Mean IOP was 14.8 ± 2.9 mm Hg in the right eyes and 14.9 ± 2.9 mm Hg in the left eyes. IOP increased with higher CCT, greater posterior segment length, higher age (all P < 0.001), thicker lens (P = 0.003), and female sex (P = 0.05), whereas the ACD was not associated with higher IOP. The IOP increased with a narrower ACA in univariable analysis (P < 0.001), but not in adjusted analysis in subjects with an open angle. Conclusions IOP values are related to ocular geometry, as shown in this population-based study on Caucasian subjects. Thus, knowledge of the architecture of the eye is an important factor when measuring IOP. Longitudinal evaluation will analyze whether some of these parameters are also risk factors for the development of glaucoma.
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Affiliation(s)
- Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Fidan Aghayeva
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Felix M Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Achim Fiess
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Philipp S Wild
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany.,Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J Lackner
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Fieß A, Marx‐Groß S, Wasielica‐Poslednik J, Nagler M, Schmidtmann I, Wild PS, Münzel T, Beutel ME, Lackner KJ, Pfeiffer N, Schuster AK. Peripheral corneal thickness and associated factors - results from the population-based German Gutenberg Health Study. Acta Ophthalmol 2021; 100:e1298-e1305. [PMID: 34758104 DOI: 10.1111/aos.15057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/25/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE Changes in peripheral corneal thickness are described in various corneal diseases such as corneal ectasia. However, few data exist describing the increase in corneal thickness from central to peripheral and reporting the normal distribution of corneal thickness in rings around the corneal centre. The aim of this study was to report these cornea characteristics and investigate associated factors in a population-based setting. METHODS The Gutenberg Health Study is a prospective, population-based study examining participants in a 5-year follow-up (age range 40-80 years) using Scheimpflug imaging. Corneal thickness was assessed in each participant at the apex, as well as in the corneal centre (thinnest corneal thickness) and in rings with 2, 4, 6, 8 and 10 mm diameter around the corneal centre, and the increase in corneal thickness towards the periphery. The relationship between corneal thickness at these locations and possible associated factors was determined using linear regression models. For this purpose, general and ocular parameters were included. RESULTS A total of 9729 participants were included in the present analysis (4874 women, age 59.2 ± 10.8 years). Multivariable analysis showed a correlation between the increase in corneal thickness in the circles from 0 to 10 mm (diameter) and the following parameters: age (B = -0.24 µm per year, p < 0.001); body height (B = -0.04 µm, p = 0.005); smoking (B = -0.72 µm, p < 0.001); spherical equivalent (B = -0.70 µm per dioptre, p < 0.001); white-to-white distance (B = -0.75 µm/mm, p < 0.001); mean corneal radius (B = -3.61 µm/mm, p < 0.001); intraocular pressure (B = -0.12 µm/mmHg, p < 0.001); glaucoma (B = -1.94 µm, p < 0.001); and pseudophakia (B = 0.89 µm, p < 0.001). CONCLUSION The results of the present study suggest that several general and ocular parameters are associated with peripheral corneal thickness. In the context of diagnosing glaucoma, a smaller increase in corneal thickness towards the periphery might be a new additional marker.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Susanne Marx‐Groß
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Joanna Wasielica‐Poslednik
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine / Department of Cardiology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine / Department of Cardiology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
- Center for Thrombosis and Hemostasis (CTH) University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
- German Center for Cardiovascular Research (DZHK) partner site Rhine‐Main Mainz Germany
| | - Thomas Münzel
- German Center for Cardiovascular Research (DZHK) partner site Rhine‐Main Mainz Germany
- Department of Cardiology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Karl J. Lackner
- German Center for Cardiovascular Research (DZHK) partner site Rhine‐Main Mainz Germany
- Institute of Clinical Chemistry and Laboratory Medicine University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
| | - Alexander K. Schuster
- Department of Ophthalmology University Medical Center of the Johannes Gutenberg University Mainz Mainz Germany
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Association of Birth Weight with Central and Peripheral Corneal Thickness in Adulthood-Results from the Population-Based German Gutenberg Health Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111006. [PMID: 34828719 PMCID: PMC8625912 DOI: 10.3390/children8111006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 12/26/2022]
Abstract
Purpose: Low birth weight (BW) is associated with altered ocular geometry such as a steeper corneal shape in adulthood. However, it is unclear whether low birth weight affects corneal thickness development in the center or periphery in adulthood which may contribute to ocular disease. The purpose of this study was to investigate corneal thickness in former low birth weight individuals in adulthood. Methods: The German Gutenberg Health Study is a prospective, population-based study in which every participant (age range 40–80 years) was measured with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). BW was collected by self-reports. The relationship between birth weight and corneal thickness at different locations were assessed. Linear regression models were carried out including uni- and multivariable analyses with adjustment for age, sex, mean corneal radius, and white-to-white distance. Main outcome measures were corneal thickness at the apex, at the pupil center, and at the corneal periphery. Results: Overall, 5657 participants were successfully measured (3019 females, aged 56.0 ± 10.3 years). In multivariable analyses a lower BW was associated with a thinner corneal thickness at the apex (B = 1.71 µm/500 g, p < 0.001) and at the pupil (B = 1.69 µm/500 g, p < 0.001). These effects diminished towards the corneal periphery resulting in no differences in the perilimbal regions. Conclusion: The present study provides evidence that lower birth weight goes along with corneal thickness alterations even into adult ages of 40 to 80 years. Thinner measurements of the cornea were particularly found in the corneal center and diminished in the periphery. This indicates that there may be fetal origins affecting corneal thickness development particularly in the corneal center.
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Jiang JH, Pan XF, Lin Z, Moonasar N, Ye C, Zhang SD, Feng KM, Liang YB. Interocular Asymmetry of Visual Field Loss, Intraocular Pressure and Corneal Parameters in Primary Open-angle Glaucoma. Ophthalmic Res 2020; 64:857-862. [PMID: 32759608 DOI: 10.1159/000510716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/04/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the association between the corneal biomechanical parameters and visual field (VF) loss in patients with asymmetric primary open-angle glaucoma (POAG). METHODS A total of 89 POAG patients (50 males, 56.2%) with asymmetric VF loss, aged 65.2 ± 13.3 years old, were enrolled in this study. Asymmetric VF loss was defined as an interocular difference of the global index mean deviation (MD) >2dB. Intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters such as maximum amplitude at the apex of highest concavity (Def ampl HC) were measured. The worse eye was defined as the eye with a smaller MD. RESULTS The worse eyes had lower MD (-11.9 ± 6.7 dB vs. -5.3 ± 5.0 dB; P<0.001) and higher IOP (14.6 ± 3.3 vs.13.9 ± 2.6 mmHg, P=0.04) than the better eyes. There was no significant difference between the two groups for CCT. The interocular difference of MD (IDMD) was negatively correlated with the interocular difference of IOP (r=-0.22, P=0.04), while positively correlated with the interocular difference of Def ampl HC (r=0.27, P=0.01). In patients with moderate asymmetric VF loss (IDMD ≥6 dB), the Def ampl HC of the worse eyes group (1.07 ± 0.12 mm) were significantly lower than the better eyes group (1.10 ± 0.11 mm, p=0.02). CONCLUSION Asymmetric POAG was associated with asymmetry in IOP and corneal biomechanical parameters but not in CCT. Lower deflection amplitude and higher IOP was found in eyes with more severe visual field damage in POAG patients.
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Affiliation(s)
- Jun Hong Jiang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xia Fei Pan
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Zhong Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | | | - Cong Ye
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Shao Dan Zhang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Ke Mi Feng
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yuan Bo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
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Canan H, Sahinoglu-Keskek N, Altan-Yaycioglu R. The relationship of central corneal thickness with the status of diabetic retinopathy. BMC Ophthalmol 2020; 20:220. [PMID: 32513125 PMCID: PMC7278140 DOI: 10.1186/s12886-020-01411-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/30/2020] [Indexed: 12/03/2022] Open
Abstract
Background To compare central corneal thickness (CCT) values measured by three different devices: slit-scanning topography (SST), ultrasonic pachymetry (UP), and optical coherence tomography (OCT) in diabetic eyes and compare the CCT values in patients with and without diabetic retinopathy. Methods Ninety-six patients with diabetes mellitus were included in this prospective study and divided into two groups according to the presence of diabetic retinopathy, as Group I with retinopathy and Group II without. The CCT of 96 eyes was measured by three different devices; SST (Orbscan II), UP and OCT. The results of CCT measurements with three different devices were compared. Also, the intergroup differences in CCT measurements were evaluated. Results The CCT was statistically insignificantly different between the two groups. Although the three methods of CCT measurements correlated well with each other, SST showed significantly (p < 0,0001) higher CCT results compared to both UP and OCT. Conclusions According to our results, neither the duration of DM nor the presence of diabetic retinopathy did have a significant effect on the CCT. The CCT values obtained with three devices were all in correlation. However, the results of SST were significantly higher compared to the other two. Our findings emphasize the value anterior segment OCT in CCT measurements, since it is a non-contact method and correlate very well with UP.
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Affiliation(s)
- Handan Canan
- Department of Ophthalmology, Baskent University, School of Medicine, Dadaloğlu Mah, Serinevler, 01250, Adana, Turkey.
| | - Nedime Sahinoglu-Keskek
- Department of Ophthalmology, Baskent University, School of Medicine, Dadaloğlu Mah, Serinevler, 01250, Adana, Turkey
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Iglesias M, Yebra F, Kudsieh B, Laiseca A, Santos C, Nadal J, Barraquer R, Casaroli-Marano RP. New applanation tonometer for myopic patients after laser refractive surgery. Sci Rep 2020; 10:7053. [PMID: 32341434 PMCID: PMC7184562 DOI: 10.1038/s41598-020-64013-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/07/2020] [Indexed: 11/25/2022] Open
Abstract
This study assesses the agreement between intraocular pressure (IOP) measurements taken with the Goldmann applanation tonometer (GAT) and a new experimental applanation tonometer with a convexly shaped apex (CT) after laser myopic refractive surgery. Two different CT radii (CT1 and CT2) were designed with a finite element analyser, and a prospective double masked study on 102 eyes from 102 patients was carried out. A Bland-Altman plot and intra-class correlation coefficient (ICC) were calculated to assess the agreement between GAT measurements and the measurements of both CT1 and CT2 before and after myopic laser assisted in situ keratomileusis (LASIK; n = 73) and photorefractive keratectomy (PRK; n = 29). We evaluated a subset of two subgroups (n = 36 each) for intra and inter-observer (IA/IE) error. From the whole cohort, the best IOP agreement was observed between GATpre and CT1post surgery: 16.09 ± 2.92 vs 16.42 ± 2.87 (p < 0.001); ICC = 0.675 (95% CI: 0.554-0.768). In the analysis of LASIK vs PRK, GATpre and CT1post showed the highest agreement, although LASIK measurements were more accurate than PRK, as the ICC = 0.718 (95% CI: 0.594-0.812) and ICC = 0.578 (95% CI: 0.182-0.795) respectively. Excellent agreement was observed for IA/IE, and there was an ICC > 0.8 (95% CI) in all cases. CT1 proved more accurate in the LASIK subgroup. In conclusion, our new version of GAT could be used with post-surgery LASIK patients as a more accurate measurement device compared to the current reference tonometer.
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Affiliation(s)
- María Iglesias
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Barcelona, 08012, Spain.
| | - Francisco Yebra
- Department of Physics, University of Vigo, 36310, Galicia, Spain
| | - Bachar Kudsieh
- Department of Ophthalmology, Hospital Universitario Puerta De Hierro, 28222, Madrid, Spain
| | - Andrea Laiseca
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Barcelona, 08012, Spain
| | - Cristina Santos
- Unitat Antropologia Biològica, Department Biologia Animal, Biologia Vegetal i Ecologia, Universitat Autònoma de Barcelona (UAB), Barcelona, 08193, Spain
| | - Jeroni Nadal
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Barcelona, 08012, Spain
| | - Rafael Barraquer
- Instituto Universitario Barraquer, Barraquer Ophthalmology Centre, Barcelona, 08012, Spain
- International University of Catalunya (UIC), Barcelona, 08017, Spain
| | - Ricardo P Casaroli-Marano
- Department of Surgery, School of Medicine and Hospital Clinic de Barcelona, University of Barcelona (UB), Barcelona, 08036, Spain
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11
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Luo XY, Dai W, Chee ML, Tao Y, Chua J, Tan NYQ, Tham YC, Aung T, Wong TY, Cheng CY. Association of Diabetes With Central Corneal Thickness Among a Multiethnic Asian Population. JAMA Netw Open 2019; 2:e186647. [PMID: 30646192 PMCID: PMC6324536 DOI: 10.1001/jamanetworkopen.2018.6647] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
IMPORTANCE Thicker or thinner central corneas may lead to either overestimation or underestimation of intraocular pressure, which is the most important causal and treatable risk factor for glaucoma. However, the findings on the associations between diabetes, random glucose, and glycated hemoglobin A1c (HbA1c) with central corneal thickness (CCT) are conflicting. OBJECTIVE To evaluate the associations between diabetes, random glucose, and HbA1c with CCT in a multiethnic Asian population. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional analysis of the Singapore Epidemiology of Eye Diseases (SEED) Study conducted from 2004 to 2011. A total of 10 033 Chinese, Malay, and Indian individuals 40 years or older residing in Singapore were recruited. Participants with incomplete information on diabetes status (448 participants), prior refractive or cataract surgery (1940 eyes), and corneal edema or dystrophy (29 eyes) were excluded. A meta-analysis was conducted to estimate the overall association of diabetes with CCT. EXPOSURES Standardized clinical examinations and interviewer-administered questionnaire to collect information about demographic, systemic, and ocular factors. MAIN OUTCOMES AND MEASURES Measurement of CCT using ultrasound pachymetry. RESULTS A total of 8846 adults (mean [SD] age, 57.9 [9.9] years; 4447 women [50.3%]) (17 201 eyes) were included in the final analyses. The CCT profile was similar among participants with and without diabetes (mean [SD] CCT, 545.3 [33.7] μm vs 544.8 [33.9] μm; P = .39). Following adjustments of age, sex, ethnicity, corneal curvature, axial length, and body mass index, CCT was a mean (SD) of 4.9 (0.8) μm (95% CI, 3.3-6.5 μm) thicker in patients with diabetes than those without diabetes. Multivariable analyses also showed that thicker CCT was associated with higher random glucose (per 10 mg/dL [to convert to mmol/L, multiply by 0.0555], β = 0.3; 95% CI, 0.2-0.4) and higher HbA1c (per percentage, β = 1.5; 95% CI, 1.0-2.1) (all P < .001). These associations were significant in the subgroup with diabetes but not in the subgroup without diabetes. A meta-analysis including 12 previous population- and clinical-based studies showed that CCT was 12.8 μm (95% CI, 8.2-17.5 μm) thicker in eyes of patients with diabetes. CONCLUSIONS AND RELEVANCE These findings suggest that diabetes and hyperglycemia were associated with thicker CCT. This study provides useful information on the interpretation of intraocular pressure in patients with diabetes.
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Affiliation(s)
- Xiao-Yang Luo
- Guangdong Eye Institute, Guangdong Academy of Medical Sciences, Department of Ophthalmology, Guangdong General Hospital, Guangzhou, China
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Wei Dai
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Miao-Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Yijin Tao
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke–National University of Singapore Medical School, Singapore
| | - Nicholas Y. Q. Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke–National University of Singapore Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke–National University of Singapore Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke–National University of Singapore Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Mwanza JC, Tulenko SE, Barton K, Herndon LW, Mathenge E, Hall A, Kim HY, Hay-Smith G, Budenz DL. Eight-Year Incidence of Open-Angle Glaucoma in the Tema Eye Survey. Ophthalmology 2018; 126:372-380. [PMID: 30316889 DOI: 10.1016/j.ophtha.2018.10.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To determine the incidence of open-angle glaucoma (OAG) and its risk factors in the Tema Eye Survey in Ghana, West Africa. DESIGN Longitudinal, observational population-based study. PARTICIPANTS One thousand two hundred five of 1500 participants 40 years of age or older selected randomly from 5603 participants originally drawn from the population and who had undergone a baseline examination. METHODS All participants underwent baseline and follow-up ophthalmologic examinations 8 years apart. Glaucoma diagnosis was determined based on the International Society for Geographical and Epidemiologic Ophthalmology criteria. MAIN OUTCOME MEASURES Incidence and odds ratio (OR). RESULTS The response rate was 80.3%. Of 1101 nonglaucomatous participants at baseline who had complete follow-up data, 4.6% (95% confidence interval [CI], 3.7%-5.2%) demonstrated OAG over the 8-year period, or 0.58% (95% CI, 0.4%-0.8%) per year. The 8-year incidence increased with age from 3.1% in those 40 to 49 years old to 7.0% in those 60 to 69 years old. Baseline risk factors for incident OAG were male gender (OR, 2.1; 95% CI, 1.1-4.0; P = 0.025), older age relative to those 40 to 49 years old (those 50-50 years old: OR, 2.6; 95% CI, 1.2-5.7; those 60-69 years old: OR, 4.3; 95% CI, 2.0-8.8; and for those 70 years of age and older: OR, 6.3; 95% CI, 2.6-15.4; all P < 0.001), higher intraocular pressure (IOP; OR, 1.4; 95% CI, 1.1-1.8; P < 0.001), larger vertical cup-to-disc ratio (OR, 5.8; 95% CI, 5.2-6.6; P < 0.001), and thinner central cornea (OR, 1.2; 95% CI, 1.03-1.5; P = 0.013). A separate analysis performed with central corneal thickness-based IOP correction did not change the outcome of the associative model of incident glaucoma. CONCLUSIONS The incidence of OAG is higher in this population than reported in nonblack populations outside Africa. This is important not only in Ghana and probably other West African countries but also wherever people of the West African diaspora reside. These data enhance our understanding of the epidemiologic factors of OAG in this setting and may serve as reference for public health policy and planning.
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Affiliation(s)
- Jean-Claude Mwanza
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Samantha E Tulenko
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Keith Barton
- Moorfields Eye Hospital and Department of Epidemiology and Genetics, Institute of Ophthalmology, University College of London, London, United Kingdom
| | - Leon W Herndon
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | | | | | - Hanna Y Kim
- Department of Ophthalmology, Kaiser Permanente Woodland Hills Medical Center, Woodland Hills, California
| | | | - Donald L Budenz
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Mwanza JC, Tulenko SE, Budenz DL, Mathenge E, Herndon LH, Kim HY, Hall A, Hay-Smith G, Spratt A, Barton K. Longitudinal Change in Central Corneal Thickness in the Tema Eye Survey. Am J Ophthalmol 2018; 186:10-18. [PMID: 29141198 DOI: 10.1016/j.ajo.2017.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/01/2017] [Accepted: 11/05/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE To determine the change and rate of change in central corneal thickness (CCT) and their determinants. DESIGN Longitudinal observational population-based study. METHODS A total of 758 normal and 58 glaucomatous subjects underwent complete eye examination, with CCT measurements at 2 separate visits. Change and rate of change in CCT were determined. Univariate and multivariate linear regression analyses were performed to determine the factors associated with change and rate of change. RESULTS The mean follow-up duration was 8.4 ± 0.7 years. The overall change was -8.9 ± 16.7 μm in OD and -9.8 ± 16.2 μm in OS, both P < .0001. Changes in glaucomatous and normal subjects were -14.1 ± 2.2 μm vs -8.6 ± 0.6 μm in OD (P = .02) and -14.5 ± 2.2 μm vs -9.5 ± 0.6 μm in OS (P = .03), respectively. The overall rate of thinning was -1.1 μm/year (OD) and -1.2 μm/year (OS). Rates in glaucomatous and normal eyes were -1.7 ± 0.3 μm/year vs -1.0 ± 0.1 μm/year in OD (P = .02) and -1.7 ± 0.3 μm/year vs -1.1 ± 0.1 μm/year in OS (P = .03), respectively. Change and rate of change were associated with baseline CCT (ß = -0.1 to -0.09 and -0.011, respectively, all P < .001) and glaucoma (ß = -6.8 to -5.6, P ≤ .009, and -0.75 to -0.69, P ≤ .007, respectively). CONCLUSION CCT decreased significantly over time. The change and rate of change were greater in glaucomatous than normal eyes, and were greater than described in cross-sectional studies.
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Affiliation(s)
- Jean-Claude Mwanza
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Samantha E Tulenko
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Donald L Budenz
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | | | - Leon H Herndon
- Duke Eye Center, Duke University, Durham, North Carolina
| | - Hanna Y Kim
- Department of Ophthalmology, Kaiser Permanente Woodland Hills Medical Center, Woodland Hills, California
| | - Alyson Hall
- Department of Ophthalmology, The Glaucoma Center, Bowie, Maryland
| | | | | | - Keith Barton
- Moorefields Eye Hospital and Department of Epidemiology and Genetics, Institute of Ophthalmology, University College of London, London, United Kingdom
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Miglior S, Zeyen T, Hoffmann EM, Torri V, Rulli E, Floriani I, Poli D, Aliyeva S, Cunha-Vaz J, Pfeiffer N. Predictive value of heidelberg retina tomograph parameters for the development of glaucoma in the European glaucoma prevention study. Am J Ophthalmol 2015; 159:265-76.e1. [PMID: 25448996 DOI: 10.1016/j.ajo.2014.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 10/26/2014] [Accepted: 10/27/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine whether baseline Heidelberg Retina Tomograph (HRT) measurements of the optic disc are associated with the development of open-angle glaucoma (OAG) in individuals with ocular hypertension in the European Glaucoma Prevention Study (EGPS). DESIGN Retrospective analysis of a prospective, randomized, multicenter, double-masked, controlled clinical trial. METHODS There were 489 participants in the HRT Ancillary Study to the EGPS. Each baseline HRT parameter was assessed in univariate and multivariate proportional hazards models to determine its association with the development of OAG. Proportional hazards models were used to identify HRT variables that predicted which participants in the EGPS had developed OAG. Development of OAG was based on visual field and/or optic disc changes. RESULTS At a median follow-up time of about 5 years, 61 participants developed OAG. In multivariate analyses, adjusting for randomization arm, age, baseline IOP, central corneal thickness, pattern standard deviation, and HRT disc area, the following HRT parameters were associated with the development of OAG: the "outside normal limits" classification of the Frederick Mikelberg (FSM) discriminant function (hazard ratio [HR] 2.51, 95% confidence interval [CI]: 1.45-4.35), larger mean cup depth (HR 1.64, 95% CI: 1.21-2.23), cup-to-disc area ratio (HR 1.43, 95% CI: 1.14-1.80), linear cup-to-disc ratio (HR 1.43, 95% CI: 1.13-1.80), cup area (HR 1.33, 95% CI: 1.08-1.64), smaller rim area (HR 1.33, 95% CI: 1.07-1.64), larger cup volume (HR 1.30, 95% CI: 1.05-1.61), smaller rim volume (HR 1.25, 95% CI: 1.01-1.54), larger maximum cup depth (HR 1.18, 95% CI: 1.01-1.36), and cup shape measure (HR 1.18, 95% CI: 1.01-1.36). CONCLUSIONS Several baseline HRT parameters, alone or in combination with baseline clinical and demographic factors, were significantly associated with the development of OAG among the EGPS participants.
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Affiliation(s)
- Stefano Miglior
- Department of Ophthalmology, University of Milan Bicocca, Policlinico di Monza, Monza, Italy.
| | | | - Esther M Hoffmann
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Valter Torri
- IRCCS Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy
| | - Eliana Rulli
- IRCCS Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy
| | - Irene Floriani
- IRCCS Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy
| | - Davide Poli
- IRCCS Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy
| | - Shakhsanam Aliyeva
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - José Cunha-Vaz
- Department of Ophthalmology, Coimbra University Hospital, Coimbra, Portugal
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
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Zhao D, Cho J, Kim MH, Friedman DS, Guallar E. Diabetes, Fasting Glucose, and the Risk of Glaucoma. Ophthalmology 2015; 122:72-8. [DOI: 10.1016/j.ophtha.2014.07.051] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/16/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022] Open
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Galgauskas S, Juodkaite G, Tutkuvienė J. Age-related changes in central corneal thickness in normal eyes among the adult Lithuanian population. Clin Interv Aging 2014; 9:1145-51. [PMID: 25075183 PMCID: PMC4106961 DOI: 10.2147/cia.s61790] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The purpose of this study was to estimate mean central corneal thickness (CCT) and determine whether there are any correlations between CCT, age, and sex in the adult Lithuanian population. Methods A total of 1,650 Caucasians of Lithuanian origin (aged 18–89 years) comprising 688 (41.7%) men and 962 (58.3%) women were examined. Subjects were stratified by age into seven groups. CCT was measured using ultrasonic pachymetry. Correlations between CCT, age, and sex were sought. Results Mean (± standard deviation) CCT for both eyes was 544.6±30.5 μm. Mean CCT was 545.2±30.5 μm in the left eye and 544.6±30.5 μm in the right eye, and was 545.0±25.6 μm in men and 544.4±33.5 μm in women. Mean CCT was 550.8±35.7 μm in subjects aged 18–29 years, 557.5±27.6 μm in those aged 30–39 years, 551.3±31.4 μm in those aged 50–59 years, 544.0±31.4 μm in those aged 50–59 years, 544.2±31.6 μm in those aged 60–79 years, 535.1±27.8 μm in those aged 70–79 years, and 530.1±16.8 μm in those aged 80–89 years. No statistically significant difference in CCT was found between the sexes (P>0.05). However, there was a significant difference in subjects aged 18–29 years; men had higher CCT than women (P<0.05). A statistically significant negative correlation was found between CCT and age (r=-0.263, P<0.05) that was stronger in men (r=-0.406, P<0.05) than in women (r=-0.118, P<0.05). Conclusion The mean CCT in adult Lithuanians was 544.6±30.5 μm, of the left eye 545.2±30.5 μm and of the right – 544.6±30.5 μm. CCT of the right eye was equal to the CCT of both eyes. Mean CCT was 545.0±25.6 μm in men and 544.4±33.5 μm in women. Young men tended to have higher CCT than women. CCT decreases over the lifetime, meaning that older people have thinner corneas. CCT’s dependence on age is stronger in men.
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Affiliation(s)
- Saulius Galgauskas
- Center of Eye Diseases, Department of Anatomy, Histology and Anthropology, Vilnius University, Vilnius, Lithuania
| | - Grazina Juodkaite
- Center of Eye Diseases, Department of Anatomy, Histology and Anthropology, Vilnius University, Vilnius, Lithuania
| | - Janina Tutkuvienė
- Faculty of Medicine, Department of Anatomy, Histology and Anthropology, Vilnius University, Vilnius, Lithuania
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Cornea in PCOS patients as a possible target of IGF-1 action and insulin resistance. Arch Gynecol Obstet 2014; 290:1255-63. [PMID: 25022555 DOI: 10.1007/s00404-014-3353-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Accepted: 06/27/2014] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Previous studies suggest that serum IGF-1 is higher in women with polycystic ovary syndrome (PCOS). The ophthalmologic effects of IGF-1 excess have not yet been investigated in women with PCOS. The aim of the current study is to compare the corneal thickness of patients with PCOS and those of healthy subjects. METHODS Forty three patients with PCOS and 30 age-matched and gender-matched healthy individuals were enrolled in this cross-sectional study. Central corneal thickness (CCT) was measured in patients with PCOS and in healthy individuals with an ultrasound pachymeter. IGF-1 values were also determined in the study group. RESULTS Women with PCOS had significantly higher levels of IGF-1 and homeostasis model assessment (HOMA-IR) levels than the control group. Right and left CCT measurements were higher in the PCOS group than in the control group. A positive correlation between IGF-1 and right and left CCT was identified in both groups. In multiple linear stepwise regression analyses, IGF-1 independently and positively associated with HOMA-IR in women with PCOS. A correlation between total testosterone and CCT was identified in the whole group. In multiple stepwise regression analyses, total testosterone independently and positively associated with left central corneal thickness in the whole group. CONCLUSIONS These findings indicate that PCOS has target organ effects on the eye. Consequently, it can change central corneal thickness. Higher IGF-1 levels seem to be the main causes of increased corneal thickness. Insulin resistance in PCOS is one of the underlying causes and promotes increase in IGF-1. We suggest a careful and detailed corneal evaluation in PCOS patients to prevent the potential risk of increased CCT, in addition to the already-known complications.
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Correlations Between Central Corneal Thickness and General Anthropometric Characteristics and Cardiovascular Parameters in a Large European Cohort From the Gutenberg Health Study. Cornea 2014; 33:359-65. [DOI: 10.1097/ico.0000000000000068] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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High intraocular pressure is associated with cardiometabolic risk factors in South Korean men: Korean National Health and Nutrition Examination Survey, 2008-2010. Eye (Lond) 2014; 28:672-9. [PMID: 24603415 DOI: 10.1038/eye.2014.43] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 01/24/2014] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Elevated intraocular pressure (IOP) contributes to the progression of visual defects such as glaucoma. This study determined whether metabolic syndrome (MetS) and cardiovascular risk factors are associated with IOP in South Korean men. METHODS We analyzed data on 4875 men who participated in the Korean National Health and Nutrition Examination Survey 2008-2010. We recorded the values for age, weight, height, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), insulin, homeostasis model assessment of estimated insulin resistance (HOMA-IR), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), non-HDL-C (NHDL-C), and TG/HDL-C, as well as sociodemographic factors. IOP was measured using Goldmann applanation tonometry. RESULTS Weight, BMI, WC, SBP, DBP, FBG, insulin, HOMA-IR, TC, LDL-C, TG, NHDL-C, TG/HDL-C, and the prevalence of MetS differed significantly among the three groups with IOP (P<0.05). Mean IOP was higher in subjects who were obese and had hypertension, diabetes mellitus, MetS, abdominal obesity, high TG, high FBG, or high BP compared with normal subjects (P<0.005). Analysis using Pearson's correlation coefficient showed that all cardiometabolic risk factors were significantly associated with IOP (P<0.005), with the exception of WC and HDL-C. A multivariate linear regression analysis showed that IOP was positively correlated with BMI, SBP, DBP, FBG, HOMA-IR, TC, LDL-C, TG, NHDL-C, and TG/HDL-C after adjusting for all covariates (all P<0.05). CONCLUSIONS Cardiometabolic risk factors, including the components of MetS, are associated with increased IOP.
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Hoffmann EM, Miglior S, Zeyen T, Torri V, Rulli E, Aliyeva S, Floriani I, Cunha-Vaz J, Pfeiffer N. The Heidelberg retina tomograph ancillary study to the European glaucoma prevention study: study design and baseline factors. Acta Ophthalmol 2013; 91:e612-9. [PMID: 23710686 DOI: 10.1111/aos.12180] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the study design and baseline factors of the Heidelberg Retina Tomograph ancillary study within the EGPS. Furthermore, to examine the relationship between HRT optic disc topographic measurements and baseline demographic and ocular factors. METHODS Four hundred and eighty-nine ocular hypertensive participants were included. Each participant completed HRT imaging at least annually. The associations between HRT measurements and IOP, central corneal thickness (CCT), baseline photographic estimates of vertical CDR ratio (CDR), asymmetry between the two eyes in CDR ratio and baseline visual field indices were assessed using regression analysis. RESULTS Associations between HRT measurements and vertical CDR by photographs were found for almost all stereometric optic disc parameters in both univariate and multivariate analysis. The strongest association was found between vertical CDR measurements and disc, cup and rim area; cup and rim volume, CDR area, linear CDR, mean and maximum cup depth and cup shape measure (all p < 0.0001). In multivariate analysis, pattern standard deviation (PSD) and HRT disc area had significant associations with several HRT optic disc measurements. Furthermore, CCT was significantly associated with reference height and the glaucoma probability score (GPS, outside normal limits). CONCLUSIONS The EGPS is the first multicentre, placebo-controlled randomized clinical trial to use HRT for monitoring optic disc changes in participants with ocular hypertension. We found strong associations between stereophotographic vertical CDR estimates, HRT disc area, PSD and several HRT parameters. We found, furthermore, that the parameters reference height and GPS were significantly related to central corneal thickness.
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Affiliation(s)
- Esther M Hoffmann
- Department of Ophthalmology, University Medical Center Mainz, Mainz, GermanyDepartment of Ophthalmology, University of Milan, Monza, ItalyLeuven University Hospitals, Leuven, BelgiumInstitute Mario Negri, Milan, ItalyDepartment of Ophthalmology, Coimbra University Hospital, Coimbra, Portugal
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Hoffmann EM, Lamparter J, Mirshahi A, Elflein H, Hoehn R, Wolfram C, Lorenz K, Adler M, Wild PS, Schulz A, Mathes B, Blettner M, Pfeiffer N. Distribution of central corneal thickness and its association with ocular parameters in a large central European cohort: the Gutenberg health study. PLoS One 2013; 8:e66158. [PMID: 23936291 PMCID: PMC3731336 DOI: 10.1371/journal.pone.0066158] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 05/02/2013] [Indexed: 11/18/2022] Open
Abstract
Main objective To evaluate the distribution of central corneal thickness (CCT) in a large German cohort and to analyse its relationship with intraocular pressure and further ocular factors. Design Population-based, prospective, cohort study. Methods The Gutenberg Health Study (GHS) cohort included 4,698 eligible enrollees of 5,000 subjects (age range 35–74 years) who participated in the survey from 2007 to 2008. All participants underwent an ophthalmological examination including slitlamp biomicroscopy, intraocular pressure measurement, central corneal thickness measurement, fundus examination, and were given a questionnaire regarding glaucoma history. Furthermore, all subjects underwent fundus photography and visual field testing using frequency doubling perimetry. Results Mean CCT was 557.3±34.3 µm (male) and 551.6±35.2 µm in female subjects (Mean CCT from right and left eyes). Younger male participants (35–44 years) presented slightly thicker CCT than those older. We noted a significant CCT difference of 4 µm between right and left eyes, but a high correlation between eyes (Wilcoxon test for related samples: p<0.0001). Univariable linear regression stratified by gender showed that IOP was correlated with CCT (p<0.0001). A 10 µm increase in CCT led to an increase in IOP between 0.35–0.38 mm Hg, depending on the eye and gender. Multivariable linear regression analysis revealed correlations between gender, spherical equivalent (right eyes), and CCT (p<.0001 and p = 0.03, respectively). Conclusions We observed positive correlations between CCT and IOP and gender. CCT was not correlated with age, contact lens wear, positive family history for glaucoma, lens status, or iris colour.
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Affiliation(s)
- Esther M Hoffmann
- University Medical Centre, Department of Ophthalmology, Mainz, Germany.
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Abstract
PURPOSE Timolol is an effective and safe medication that is widely used in glaucoma treatment. Although it is known that it is quickly taken up by the cornea following topical administration and that the cornea exhibits -adrenergic receptors, there are few studies available on the clinical impact of timolol on central corneal thickness (CCT). METHODS Twenty healthy subjects were tested in a double-blind, prospective, and randomized study. Intraocular pressure (IOP) and CCT were measured before and during administration of timolol 0.5% eyedrops over 28 days. RESULTS Administration of timolol 0.5% resulted in a reduction of IOP from an initial value of 16 ± 2 mm Hg to 13 ± 0 mm Hg (p<0.001, R2 = 0.7033) as well as an increase in CCT from 555 ± 11 µm from the time of the baseline examination to 567 ± 9 µm (p = 0.005, R2 = 0.8754), an increase of epithelial thickness from 53 ± 2 µm to 59 ± 3 µm (p<0.001, R2 = 0.5063), and an increase of stromal thickness from 494 ± 4 µm to 498 ± 9 µm (p = 0.045, R2 = 0.4352) after 9 days each. From day 10 on, a decrease in CCT (R2 = 0.6164), epithelial thickness (R2 = 0.2216), and stromal thickness (R2 = 0.2092) was observed. At the end, the values had returned toward the initial values measured (CCT 553 ± 8 µm, p = 0.391; epithelial thickness, 50 ± 2 µm, p = 0.214; and stromal thickness, 493 ± 8 µm, p = 0.483). In contrast, endothelial thickness did not vary following administration of timolol 0.5% (p = 0.727, R2 = 0.009). CONCLUSIONS Topical administration of timolol 0.5% results in a reversible increase in CCT. These modest changes are unlikely to influence tonometry or clinical decision-making.
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Hagman J. Comparison of resource utilization in the treatment of open-angle glaucoma between two cities in Finland: is more better? Acta Ophthalmol 2013; 91 Thesis 3:1-47. [PMID: 23621767 DOI: 10.1111/aos.12141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Glaucoma is a progressive optic neuropathy associated with neural rim loss of the optic disc and the retinal nerve fibre layer typically causing visual field (VF) deterioration. Generally, glaucomatous lesions in the eye and in the visual field progress slowly over the years. In population-based cross-sectional studies, the percentage of unilateral or bilateral visual impairment varied between 3-12%. In screening studies, 0.03-2.4% of patients have been found to suffer visual impairment. Glaucoma has previously been associated with substantial healthcare costs and resource consumption attributable to the treatment of the disease. The disease also causes reduction in health-related quality of life (HRQoL) in patients with glaucoma. OBJECTIVE AND METHODS This study compares patients with diagnosed open-angle glaucoma from two geographically different regions in Finland. A total of 168 patients were examined, 85 subjects from an area with higher per patient treatment costs (Oulu) and 83 patients from a region with lower per patient treatment costs (Turku). All patients had a history of continuous glaucoma medication use for a period of 11 years. For each patient, the total direct costs from glaucoma treatment were calculated and the total amount of resource consumption was determined from registries and patient records. Each patient underwent a clinical examination with visual field assessment and fundus photography. These data were used to determine the current stage of disease for each patient. Health-related quality of life questionnaire (15D) was used in determining each patient's subjective HRQoL score. RESULTS When applying the current diagnostic criteria for open-angle glaucoma, a total of 40% of patients did not to display any structural or functional damage suggesting glaucoma after 11 years of continuous medical treatment and follow-up. Patients with higher glaucoma stage (worse disease) were found to have statistically higher treatment costs compared with those at lower disease stages. Resource consumption was also greater in the patients in higher glaucoma stage. Patients in the Oulu district consumed more resources, and glaucoma treatment was more expensive than in the Turku area. The total treatment cost in Oulu and Turku was 6010 € and 4452 €, respectively, for the whole 11-year period. There was no statistically significant difference in quality-of-life scores between the two areas. No difference was noted between the higher-spending and lower-spending areas in this respect. However, when the population was analysed as a whole, patients with higher glaucoma stage were found to have lower vision-based 15D scores compared with those at lower disease stages. This observation was made also at both districts independently. CONCLUSIONS Major cost source in open-angle glaucoma treatment is medication, up to 74% of annual costs. In addition, it seems that higher resource consumption and higher treatment costs do not increase the patients' HRQoL as assessed by the 15D instrument.
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Affiliation(s)
- Juha Hagman
- Department of Ophthalmology, Faculty of Medicine, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
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Investigation of the human anterior segment in normal Chinese subjects using a dual Scheimpflug analyzer. Ophthalmology 2012; 120:703-8. [PMID: 23260258 DOI: 10.1016/j.ophtha.2012.09.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 09/20/2012] [Accepted: 09/20/2012] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To investigate anterior segment parameters in normal Chinese subjects and study factors influencing these parameters, such as age, gender, and laterality. DESIGN A prospective observational case series. PARTICIPANTS A total of 291 normal subjects (582 eyes) were included. METHODS The anterior segment data were determined with a dual Scheimpflug analyzer. MAIN OUTCOME MEASURES The corneal thinnest-point thickness (CTPT), corneal thinnest-point distribution (CTPD), central corneal thickness (CCT), corneal thickness (CT) in the central 10 mm diameter, pupil diameter (PD), pupil center distribution (PCD), anterior chamber depth (ACD), and anterior chamber volume (ACV, 8-mm diameter) were measured. RESULTS The mean distance between the thinnest point and the corneal vertex was 0.70 ± 0.32 mm in the right eyes and 0.42 ± 0.25 mm in the left eyes; the thinnest point was located in the inferior temporal region in 71.1% of the right eyes and 55% of the left eyes. The CCT values were thicker than the CTPT values, and they were positively correlated (right eyes r = 0.994, P<0.001; left eyes r = 0.997, P<0.001). The distance between the pupillary center and the corneal vertex was approximately 0.39 ± 0.27 mm in the right eyes and 0.37 ± 0.24 mm in the left eyes. Furthermore, the percentage of pupillary centers located in the superior regions was 72.2% in the right eyes and 73.5% in the left eyes. Age was negatively correlated with the peripheral CT (7-10 mm diameter), PD, ACD, and ACV of both eyes and the mid-peripheral CT (4-7 mm diameter) of the right eye. Laterality correlated with CTPT (P<0.001) and PD (P<0.001), whereas gender correlated with ACD (P<0.001) and ACV (P = 0.009). CONCLUSIONS The majority of the thinnest corneal points were located in the inferior temporal quadrant, and the pupillary center was located in the superior region of the cornea; both differed substantially from the corneal vertex. The CT increased gradually from the center to the periphery. Age, gender, and laterality correlated with some indexes.
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Relationship of central corneal thickness to postural IOP changes in patients with and without glaucoma in southern India. Int Ophthalmol 2012; 32:307-11. [DOI: 10.1007/s10792-012-9522-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 01/16/2012] [Indexed: 11/25/2022]
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[Recommendations for follow-up examinations in patients with ocular hypertension]. Ophthalmologe 2011; 108:1016, 1018-22. [PMID: 22090088 DOI: 10.1007/s00347-011-2382-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Ocular hypertension (OHT) describes a condition with elevated intraocular pressure (IOP) above the norm ( > 21 mmHg). By definition the anterior chamber angle is open and there are neither signs of glaucomatous optic nerve damage nor visual field defects. Thus, for the diagnosis of OHT an extensive baseline examination is mandatory in order to rule out pre-existing glaucomatous damage. Patients with ocular hypertension are at a higher risk of developing glaucoma. Therefore, periodical routine examinations with a standardized protocol for specific follow-up examinations are highly recommended.
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Wang D, Huang W, Li Y, Zheng Y, Foster PJ, Congdon N, He M. Intraocular pressure, central corneal thickness, and glaucoma in chinese adults: the liwan eye study. Am J Ophthalmol 2011; 152:454-462.e1. [PMID: 21679915 DOI: 10.1016/j.ajo.2011.03.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2010] [Revised: 03/03/2011] [Accepted: 03/08/2011] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe the distribution of central corneal thickness (CCT), intraocular pressure (IOP), and their determinants and association with glaucoma in Chinese adults. DESIGN Population-based cross-sectional study. METHODS Chinese adults aged 50 years and older were identified using cluster random sampling in Liwan District, Guangzhou. CCT (both optical [OCCT] and ultrasound [UCCT]), intraocular pressure (by Tonopen, IOP), refractive error (by autorefractor, RE), radius of corneal curvature (RCC), axial length (AL), and body mass index (BMI) were measured, and history of hypertension and diabetes (DM) was collected by questionnaire. Right eye data were analyzed. RESULTS The mean values of OCCT, UCCT, and IOP were 512 ± 29.0 μm, 542 ± 31.4 μm, and 15.2 ± 3.1 mm Hg, respectively. In multiple regression models, CCT declined with age (P < .001) and increased with greater RCC (P < .001) and DM (P = .037). IOP was positively associated with greater CCT (P < .001), BMI (P < .001), and hypertension (P < .001). All 25 persons with open-angle glaucoma had IOP <21 mm Hg. CCT did not differ significantly between persons with and without open- or closed-angle glaucoma. Among 65 persons with ocular hypertension (IOP >97.5th percentile), CCT (555 ± 29 μm) was significantly (P = .01) higher than for normal persons. CONCLUSIONS The distributions of CCT and IOP in this study are similar to that for other Chinese populations, though IOP was lower than for European populations, possibly due to lower BMI and blood pressure. Glaucoma with IOP <21 mm Hg is common in this population. We found no association between glaucoma and CCT, though power (0.3) for this analysis was low.
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Affiliation(s)
- Dandan Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuetao Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yingfeng Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Paul J Foster
- National Biomedical Research Centre for Ophthalmology, Institute of Ophthalmology, University College London and Moorfields Eye Hospital, London, United Kingdom
| | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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Abstract
PURPOSE To evaluate the association of central corneal thickness (CCT) with diabetes mellitus and compare it with age and sex-matched healthy controls. MATERIALS AND METHODS This study included 245 eyes of 245 subjects (one eye per subject). One hundred diabetic patients constituted the study group and 145 were healthy controls. The study group was subdivided into 3 subgroups: subgroup 1 (no diabetic retinopathy), subgroup 2 (nonproliferative diabetic retinopathy), and subgroup 3 (proliferative diabetic retinopathy). CCT was determined with ultrasonic pachymeter. None of the patients had glaucoma, retinal laser treatment, and history of ocular surgery. Statistical analyses were performed by analysis of variance and Kruskall-Wallis tests. Correlation analysis was performed to assess the association between disease duration and glycosylated hemoglobin levels among subgroups. RESULTS Demographic characteristics of study and control groups were similar (P>0.05). The mean CCT was significantly greater in study group (564±30 μm) compared with control group (538±35 μm) (P=0.001). In addition, mean CCT was found to be greater in subgroup 3 (582±23 μm) compared with subgroups 1 (565±32 μm) and 2 (558±31 μm); but the difference did not reach statistical significance (P=0.056). Also, there was no significant correlation in respect to the level of glycosylated hemoglobin and disease duration among the subgroups. CONCLUSIONS We found that the central cornea of diabetic patients is thicker when compared with nondiabetic patients. Thicker central cornea associated with diabetes mellitus should be taken into consideration while obtaining accurate intraocular pressure measurements in diabetics.
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Wang D, Singh K, Weinreb R, Kempen J, He M, Lin S. Central corneal thickness and related factors in an elderly American Chinese population. Clin Exp Ophthalmol 2011; 39:412-20. [DOI: 10.1111/j.1442-9071.2010.02472.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yalvac IS, Kulacoglu DN, Satana B, Eksioglu U, Duman S. Correlation between optical coherence tomography results and the Scoring Tool for Assessing Risk (STAR) score in patients with ocular hypertension. Eur J Ophthalmol 2010; 20:1018-25. [PMID: 20544677 DOI: 10.1177/112067211002000623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To correlate retinal nerve fiber layer thickness (RNFL) and optic nerve head (ONH) parameters measured with optical coherence tomography (OCT) with the Scoring Tool for Assessing Risk (STAR) threshold in patients with ocular hypertension (OH). METHODS The study included 92 patients with OH. They were divided into low-risk (n=32), moderate-risk (n=36), and high-risk (n=24) groups according to STAR criteria. RNFL and ONH OCT protocols were used to evaluate all study participants. Major parameters for RNFL analysis were average RNFL thickness, superior quadrant, nasal quadrant, inferior quadrant, temporal quadrant, and segmental thickness per 12 o'clock hour position. ONH parameters were vertical integrated rim area (VIRA), horizontal integrated rim width (HIRW), disc diameter, disc area, cup area, rim area, cup-to-disc (C/D) area ratio, horizontal C/D ratio, and vertical C/D ratio. RESULTS The highest area under receiver operating characteristics curves for distinguishing the high-risk group from the other groups were vertical C/D ratio (0.88), C/D area (0.88), VIRA (0.87), and HIRW (0.81) for ONH parameters, and inferior (0.82) and 6 o'clock hour position (0.77) for peripapillary RNFL thickness measurements. CONCLUSIONS Inferior average, 6 o'clock hour position analyses for RNFL measurement, and VIRA, HIRW, C/D area, and vertical C/D ratio for ONH measurement were the best parameters for STAR staging in patients with OH.
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Affiliation(s)
- Ilgaz Sagdic Yalvac
- Ophthalmology Department, Medical School, Yeditepe University, Istanbul, Turkey.
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Abstract
OBJECTIVE To describe the ultrasonographically detected central corneal thickness (CCT) in patients with Type II and VI mucopolysaccharidosis (MPS) and its impact on applanation tonometry and glaucoma detection. METHODS Twenty-eight patients with MPS (19 MPS II, nine MPS VI) underwent pachymetric investigation of CCT. Additionally, ultrasound measurements of axial length of the globe, slit-lamp evaluation with semiquantitative grading of corneal clouding, applanation tonometry, and assessment of refractive error were performed. RESULTS Median average corneal thickness was 534.5 microm (range, 491.5-579.0 microm) in the MPS II and 547.0 microm (range, 492.5-693.05 microm) in the MPS VI group. CCT depended on degree of corneal clouding and patients' age, but did not correlate with intraocular pressure, refractive error, axial length, or MPS type. There were no substantial differences in refractive error between MPS II and MPS VI. CONCLUSION In our patients, CCT in MPS II and VI did not differ statistically significantly from age-related values found in healthy subjects. Thus, intraocular pressure readings detected by applanation tonometry in MPS II and VI in the majority of patients can be regarded as reliable. In the case of clinically marked corneal clouding, measurement of CCT is recommended to adequately assess intraocular pressure and possible coexistent glaucoma.
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Al-Mezaine HS, Al-Obeidan S, Kangave D, Sadaawy A, Wehaib TA, Al-Amro SA. The relationship between central corneal thickness and degree of myopia among Saudi adults. Int Ophthalmol 2008; 29:373-8. [PMID: 18587538 DOI: 10.1007/s10792-008-9249-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Accepted: 06/09/2008] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the relationship between central corneal thickness (CCT) and myopia among Saudi adults. METHODS In a prospective study, the CCT of 982 myopic eyes and 158 emmetropic eyes as a control group was measured using ultrasound pachymetry at the Eye Consultants Center, Riyadh, Saudi Arabia. RESULT The mean myopic spherical equivalent (SE) was -3.7 +/- 2.12 D, range -0.25 to -15.0 D.The mean CCT of the myopic group was 543.8 +/- 35.40 microm, while for the emmetropic group it was 545.7 +/- 27.6 microm. The difference in mean CCT between the two groups was statistically insignificant (P = 0.5). There was no correlation between CCT and the degree of myopic spherical equivalent (r = -0.014, P = 0.939). CONCLUSION This clinical study showed that there was no difference in CCT between emmetropic and myopic eyes. CCT did not correlate with the degree of myopia. It seems that the central cornea is not significantly involved in the process of myopic progression.
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Affiliation(s)
- Hani S Al-Mezaine
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh 11321, Kingdom of Saudi Arabia.
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Diabetes, Hyperglycemia, and Central Corneal Thickness. Ophthalmology 2008; 115:964-968.e1. [DOI: 10.1016/j.ophtha.2007.08.021] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 07/27/2007] [Accepted: 08/10/2007] [Indexed: 12/17/2022] Open
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Brandt JD, Gordon MO, Beiser JA, Lin SC, Alexander MY, Kass MA. Changes in central corneal thickness over time: the ocular hypertension treatment study. Ophthalmology 2008; 115:1550-6, 1556.e1. [PMID: 18378313 DOI: 10.1016/j.ophtha.2008.02.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 02/04/2008] [Accepted: 02/04/2008] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To describe how much change, if any, occurs between central corneal thickness (CCT) measurements performed an average of 3.8 years apart in participants in the Ocular Hypertension Treatment Study (OHTS) and to identify clinical and demographic factors that are associated with changes in CCT, including baseline intraocular pressure, duration and class of ocular hypotensive medication, medical history, and systemic medication. DESIGN Secondary analysis of data from a randomized clinical trial. PARTICIPANTS Ocular Hypertension Treatment Study participants. Participants who had undergone incisional intraocular or keratorefractive surgery between CCT measurements were excluded. TESTING The first CCT measurements were performed starting in 1999, and the second measurements were performed starting in 2002. Measurements were performed by OHTS certified technicians using an ultrasonic pachymeter under a standardized protocol. MAIN OUTCOME MEASURE Central corneal thickness measurement (micrometers). RESULTS First and second CCT measurements were available from 73% (1191) of the 1636 OHTS participants randomized. Central corneal thickness decreased a mean rate of -0.74+/-3.5 microm/year between the first and second CCT measurements. The mean medication exposure between first and second CCT measurements in participants originally randomized to observation (n = 595) was 1.1+/-1.6 years, versus 5.0+/-2.7 years in participants originally randomized to medication (n = 596). Central corneal thickness decreased by a mean of 1.0+/-3.4 microm/year among participants originally randomized to observation, compared with 0.5+/-3.5 microm/year among participants originally randomized to medication (P<0.0001). Subgroup analyses suggest that participants treated only with topical prostaglandin analogues (PGAs) between the two CCT measurements had a greater rate of decrease per year than participants treated only with topical beta-blockers. CONCLUSIONS The rate of CCT decrease over 3.8 years is comparable to the cross-sectional age differences reported in the OHTS at the first measurement (0.6 microm/year) and comparable to other cross-sectional studies. Use of topical PGAs may be associated with a slightly higher rate of thinning. The modest age- and drug-related rates of thinning observed are unlikely to influence tonometry or clinical decision-making substantially in most clinical situations.
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Affiliation(s)
- James D Brandt
- Department of Ophthalmology and Vision Science, University of California, Sacramento, California, USA
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Coste R, Cornand E, Denis D. Pachymétrie cornéenne centrale dans la population pédiatrique par microscopie spéculaire non-contact : à propos de 405 cas. J Fr Ophtalmol 2008; 31:273-8. [DOI: 10.1016/s0181-5512(08)74804-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Manni G, Oddone F, Parisi V, Tosto A, Centofanti M. Intraocular pressure and central corneal thickness. PROGRESS IN BRAIN RESEARCH 2008; 173:25-30. [PMID: 18929099 DOI: 10.1016/s0079-6123(08)01103-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
From the results of the Ocular Hypertension Treatment Study emerged the conclusion that ocular hypertensive subjects with thinner central corneal thickness (CCT) are at increased risk of developing glaucoma. Although possible underlying biases that could have led to this conclusion are still under investigation, there is an increasing interest in the scientific community to understand the potential mechanisms of this increased risk profile. It has been proposed that interindividual differences in CCT might be purely responsible for inaccuracies of the tonometric readings with potential underestimation of the true IOP in subjects with thinner CCT although it is becoming progressively clearer that the true IOP is unpredictable with linear correction formulas for CCT, and it is likely that other material properties of the cornea contribute, together with CCT, to the tonometric artifact. Recently, it has become possible to measure the biomechanical properties of the cornea in vivo and it has been suggested that differences in corneal biomechanics may be the expression of interindividual structural differences of the ocular tissues (including lamina cribrosa), with potential consequences on the interindividual susceptibility to the glaucomatous damage under the same IOP level. A possible underlying biological risk related to thinner CCTs, independent of the influence on tonometric reading, has been proposed and largely studied after the results of the OHTS were published. Besides the understanding of the mechanism underlying the role of CCT as a risk factor for the development of glaucoma, it is important to understand how the information about CCT should be integrated in the clinical management of both ocular hypertension (OHT) and glaucoma and whether other ocular properties should be measured to better understand the individual risk profile.
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Affiliation(s)
- Gianluca Manni
- Biopathology Department, University of Tor Vergata, Rome, Italy.
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Brandt JD. Central corneal thickness, tonometry, and glaucoma risk — a guide for the perplexed. Can J Ophthalmol 2007. [DOI: 10.3129/can.j.ophthalmol.i07-095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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