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Effect of Hypercholesterolemia, Systemic Arterial Hypertension and Diabetes Mellitus on Peripapillary and Macular Vessel Density on Superficial Vascular Plexus in Glaucoma. J Clin Med 2023; 12:jcm12052071. [PMID: 36902860 PMCID: PMC10004387 DOI: 10.3390/jcm12052071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND/AIMS Vascular factors are involved in the development of glaucoma, including diseases such as hypercholesterolemia (HC), systemic arterial hypertension (SAH), and diabetes mellitus (DM). The aim of this study was to determine the effect of glaucoma disease on peripapillary vessel density (sPVD) and macular vessel density (sMVD) on the superficial vascular plexus, controlling differences on comorbidities such as SAH, DM and HC between glaucoma patients and normal subjects. METHODS In this prospective, unicenter, observational cross-sectional study, sPVD and sMVD were measured in 155 glaucoma patients and 162 normal subjects. Differences between normal subjects and glaucoma patients' groups were analyzed. A linear regression model with 95% confidence and 80% statistical power was performed. RESULTS Parameters with greater effect on sPVD were glaucoma diagnosis, gender, pseudophakia and DM. Glaucoma patients had a sPVD 1.2% lower than healthy subjects (Beta slope 1.228; 95%CI 0.798-1.659, p < 0.0001). Women presented 1.19% more sPVD than men (Beta slope 1.190; 95%CI 0.750-1.631, p < 0.0001), and phakic patients presented 1.7% more sPVD than men (Beta slope 1.795; 95%CI 1.311-2.280, p < 0.0001). Furthermore, DM patients had 0.9% lower sPVD than non-diabetic patients (Beta slope 0.925; 95%CI 0.293-1.558, p = 0.004). SAH and HC did not affect most of the sPVD parameters. Patients with SAH and HC showed 1.5% lower sMVD in the outer circle than subjects without those comorbidities (Beta slope 1.513; 95%CI 0.216-2.858, p = 0.021 and 1.549; 95%CI 0.240-2.858, p = 0.022 respectively. CONCLUSIONS Glaucoma diagnosis, previous cataract surgery, age and gender seem to have greater influence than the presence of SAH, DM and HC on sPVD and sMVD, particularly sPVD.
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Omodaka K, Kikawa T, Kabakura S, Himori N, Tsuda S, Ninomiya T, Takahashi N, Pak K, Takeda N, Akiba M, Nakazawa T. Clinical characteristics of glaucoma patients with various risk factors. BMC Ophthalmol 2022; 22:373. [PMID: 36123604 PMCID: PMC9484257 DOI: 10.1186/s12886-022-02587-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Abstract
Background Glaucoma is multifactorial, but the interrelationship between risk factors and structural changes remains unclear. Here, we adjusted for confounding factors in glaucoma patients with differing risk factors, and compared differences in structure and susceptible areas in the optic disc and macula. Methods In 458 eyes with glaucoma, we determined confounding factors for intraocular pressure (IOP), central corneal thickness (CCT), axial length (AL), LSFG-measured ocular blood flow (OBF), which was assessed with laser speckle flowgraphy-measured mean blur rate in the tissue area (MT) of the optic nerve head, biological antioxidant potential (BAP), and systemic abnormalities in diastolic blood pressure (dBP). To compensate for measurement bias, we also analyzed corrected IOP (cIOP; corrected for CCT) and corrected MT (cMT; corrected for age, weighted retinal ganglion cell count, and AL). Then, we determined the distribution of these parameters in low-, middle-, and high-value subgroups and compared them with the Kruskal–Wallis test. Pairwise comparisons used the Steel–Dwass test. Results The high-cIOP subgroup had significantly worse mean deviation (MD), temporal, superior, and inferior loss of circumpapillary retinal nerve fiber layer thickness (cpRNFLT), and large cupping. The low-CCT subgroup had temporal cpRNFLT loss; the high-CCT subgroup had low cup volume. The high-AL subgroup had macular ganglion cell complex thickness (GCCT) loss; the low-AL subgroup had temporal cpRNFLT loss. The high-systemic-dBP subgroup had worse MD, total, superior, and inferior cpRNFLT loss and macular GCCT loss. The low-BAP subgroup had more male patients, higher dBP, and cpRNFLT loss in the 10 o’clock area. The high-OBF subgroup had higher total, superior and temporal cpRNFLT and macular GCCT. Conclusions Structural changes and local susceptibility to glaucomatous damage show unique variations in patients with different risk factors, which might suggest that specific risk factors induce specific types of pathogenesis and corresponding glaucoma phenotypes. Our study may open new avenues for the development of precision medicine for glaucoma.
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Affiliation(s)
- Kazuko Omodaka
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Ophthalmic Imaging and Information Analytics, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | | | - Sayaka Kabakura
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Noriko Himori
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Aging Vision Healthcare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Takahiro Ninomiya
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Naoki Takahashi
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | | | - Masahiro Akiba
- R and D Division, Topcon Corporation, Tokyo, Japan.,Cloud-Based Eye Disease Diagnosis Joint Research Team, Riken, Wako, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University, Graduate School of Medicine, Sendai, Japan. .,Department of Ophthalmic Imaging and Information Analytics, Tohoku University, Graduate School of Medicine, Sendai, Japan.
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3
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Funk RO, Hodge DO, Kohli D, Roddy GW. Multiple Systemic Vascular Risk Factors Are Associated With Low-Tension Glaucoma. J Glaucoma 2022; 31:15-22. [PMID: 34731871 PMCID: PMC9337264 DOI: 10.1097/ijg.0000000000001964] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022]
Abstract
PRCIS Multiple systemic vascular-associated conditions including systemic hypertension and hypotension, diabetes mellitus, migraine headache, peripheral vascular disease, Raynaud syndrome, and anemia were associated with low-tension glaucoma. PURPOSE The purpose of this study was to identify systemic risk factors associated with low-tension glaucoma. PATIENTS AND METHODS A retrospective case-control study design was employed to identify patients seen at the Mayo Clinic Department of Ophthalmology between 2005 and 2015 with low-tension glaucoma and an age-matched and sex-matched control group, each containing 277 patients. RESULTS The low-tension glaucoma group had more myopic refractive errors (-1.6 vs. -1.0 D, P<0.001), lower intraocular pressure (14.2 vs. 15.2 mm Hg, P<0.001), and a higher cup-to-disc ratio (0.7 vs. 0.3, P<0.001). The low-tension glaucoma group was significantly less likely to be obese (body mass index >30, P=0.03). This group had a significantly higher prevalence of systemic hypertension [odds ratio (OR): 1.64, P=0.004], diabetes mellitus (OR: 3.01, P<0.001), peripheral vascular disease (OR: 2.61, P=0.009), migraine headache (OR: 2.12, P=0.02), anemia (OR: 2.18, P=0.003), systemic hypotension (OR: 4.43, P<0.001), Raynaud syndrome (OR: 3.09, P=0.05), and angiotensin-converting enzyme inhibitor (OR: 1.64, P=0.01) or calcium channel blocker use (OR: 1.98, P=0.004). After adjusting for systemic hypertension, calcium channel blocker use remained significant (OR: 1.70, P=0.03). No significant difference was found between groups with respect to hyperlipidemia, obstructive sleep apnea, coronary artery disease, carotid stenosis, stroke, or statin, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, beta-blocker, or metformin use. CONCLUSIONS Multiple vascular-associated conditions were associated with low-tension glaucoma including systemic hypertension, diabetes mellitus, peripheral vascular disease, migraine headache, Raynaud syndrome, anemia, systemic hypotension, and calcium channel blocker use. This study strengthens the evidence for the vascular hypothesis of low-tension glaucoma.
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Affiliation(s)
| | - David O. Hodge
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL
| | - Darrell Kohli
- Department of Ophthalmology, Mayo Clinic, Rochester, MN
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4
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Fortepiani L, Foutch BK, Wilson MR. The Effects of Sex, Oral Contraception, and Menstrual Cycle Phase on Intraocular Pressure, Central Corneal Thickness, and Foveal Thickness: A Descriptive Analysis. Vision (Basel) 2021; 5:vision5040048. [PMID: 34698316 PMCID: PMC8544721 DOI: 10.3390/vision5040048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/03/2023] Open
Abstract
The primary goal of this study was to investigate the effects of sex, oral contraceptive (OC) use, and menstrual cycle phase on common ocular parameters assessed during ophthalmic evaluations, namely intraocular pressure (IOP), central corneal thickness (CCT), and foveal thickness (FT), in young healthy adults. We measured IOP, CCT, and FT in 60 participants (16 men, 16 contraceptive users, and 28 cycling women) over two sessions that characterized the menstrual cycle phase in women. For men in our study, two sessions were separated by two weeks. For women, the two sessions were scheduled during the follicular and luteal phases of the menstrual cycle. There was a trend towards higher IOP in men, and the difference was significant for white, non-Hispanic subjects and for white subjects considered separately. There was also a trend for thicker corneas in women, but men had significantly thicker foveae. CCT and FT were not different between men and OC-users, hinting at a moderating hormonal effect of oral contraceptive use. We found that IOP, CCT, and FT were equivalent between the follicular and luteal phases, which may be owing to the timing of our sessions. However, our findings strongly suggest that clinicians should consider contraceptive use during routine ophthalmic evaluations, as it could inform glaucomatous risk in women.
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Affiliation(s)
- Lourdes Fortepiani
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA; (L.F.); (M.R.W.)
- Department of Cellular and Integrative Physiology, UT Health San Antonio, San Antonio, TX 78229, USA
| | - Brian K. Foutch
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA; (L.F.); (M.R.W.)
- Correspondence: or ; Tel.: +1-210-930-8162
| | - Molly R. Wilson
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, TX 78229, USA; (L.F.); (M.R.W.)
- Omni Vision, San Antonio, TX 78245, USA
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5
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Ong APC, Zhang J, Vincent AL, McGhee CNJ. Megalocornea, anterior megalophthalmos, keratoglobus and associated anterior segment disorders: A review. Clin Exp Ophthalmol 2021; 49:477-497. [PMID: 34114333 DOI: 10.1111/ceo.13958] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 01/21/2023]
Abstract
Megalocornea and anterior megalophthalmos (megalocornea spectrum) disorders are typically defined by corneal diameter > 12.5 mm in the absence of elevated intraocular pressure. Clinical features overlap with keratoglobus but are distinct from buphthalmos and severe (globus) keratoconus. Megalocornea spectrum disorders and keratoglobus are primarily congenital disorders, often with syndromic associations; both can present with large and thin corneas, creating difficulty in diagnosis, however, only keratoglobus is typically progressive. Molecular genetics provide significant insight into underlying aetiologies. Nonetheless, careful clinical assessment remains intrinsic to diagnosis. Surgical management can be challenging due to the enlarged ciliary ring and weakened zonules in megalocornea spectrum disorders and the extreme corneal thinning of keratoglobus. In this review, the established literature on measurement of corneal diameter, diagnosis of megalocornea, anterior megalophthalmos and keratoglobus, differentiation from severe keratoconus, recent molecular genetics research and key surgical modalities in the management of these rare disorders are outlined and discussed.
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Affiliation(s)
- Aaron P C Ong
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Ophthalmology, Southern District Health Board, Dunedin, New Zealand
| | - Jie Zhang
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Andrea L Vincent
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Charles N J McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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6
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Park SW, Kim JM, Lee JW, Maglambayan J, Simonyi S, Park KH. Efficacy and safety of fixed-combination brimonidine tartrate/timolol maleate in primary open-angle glaucoma, including normal-tension glaucoma. Jpn J Ophthalmol 2021; 65:295-305. [PMID: 33591471 DOI: 10.1007/s10384-020-00796-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/23/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess the 12-month efficacy and safety of fixed-combination brimonidine tartrate 0.2%/timolol maleate 0.5% (FCBT) with or without bimatoprost 0.01% (BIM) in primary open-angle glaucoma (POAG), including normal-tension glaucoma (NTG). STUDY DESIGN Prospective, multicenter, open-label study. METHODS FCBT was self-administered twice daily after applicable washout (study eye). Intraocular pressure (IOP) was measured at baseline and months 1, 3, 6, 9, and 12. BIM could be added for IOP ≥ 21 mmHg, IOP reduction from baseline < 20%, or the investigator deemed it necessary. Primary endpoint: mean (11-a.m.) month-12 IOP change from baseline. Secondary endpoints included mean IOP changes from baseline at other visits, median time to achieving and patients (%) achieving target IOP reduction with FCBT, and visual field (VF) progression rate over 12 months. Safety was assessed at each visit. RESULTS Of 118 eyes with POAG (NTG, n = 93), 87 used FCBT; 31 required FCBT + BIM. Mean IOP changes from baseline (16.8 and 15.3 mmHg) to month 12 were - 4.1 mmHg (FCBT, n = 62) and - 3.5 mmHg (FCBT + BIM, n = 15), respectively (both P < 0.0001). Patients who achieved target IOP reduction with FCBT did so in 1 month (median). VF progression rates were 0.17%/year (FCBT, P = 0.8367) and - 0.08%/year (FCBT + BIM, P = 0.9410). Ocular treatment-emergent adverse events occurred in 42.5% (FCBT) and 71.0% (FCBT + BIM) of patients; most were mild and included ocular hyperemia (9.2% and 41.9%, respectively). CONCLUSIONS Despite low mean baseline IOP, ≥ 20% IOP reduction from baseline persisted over 12 months with FCBT and FCBT + BIM, without clinically significant VF progression. Tolerability was consistent with reported drug safety profiles.
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Affiliation(s)
- Sang Woo Park
- Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Woong Lee
- Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Joy Maglambayan
- Medical Affairs, Allergan (an AbbVie company), Singapore, Singapore
| | - Susan Simonyi
- Medical Affairs, Allergan (an AbbVie company), Singapore, Singapore
| | - Ki Ho Park
- Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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7
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Gedde SJ, Vinod K, Wright MM, Muir KW, Lind JT, Chen PP, Li T, Mansberger SL. Primary Open-Angle Glaucoma Preferred Practice Pattern®. Ophthalmology 2021; 128:P71-P150. [DOI: 10.1016/j.ophtha.2020.10.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 12/17/2022] Open
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8
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Gedde SJ, Lind JT, Wright MM, Chen PP, Muir KW, Vinod K, Li T, Mansberger SL. Primary Open-Angle Glaucoma Suspect Preferred Practice Pattern®. Ophthalmology 2021; 128:P151-P192. [DOI: 10.1016/j.ophtha.2020.10.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022] Open
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9
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Ho WC, Lam PTH, Chiu TYH, Yim MCM, Lau FTC. Comparison of central corneal thickness measurement by scanning slit topography, infrared, and ultrasound pachymetry in normal and post-LASIK eyes. Int Ophthalmol 2020; 40:2913-2921. [PMID: 32617805 DOI: 10.1007/s10792-020-01475-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/20/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To compare central corneal thickness (CCT) measurements by scanning slit topography (SST), infrared pachymetry (IRP), and ultrasound pachymetry (USP), and their agreement in normal and post-laser in situ keratomileusis (LASIK) eyes. METHODS Sixty normal and 35 post-LASIK subjects were recruited. Only one eye from each subject was analyzed. Non-contact pachymetry was performed first, and the order for SST (Orbscan IIz) and IRP (Tonoref III) was randomized for each patient, to be followed by contact USP (Echoscan US-4000). Pearson's correlation, paired t test, and Bland-Altman plots were used to investigate association, difference, and agreement among different instruments respectively. RESULTS The measurements obtained with the instruments were highly correlated. Compared to CCT determined by USP (CCTUSP), CCT determined by SST (after correction with acoustic factor) (CCTSSTC) was thicker by 7 µm in normal eyes (P < 0.001). There was no significant difference between CCTSSTC and CCTUSP (P = 0.128), but a thickness-dependent deviation in post-LASIK eyes (P = 0.003). The CCT determined by IRP (CCTIRP) was thicker than CCTUSP in normal (P < 0.001) and post-LASIK eyes (P < 0.001) and demonstrated proportional overestimation with thinner corneas, with less predictable ultrasonic equivalent corneal thickness in normal eyes. Conversely, CCTIRP significantly underestimated CCT compared to CCTSST and showed increasing underestimation with thinner corneas in both normal and post-LASIK eyes (both P < 0.001). CONCLUSION Central corneal thickness determined by SST, IRP and USP were not interchangeable or interconvertible, probably attributed to difference in methodologies. Compensation with algorithms may improve agreements amongst instruments.
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Affiliation(s)
- Wing-Cheung Ho
- Eye Centre, Hong Kong Baptist Hospital, 222 Waterloo Road, Kowloon Tong, Hong Kong, People's Republic of China
| | - Philip Tsze-Ho Lam
- Eye Centre, Hong Kong Baptist Hospital, 222 Waterloo Road, Kowloon Tong, Hong Kong, People's Republic of China.
| | - Thomas Yee-Hang Chiu
- Eye Centre, Hong Kong Baptist Hospital, 222 Waterloo Road, Kowloon Tong, Hong Kong, People's Republic of China
| | - Mandy Ching-Man Yim
- Eye Centre, Hong Kong Baptist Hospital, 222 Waterloo Road, Kowloon Tong, Hong Kong, People's Republic of China
| | - Fion Tung-Ching Lau
- Eye Centre, Hong Kong Baptist Hospital, 222 Waterloo Road, Kowloon Tong, Hong Kong, People's Republic of China
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10
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Kontadakis GA, Pennos A, Pentari I, Kymionis GD, Pallikaris IG, Ginis H. Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas. Ther Adv Ophthalmol 2020; 12:2515841420923190. [PMID: 32577607 PMCID: PMC7288812 DOI: 10.1177/2515841420923190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/26/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose: To investigate in vitro the accuracy of dynamic contour
tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous
corneas. Methods: Experimental study included 20 freshly enucleated porcine eyes. Epithelium
was debrided, and eyes were divided in four groups. Groups were immersed in
35%, 40%, 50%, and 60% glycerin solutions for 3 hours. Subsequently, globes
were mounted in a special holder, and their intraocular pressure was
hydrostatically adjusted. Intraocular pressure was measured by means of
dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL
while adjusting true intraocular pressure to 17, 33, and 50 mm Hg.
Ultrasound pachymetry was performed. Results: Mean corneal thickness was 914.5 ± 33.3 μm (730–1015 μm). In true intraocular
pressure of 33 mm Hg, Goldmann applanation tonometry and dynamic contour
tonometry significantly underestimated true intraocular pressure (mean
Goldmann applanation tonometry: 14.7 ± 4.8 mm Hg,
p < 0.001, mean dynamic contour tonometry: 21.6 ± 6.8,
p < 0.001). Tono-Pen XL also underestimated, but
difference was not statistically significant (Tono-Pen XL: 27.9 ± 9.7,
p = 0.064). In true intraocular pressure of 50 mm Hg,
all three methods significantly underestimated (Goldmann applanation
tonometry: 17.6 ± 5.3 mm Hg, p < 0.001, dynamic contour
tonometry: 26.8 ± 6.3 mm Hg, p < 0.001, Tono-Pen XL:
35.6 ± 8.4 mm Hg, p < 0.001). The error in measured
intraocular pressure for each method (true minus measured intraocular
pressure) was significantly correlated to true intraocular pressure
(p < 0.001). The intraocular pressure measurements
of each eye taken under true intraocular pressure of 17 and 33 mm Hg with
the three methods were correlated to each other. Measurements taken under
intraocular pressure of 50 mmHg were not correlated to each other. Corneal
thickness was not correlated to intraocular pressure measurement. Conclusion: Goldmann applanation tonometry, dynamic contour tonometry, and Tono-Pen XL
underestimate intraocular pressure when measured under edematous conditions.
Tono-Pen XL showed better accuracy, especially in lower true intraocular
pressure. The measurement error increases when true intraocular pressure
increases in all three methods.
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Affiliation(s)
- George A Kontadakis
- Institute of Vision and Optics (IVO), Medical School, University of Crete, 71003 Heraklion, Crete, Greece
| | - Alexandros Pennos
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - Iro Pentari
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - George D Kymionis
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - Ioannis G Pallikaris
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece
| | - Harilaos Ginis
- Institute of Vision and Optics (IVO), Medical School, University of Crete, Heraklion, Greece Athens Eye Hospital, Athens, Greece
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11
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Hashemi H, Nabovati P, Khabazkhoob M, Emamian MH, Yekta A, Fotouhi A. Agreement of Central Corneal Thickness Measurements between Scheimpflug Photography and Optical Low-Coherence Reflectometry in Children. Semin Ophthalmol 2020; 35:252-256. [PMID: 32845784 DOI: 10.1080/08820538.2020.1810288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Central corneal thickness (CCT) is a key indicator of the corneal health status and is therefore of clinical importance. The aim of the present study was to determine the agreement between Scheimpflug photography (SP) and optical low-coherence reflectometry (OLCR) systems in measuring the CCT in children. METHODS In this cross-sectional study, the samples were selected from Shahroud schoolchildren using cluster sampling. The samples then underwent optometric examinations, including the measurement of visual acuity and refraction. CCT measurements were done by the SP and OLCR systems between 8 am and 4 pm. To evaluate the agreement between these devices, 95% limits of agreement (LoA) and interclass correlation coefficient (ICC) were reported. RESULTS After applying the exclusion criteria, 4890 right eyes (53.2% male) were analyzed. The mean age of the students was 9.22 ± 1.72 years (range: 6-12 years). The mean CCT by the SP and OLCR systems was 555.30 ± 34.15 and 550.23 ± 35.11 µm, respectively. The 95% LoA between the two devices was -19.81 to 9.66 µm, and the ICC was 0.983. The CCT difference between the SP and OLCR systems was 5.61 µm in boys and 3.36 µm in girls. The CCT difference between the two devices was 6.41 µm in 6-year-old and 3.54 µm in 12-year-old children. The 95% LoA was -17.96 to 9.58 µm and -18.89 to 8.47 µm and the ICC was 0.987 and 0.984 in myopic and hyperopic subjects, respectively. CONCLUSION The results of this study showed a high agreement between OLCR and SP measurements of CCT in children.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital , Tehran, Iran
| | - Payam Nabovati
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences , Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences , Shahroud, Iran
| | - Abbasali Yekta
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences , Mashhad, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran
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12
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Bonnemaijer PWM, Leeuwen EMV, Iglesias AI, Gharahkhani P, Vitart V, Khawaja AP, Simcoe M, Höhn R, Cree AJ, Igo RP, Gerhold-Ay A, Nickels S, Wilson JF, Hayward C, Boutin TS, Polašek O, Aung T, Khor CC, Amin N, Lotery AJ, Wiggs JL, Cheng CY, Hysi PG, Hammond CJ, Thiadens AAHJ, MacGregor S, Klaver CCW, Duijn CMV. Multi-trait genome-wide association study identifies new loci associated with optic disc parameters. Commun Biol 2019; 2:435. [PMID: 31798171 PMCID: PMC6881308 DOI: 10.1038/s42003-019-0634-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 09/23/2019] [Indexed: 12/24/2022] Open
Abstract
A new avenue of mining published genome-wide association studies includes the joint analysis of related traits. The power of this approach depends on the genetic correlation of traits, which reflects the number of pleiotropic loci, i.e. genetic loci influencing multiple traits. Here, we applied new meta-analyses of optic nerve head (ONH) related traits implicated in primary open-angle glaucoma (POAG); intraocular pressure and central corneal thickness using Haplotype reference consortium imputations. We performed a multi-trait analysis of ONH parameters cup area, disc area and vertical cup-disc ratio. We uncover new variants; rs11158547 in PPP1R36-PLEKHG3 and rs1028727 near SERPINE3 at genome-wide significance that replicate in independent Asian cohorts imputed to 1000 Genomes. At this point, validation of these variants in POAG cohorts is hampered by the high degree of heterogeneity. Our results show that multi-trait analysis is a valid approach to identify novel pleiotropic variants for ONH.
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Affiliation(s)
- Pieter W. M. Bonnemaijer
- Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Elisabeth M. van Leeuwen
- Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Adriana I. Iglesias
- Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, Australia
| | - Veronique Vitart
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Anthony P. Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Mark Simcoe
- Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - René Höhn
- Department of Ophthalmology, Inselspital, University Hospital Bern, University of Bern, Bern, Germany
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Angela J. Cree
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rob P. Igo
- Department of Ophthalmology, Harvard Medical School, Boston, MA USA
| | - Aslihan Gerhold-Ay
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - James F. Wilson
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
- Centre for Global Health Research, The Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Thibaud S. Boutin
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Ozren Polašek
- Faculty of Medicine, University of Split, Split, Croatia
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chiea Chuen Khor
- Division of Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Andrew J. Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Janey L. Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, MA USA
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Pirro G. Hysi
- Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | | | - Alberta A. H. J. Thiadens
- Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Brisbane, Australia
| | - Caroline C. W. Klaver
- Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud Medical Center, Nijmegen, The Netherlands
- Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Cornelia M. van Duijn
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Nuffield Department of Public Health, University of Oxford, Oxford, UK
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Teberik K, Eski MT, Kaya M, Ankaralı H. Comparison of central corneal thickness with four different optical devices. Int Ophthalmol 2017; 38:2363-2369. [PMID: 29022163 DOI: 10.1007/s10792-017-0736-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND To compare the consistency between the average scores of the contact central corneal thickness measurements from ultrasound pachymetry devices still gold standard, such as iPac® and Echoscan US-500, and noncontact measurements via Pentacam HR and Sirius topography. METHODS This prospective study, subsequently admitted to the ophthalmology department, 76 healthy individuals were performed. The measurements were repeated three times for each eye, and average scores were statistically analyzed on the same day and almost at the same time. While measuring the eyes, Pentacam HR, Sirius topography, iPac®, and Echoscan US-500 were used, respectively. The inter-rater agreement of measurements from the devices was assessed with intraclass correlation coefficient, and 95% Confidence Interval and p values demonstrating statistically significance were also presented. In the graphical assessment of the agreement, the Bland-Altman graph was used. RESULTS Among 76 study participants, 43 (56.6%) were composed of women, and age level was 38.6 ± 12.5 years, ranging between 18 and 69. It was observed that the highest agreement was between the measurements obtained from Echoscan US-500 and iPac® devices, but the agreement between the measurements of different devices was higher than 0.90. Bland-Altman graphics were also investigated; the results of four different devices were seen to be consistent with one another. CONCLUSIONS Therefore, the devices we compared in the study can be used as alternatives to one another due to the higher consistency between CCT measurements provided with through UP devices of Echoscan US-500 and iPac®, and Pentacam HR and Sirius topography devices. CLINICAL TRIAL REGISTRATION NUMBER 2016/112.
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Affiliation(s)
- Kuddusi Teberik
- Department of Ophthalmology, Düzce University Medical School, Orhangazi Mah., Konuralp 500. Cd, No: 125/7, 81450, Düzce, Turkey.
| | - Mehmet Tahir Eski
- Department of Ophthalmology, Düzce University Medical School, Orhangazi Mah., Konuralp 500. Cd, No: 125/7, 81450, Düzce, Turkey
| | - Murat Kaya
- Department of Ophthalmology, Düzce University Medical School, Orhangazi Mah., Konuralp 500. Cd, No: 125/7, 81450, Düzce, Turkey
| | - Handan Ankaralı
- Department of Biostatistics and Medical Informatics, Düzce University Medical School, Düzce, Turkey
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Goudie C, Pronin S, Court H, Pooley J, Tatham AJ. A national survey of the use of pachymeters by optometrists in Scotland: experience, views and barriers to use. Ophthalmic Physiol Opt 2017; 37:177-183. [DOI: 10.1111/opo.12352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 12/13/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Colin Goudie
- Princess Alexandra Eye Pavilion and Department of Ophthalmology; University of Edinburgh; Edinburgh UK
| | - Savva Pronin
- Princess Alexandra Eye Pavilion and Department of Ophthalmology; University of Edinburgh; Edinburgh UK
| | - Helen Court
- National Health Service (NHS) Education for Scotland; Edinburgh UK
| | - Janet Pooley
- National Health Service (NHS) Education for Scotland; Edinburgh UK
| | - Andrew J. Tatham
- Princess Alexandra Eye Pavilion and Department of Ophthalmology; University of Edinburgh; Edinburgh UK
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Sawada Y, Hangai M, Ishikawa M, Yoshitomi T. Association of Myopic Optic Disc Deformation with Visual Field Defects in Paired Eyes with Open-Angle Glaucoma: A Cross-Sectional Study. PLoS One 2016; 11:e0161961. [PMID: 27571303 PMCID: PMC5003372 DOI: 10.1371/journal.pone.0161961] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/15/2016] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To examine the association of myopia with the visual field (VF) defects in open-angle glaucoma (OAG) using paired eyes to eliminate the effect of unknown confounding factors that are diverse among individuals. METHODS One hundred eighteen eyes of 59 subjects with myopia (spherical equivalent [SE] ≥ -2 diopter [D] and axial length ≥ 24.0 mm) whose intra-ocular pressure between paired eyes was similar and the mean deviation (MD) of the Humphrey VF test differed by more than 6 dB were included. Refractive errors (SE, axial length) and parameters associated with the papillary and parapapillary myopic deformation (tilt ratio, torsion angle, and β-zone parapapillary atrophy [PPA] area without Bruch's membrane) were measured in each eye. The paired eyes were divided into worse and better eyes according to the MD of the VF, and parameters were compared between them. Further, multiple linear regression analysis was performed to examine the correlation of the difference in various parameters with the MD difference between paired eyes. RESULTS The SE of all eyes was -6.39 ± 2.15 D (mean ± standard deviation) and axial length was 26.42 ± 1.07 mm. MD of the worse and better VF eyes were -13.56 ± 6.65 dB and -4.87 ± 5.32 dB, respectively. Eyes with worse VFs had significantly greater SE, axial length, tilt ratio, and PPA area without Bruch's membrane than those with better VFs (all P < 0.05). In multiple linear regression analysis, the difference of the MD between paired eyes was significantly correlated with the difference in the tilt ratio and PPA area without Bruch's membrane. CONCLUSION The myopic papillary and parapapillary deformations, but not refractive error itself, were related to the worse VF in paired eyes with OAG. This suggests that myopia influences the severity of the glaucomatous VF defects via structural deformation.
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Affiliation(s)
- Yu Sawada
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
| | - Masanori Hangai
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Makoto Ishikawa
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
| | - Takeshi Yoshitomi
- Department of Ophthalmology, Akita University Graduate School of Medicine, Akita, Japan
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Maslin JS, Teng CC, Chadha N, Liu J. Effect of supine body position on central corneal thickness. Clin Exp Ophthalmol 2016; 44:678-683. [PMID: 26991869 DOI: 10.1111/ceo.12742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 02/28/2016] [Accepted: 03/01/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND To evaluate the effect of supine body position on central corneal thickness (CCT) in open-angle glaucoma patients and in healthy subjects. DESIGN A cross-sectional study at a university eye clinic. PARTICIPANTS Twenty-three subjects were recruited in each group, for a total of 46 patients. METHODS CCT was measured using an ultrasound pachymeter in each subject. Three consecutive measurements in each eye were first taken in the sitting position, and repeated after 10 min and 30 min in a supine position. Results were analyzed using mixed model repeated measures, which adjusted for age, gender and laterality of eyes. MAIN OUTCOME MEASURES CCT RESULTS: In healthy subjects, CCT decreased with supine positioning at 10 min (mean = -5.2 µm, P = 0.0043) and at 30 min (mean = -6.5 µm, P < 0.0001). In the glaucoma group, CCT decreased with supine positioning at 10 min (mean = -6.7 µm, P = 0.0043) and at 30 min (mean = -10.2 µm, P < 0.0001). There was no statistically significant difference between the CCT at 10 min supine and at 30 min supine in the healthy subjects (P = 0.37) and glaucoma patients (P = 0.14). CCT was shown to decrease linearly over time (P < 0.0001), and the slopes were not statistically different between groups (P = 0.40). CONCLUSIONS CCT is a dynamic measurement that can be influenced by body position. It decreases linearly in the first 30 min of supine positioning at a similar rate in both open angle glaucoma patients and in healthy subjects.
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Affiliation(s)
- Jessica S Maslin
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Christopher C Teng
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nisha Chadha
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
| | - Ji Liu
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
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Rampersad N, Hansraj R. A review of African studies on central corneal thickness. AFRICAN VISION AND EYE HEALTH 2016. [DOI: 10.4102/aveh.v75i1.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Recently, there has been increasing interest in understanding central corneal thickness (CCT) measurements in various populations. This may be related to the influence of CCT in the diagnosis, classification and management of glaucoma. In addition, CCT measurements are also important for monitoring corneal diseases and contact lens wear, indicating the overall health of the cornea and assessing eligibility for refractive surgery. This article reviews studies that have reported CCT measurements in non-glaucomatous African sub-populations. The CCT measurements, gender associations and limitations of these studies are highlighted. The findings of these studies and their implications are discussed in relation to global studies reporting on CCT measurements.
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Abu-Amero K, Kondkar AA, Chalam KV. An Updated Review on the Genetics of Primary Open Angle Glaucoma. Int J Mol Sci 2015; 16:28886-911. [PMID: 26690118 PMCID: PMC4691082 DOI: 10.3390/ijms161226135] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 11/19/2015] [Accepted: 11/27/2015] [Indexed: 01/07/2023] Open
Abstract
Epidemiological studies suggest that by 2020 the prevalence of primary open angle glaucoma (POAG) is estimated to increase to 76.0 million, and to 111.8 million by 2040 globally due to the population aging. The prevalence of POAG is the highest among those of African descent, followed by Asians, and the lowest in Europeans. POAG is a genetically complex trait with a substantial fraction exhibiting a significant heritability. Less than 10% of POAG cases in the general population are caused by specific gene mutations and the remaining cases are polygenic. Quantitative traits related to POAG pathogenesis such as intra-ocular pressure (IOP), vertical cup/disc ratio (VCDR), optic disc area, and central corneal thickness (CCT) are highly heritable, and likely to be influenced at least in part by genes and show substantial variation in human populations. Recent genome-wide association studies (GWAS) have identified several single nucleotide polymorphisms (SNPs) at different loci including CAV1/CAV2, TMCO1, CDKN2B-AS1, CDC7-TGFBR3, SIX1/SIX6, GAS7 and ATOH7 to be associated with POAG and its related quantitative traits (endophenotypes). The chapter provides a brief overview on the different GWAS and SNP association studies and their correlation with various clinical parameters important for POAG in the population worldwide, including the Middle East.
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Affiliation(s)
- Khaled Abu-Amero
- Glaucoma Research Chair, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh 11424, Saudi Arabia.
- Department of Ophthalmology, University of Florida College of Medicine, 580, W, 8th Street, Tower-2, Jacksonville, FL 32209, USA.
| | - Altaf A Kondkar
- Glaucoma Research Chair, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh 11424, Saudi Arabia.
| | - Kakarla V Chalam
- Department of Ophthalmology, University of Florida College of Medicine, 580, W, 8th Street, Tower-2, Jacksonville, FL 32209, USA.
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Repeatability of Pentacam peripheral corneal thickness measurements. Cont Lens Anterior Eye 2015; 38:424-9. [DOI: 10.1016/j.clae.2015.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 04/01/2015] [Accepted: 05/13/2015] [Indexed: 11/18/2022]
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Abstract
PURPOSE To evaluate intrasubject asymmetry in central corneal thickness (CCT) among patients with primary open-angle glaucoma (POAG) as compared with that of normal subjects and to determine whether the eye with thinner cornea has more severe glaucomatous visual field damage. METHODS In this case-control study, CCT of both eyes was measured using an ultrasonic pachymeter (UP-1000; Nidek Technologies, Gamagori, Japan) among POAG patients and normal subjects. The intrasubject difference in CCT was calculated and compared between the study groups; correlations between CCT and intraocular pressure (IOP), vertical cup-to-disc ratio (VCDR), and visual field defects were also evaluated. RESULTS A total of 62 patients with bilateral POAG and 56 normal subjects were included. There was no significant difference between the study groups in terms of age, sex, and ocular parameters except for visual acuity, IOP, and VCDR. The POAG patients demonstrated significantly greater intrasubject asymmetry in CCT (8 ± 7 μm vs. 5 ± 3 μm; p = 0.041) and a higher prevalence of significant (>10 μm) intrasubject CCT difference (30.6 vs. 5.4%; p < 0.001) as compared with normal subjects. Although each higher level of glaucomatous damage was associated with 4-μm thinner CCT, the correlation was not statistically significant (95% confidence interval, -8 to 1 μm; p = 0.117; GEE analysis). No significant correlation was observed between CCT and IOP or VCDR (p = 0.302 and 0.137, respectively). CONCLUSIONS Patients with POAG demonstrate a larger amount of intrasubject difference in CCT as compared with normal subjects.
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Cuchra M, Markiewicz L, Mucha B, Pytel D, Szymanek K, Szemraj J, Szaflik J, Szaflik JP, Majsterek I. The role of base excision repair in the development of primary open angle glaucoma in the Polish population. Mutat Res 2015; 778:26-40. [PMID: 26056729 DOI: 10.1016/j.mrfmmm.2015.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/01/2015] [Accepted: 05/09/2015] [Indexed: 12/13/2022]
Abstract
Glaucoma is a leading cause of irreversible blindness in developing countries. Previous data have shown that progressive loss of human TM cells may be connected with chronic exposure to oxidative stress. This hypothesis may suggest a role of the base excision repair (BER) pathway of oxidative DNA damage in primary open angle glaucoma (POAG) patients. The aim of our study was to evaluate an association of BER gene polymorphism with a risk of POAG. Moreover, an association of clinical parameters was examined including cup disk ratio (c/d), rim area (RA) and retinal nerve fiber layer (RNFL) with glaucoma progression according to BER gene polymorphisms. Our research included 412 patients with POAG and 454 healthy controls. Gene polymorphisms were analyzed by PCR-RFLP. Heidelberg Retinal Tomography (HRT) clinical parameters were also analyzed. The 399 Arg/Gln genotype of the XRCC1 gene (OR 1.38; 95% CI 1.02-1.89 p = 0.03) was associated with an increased risk of POAG occurrence. It was indicated that the 399 Gln/Gln XRCC1 genotype might increase the risk of POAG progression according to the c/d ratio (OR 1.67; 95% CI 1.07-2.61 P = 0.02) clinical parameter. Moreover, the association of VF factor with 148 Asp/Glu of APE1 genotype distribution and POAG progression (OR 2.25; 95% CI 1.30-3.89) was also found. Additionally, the analysis of the 324 Gln/His MUTYH polymorphism gene distribution in the patient group according to RNFL factor showed that it might decrease the progression of POAG (OR 0.47; 95% CI 0.30-0.82 P = 0.005). We suggest that the 399 Arg/Gln polymorphism of the XRCC1 gene may serve as a predictive risk factor of POAG.
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Affiliation(s)
- Magda Cuchra
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Poland
| | - Lukasz Markiewicz
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Poland
| | - Bartosz Mucha
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Poland
| | - Dariusz Pytel
- The Abramson Family Cancer Research Institute, Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Biochemistry and Molecular Biology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Katarzyna Szymanek
- Department of Ophthalmology, Medical University of Warsaw, SPKSO Hospital, Warsaw, Poland
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Jerzy Szaflik
- Department of Ophthalmology, Medical University of Warsaw, SPKSO Hospital, Warsaw, Poland
| | - Jacek P Szaflik
- Department of Ophthalmology, Medical University of Warsaw, SPKSO Hospital, Warsaw, Poland
| | - Ireneusz Majsterek
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Poland.
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Accutome PachPen handheld ultrasonic pachymeter: intraobserver repeatability and interobserver reproducibility by personnel of different training grades. Int Ophthalmol 2014; 35:651-5. [PMID: 25189684 DOI: 10.1007/s10792-014-9989-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 08/09/2014] [Indexed: 10/24/2022]
Abstract
To assess the intra-observer repeatability and inter-observer reproducibility of central corneal thickness (CCT) measurements of PachPen (Accutome, Inc., Pennsylvania, USA), a hand-held, portable ultrasonic pachymeter when used by an ophthalmic nurse compared to an ophthalmologist. Ophthalmology Clinic, University of Malaya Medical Center In this prospective study, CCT was measured in 184 eyes of 92 healthy subjects, first by a corneal surgeon experienced in ultrasound pachymetry (Observer 1) followed by an ophthalmic nurse new to the procedure (Observer 2). Nine measurements were obtained from each eye by each observer, independently. Measurements were compared between the observers. Coefficients of repeatability and reproducibility were calculated. The Bland-Altman plot was used to assess agreement between observers. Mean age of the study population was 54.3 ± 15.2 years old and consisted of 43.5% male. Mean CCT as measured by Observers 1 and 2 were 528.3 ± 32.9 and 530.7 ± 33.3 µm, respectively. Observer 1 showed higher repeatability of measurements compared to that of Observer 2 (coefficient of repeatability 3.46 vs. 5.55%). The measurements by both observers showed high correlation (0.96) and good agreement (mean difference -2.4 µm; 95% limits of agreement -21.4, 16.7 µm). Coefficient of reproducibility of measurements between observers was 5.08%. Accutome PachPen hand-held ultrasound pachymeters gives excellent intra-observer repeatability and inter-observer reproducibility by personnel of different training grades.
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Lechner J, Porter LF, Rice A, Vitart V, Armstrong DJ, Schorderet DF, Munier FL, Wright AF, Inglehearn CF, Black GC, Simpson DA, Manson F, Willoughby CE. Enrichment of pathogenic alleles in the brittle cornea gene, ZNF469, in keratoconus. Hum Mol Genet 2014; 23:5527-35. [PMID: 24895405 DOI: 10.1093/hmg/ddu253] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Keratoconus, a common inherited ocular disorder resulting in progressive corneal thinning, is the leading indication for corneal transplantation in the developed world. Genome-wide association studies have identified common SNPs 100 kb upstream of ZNF469 strongly associated with corneal thickness. Homozygous mutations in ZNF469 and PR domain-containing protein 5 (PRDM5) genes result in brittle cornea syndrome (BCS) Types 1 and 2, respectively. BCS is an autosomal recessive generalized connective tissue disorder associated with extreme corneal thinning and a high risk of corneal rupture. Some individuals with heterozygous PRDM5 mutations demonstrate a carrier ocular phenotype, which includes a mildly reduced corneal thickness, keratoconus and blue sclera. We hypothesized that heterozygous variants in PRDM5 and ZNF469 predispose to the development of isolated keratoconus. We found a significant enrichment of potentially pathologic heterozygous alleles in ZNF469 associated with the development of keratoconus (P = 0.00102) resulting in a relative risk of 12.0. This enrichment of rare potentially pathogenic alleles in ZNF469 in 12.5% of keratoconus patients represents a significant mutational load and highlights ZNF469 as the most significant genetic factor responsible for keratoconus identified to date.
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Affiliation(s)
- Judith Lechner
- Centre for Vision and Vascular Science, Queen's University Belfast, Belfast BT12 6BA, UK
| | - Louise F Porter
- Institute of Human Development, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WU, UK
| | - Aine Rice
- Leeds Institute of Molecular Medicine, St. James's University Hospital, University of Leeds, Leeds LS9 7TF, UK
| | - Veronique Vitart
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK
| | - David J Armstrong
- Department of Ophthalmology, Royal Victoria Hospital, Belfast BT12 6BA, UK
| | - Daniel F Schorderet
- IRO - Institute for Research in Ophthalmology, Sion, Switzerland Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland Faculty of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Francis L Munier
- IRO - Institute for Research in Ophthalmology, Sion, Switzerland Jules-Gonin Eye Hospital, Lausanne, Switzerland
| | - Alan F Wright
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK
| | - Chris F Inglehearn
- Leeds Institute of Molecular Medicine, St. James's University Hospital, University of Leeds, Leeds LS9 7TF, UK
| | - Graeme C Black
- Institute of Human Development, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WU, UK
| | - David A Simpson
- Centre for Vision and Vascular Science, Queen's University Belfast, Belfast BT12 6BA, UK
| | - Forbes Manson
- Institute of Human Development, The University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WU, UK
| | - Colin E Willoughby
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool L69 3GA, UK
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The NEIGHBOR consortium primary open-angle glaucoma genome-wide association study: rationale, study design, and clinical variables. J Glaucoma 2014; 22:517-25. [PMID: 22828004 DOI: 10.1097/ijg.0b013e31824d4fd8] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Primary open-angle glaucoma (POAG) is a common disease with complex inheritance. The identification of genes predisposing to POAG is an important step toward the development of novel gene-based methods of diagnosis and treatment. Genome-wide association studies (GWAS) have successfully identified genes contributing to complex traits such as POAG however, such studies frequently require very large sample sizes, and thus, collaborations and consortia have been of critical importance for the GWAS approach. In this report we describe the formation of the NEIGHBOR consortium, the harmonized case control definitions used for a POAG GWAS, the clinical features of the cases and controls, and the rationale for the GWAS study design.
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Borrego-Sanz L, Sáenz-Francés F, Bermudez-Vallecilla M, Morales-Fernández L, Martínez-de-la-Casa J, Santos-Bueso E, Jañez L, García-Feijoo J. Agreement between Central Corneal Thickness Measured Using Pentacam, Ultrasound Pachymetry, Specular Microscopy and Optic Biometer Lenstar LS 900 and the Influence of Intraocular Pressure. Ophthalmologica 2014; 231:226-35. [DOI: 10.1159/000356724] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 09/20/2013] [Indexed: 11/19/2022]
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Janssen SF, Gorgels TG, Ramdas WD, Klaver CC, van Duijn CM, Jansonius NM, Bergen AA. The vast complexity of primary open angle glaucoma: Disease genes, risks, molecular mechanisms and pathobiology. Prog Retin Eye Res 2013; 37:31-67. [DOI: 10.1016/j.preteyeres.2013.09.001] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 07/26/2013] [Accepted: 09/03/2013] [Indexed: 12/21/2022]
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Evaluation of central corneal thickness after cataract surgery, penetrating keratoplasty and long-term soft contact lens wear. Cont Lens Anterior Eye 2013; 36:238-42. [DOI: 10.1016/j.clae.2013.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 03/20/2013] [Accepted: 03/21/2013] [Indexed: 11/24/2022]
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Abstract
PURPOSE The aim of this study was to compare 4 methods of central corneal thickness (CCT) measurements in terms of their agreement, repeatability, and measurement time. METHODS CCT was measured in 184 eyes of 92 healthy subjects by the same examiner. The methods used were as follows: noncontact specular microscopy (SM; Topcon SP-3000P; Topcon Corporation, Tokyo, Japan), Pentacam rotating Scheimpflug photography system (Oculus Inc, Wetzlar, Germany), optical low-coherence reflectometry (OLCR; LenStar LS900; Haag-Streit AG, Koeniz, Switzerland), and ultrasound pachymetry (UP; PachPen; Accutome Inc, Malvern, PA). The duration for each examination was measured by an independent observer. RESULTS The mean age (±SD) of the subjects was 54.3 (± 15.3) years. The mean CCTs (± SD) for SM, Pentacam, OLCR, and UP were 507.8 (± 30.2), 538.4 (± 31.7), 531.8 (± 31.4), and 528.3 (± 32.9) μm, respectively. The Bland-Altman plots showed closest agreement for OLCR-UP, followed by OLCR-Pentacam and Pentacam-UP. SM had the poorest agreement with the other methods. CCTs measured by SM were on average 20 to 30 μm thinner than those of the other methods. The coefficient of repeatability for SM, Pentacam, OLCR, and UP were 3.14%, 4.23%, 1.51%, and 3.46%, respectively. The mean measurement times (± SD) were 13.5 (± 5.7), 45.7 (± 12.3), 18.5 (± 7.1), and 5.6 (± 1.0) seconds, respectively. CONCLUSIONS CCT measurements between OLCR-UP and OLCR-Pentacam are comparable and can be used interchangeably in clinical practice. However, SM underestimates CCT compared with the other methods, whereas Pentacam was found to be the least repeatable and took the longest time.
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Abdu L. Epidemiological properties of primary open angle glaucoma in Nigeria. J Ophthalmol 2013; 2013:402739. [PMID: 23762529 PMCID: PMC3677608 DOI: 10.1155/2013/402739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 04/17/2013] [Accepted: 04/22/2013] [Indexed: 11/23/2022] Open
Abstract
Background. Primary open angle glaucoma (POAG) is progressive chronic optic neuropathy in adults in which intraocular pressure (IOP) and other currently unknown factors contribute to damage. POAG is the second commonest cause of avoidable blindness in Nigeria. Pattern of Presentation. POAG is characterized by late presentation. Absence of pain which is a driving force for seeking medical help, inadequacy of trained eye care personnel, paucity of facilities, misdistribution of resources, lack of awareness, poor education, and poverty may all contribute to this. Medical and surgical treatment options available are challenging and tasking. Screening for Glaucoma. Screening is the presumptive identification of unrecognized disease (POAG) by applying test(s) which can be applied rapidly. Such test(s) should be of high reliability, validity, yield, acceptable, and cost effective. The test should ideally be sensitive, specific, and efficient. It is difficult to select a suitable test that meets these criteria. Intraocular pressure (IOP) appears to be the easiest option. But, high IOP is not diagnostic nor does normal value exclude the disease. Health education is a possible strategy in early case detection and management. Treatment of POAG. Glaucoma treatment can either be medical or surgical (this includes laser). Considering unavailability, potency, cost, and long-term effects of medication, surgery (trabeculectomy) could be a better option. Laser trabeculoplasty is available in a few centers. Viscocanalostomy is not routinely performed. Patient education is vital to success as management is for life. Conclusion. POAG remains a cause of avoidable blindness in Nigeria. There is need for long-term strategy to identify patients early and institute prompt management. Improvement in training of eye care personnel and provision of up to date equipment is essential in achieving this goal.
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Affiliation(s)
- Lawan Abdu
- Department of Ophthalmology, Aminu Kano Teaching Hospital, Faculty of Medicine, Bayero University, PMB 3452, Kano, Nigeria
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Comparative Study of Central Corneal Thickness Using Fourier-Domain Optical Coherence Tomography Versus Ultrasound Pachymetry in Primary Open-Angle Glaucoma. Cornea 2013; 32:9-13. [DOI: 10.1097/ico.0b013e318242fd0f] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Huang C, Zhang M, Huang Y, Chen B, Lam DSC, Congdon N. Corneal Hysteresis Is Correlated with Reduction in Axial Length After Trabeculectomy. Curr Eye Res 2012; 37:381-7. [DOI: 10.3109/02713683.2011.620729] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Beck AD, Freedman SF, Lynn MJ, Bothun E, Neely DE, Lambert SR. Glaucoma-related adverse events in the Infant Aphakia Treatment Study: 1-year results. ACTA ACUST UNITED AC 2011; 130:300-5. [PMID: 22084157 DOI: 10.1001/archophthalmol.2011.347] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To report the incidence of glaucoma and glaucoma suspects in the IATS, and to evaluate risk factors for the development of a glaucoma-related adverse event in patients in the IATS in the first year of follow-up. METHODS A total of 114 infants between 1 and 6 months of age with a unilateral congenital cataract were assigned to undergo cataract surgery either with or without an intraocular lens implant. Standardized definitions of glaucoma and glaucoma suspect were created and used in the IATS. RESULTS Of these 114 patients, 10 (9%) developed glaucoma and 4 (4%) had glaucoma suspect, for a total of 14 patients (12%) with a glaucoma-related adverse event in the treated eye through the first year of follow-up. Of the 57 patients who underwent lensectomy and anterior vitrectomy, 5 (9%) developed a glaucoma-related adverse event; of the 57 patients who underwent an intraocular lens implant, 9 (16%) developed a glaucoma-related adverse event. The odds of developing a glaucoma-related adverse event were 3.1 times higher for a child with persistent fetal vasculature and 1.6 times higher for each month of age younger at cataract surgery. CONCLUSIONS Modern surgical techniques do not eliminate the early development of glaucoma following congenital cataract surgery with or without an intraocular lens implant. Younger patients with or without persistent fetal vasculature seem more likely to develop a glaucoma-related adverse event in the first year of follow-up. Vigilance for the early development of glaucoma is needed following congenital cataract surgery, especially when surgery is performed during early infancy or for a child with persistent fetal vasculature. Five-year follow-up data for the IATS will likely reveal more glaucoma-related adverse events. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00212134.
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The effect of thin, thick, and normal corneas on Goldmann intraocular pressure measurements and correction formulae in individual eyes. Ophthalmology 2011; 119:443-9. [PMID: 22035576 DOI: 10.1016/j.ophtha.2011.07.058] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 07/28/2011] [Accepted: 07/29/2011] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the usefulness of the central corneal thickness (CCT)-based correction formulae for stratified CCT groups, with intraocular pressure (IOP) from the Pascal dynamic contour tonometer (PDCT) as the reference standard. DESIGN Retrospective case series. PARTICIPANTS Two hundred eighty-nine patients attending a specialist glaucoma practice and a mixture of normal subjects and subjects with confirmed glaucomatous optic neuropathy. METHODS Intraocular pressure was measured using PDCT, Goldmann applanation tonometry (GAT), and the Ocular Response Analyzer (ORA; Reichert Corp, Buffalo, NY). The GAT readings were obtained before automated readings and were adjusted for CCT using 4 different correction formulae. Discrepancies between GAT and CCT-corrected GAT readings were evaluated after stratification into thin, intermediate, and thick CCT groups. The IOP measurements from GAT, the ORA, and CCT-adjusted IOP were compared against PDCT IOP measurements using Bland-Altman analysis. MAIN OUTCOME MEASURES Mean, 95% limits of agreement, and proportion of patients with IOP difference of 20% or more between PDCT IOP and each of GAT IOP, Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc), and adjusted IOP using CCT-based correction formulae. RESULTS Average PDCT IOP values were higher than GAT, IOPg, IOPcc, and CCT-adjusted IOP. The GAT IOP readings demonstrated poor agreement with PDCT IOP (95% limits of agreement, ± 4.7 mmHg); however, IOPg, IOPcc, and adjustment of GAT IOP with CCT-based formulae resulted in even poorer agreement (range of 95% limits of agreement, ± 5.1 to 6.7 mmHg). If PDCT was used as the reference standard, there was a 26% to 39% risk of making an erroneous IOP adjustment of magnitude of 20% or more at all levels of CCT. This risk was greatest in the patients with thicker corneas (CCT, ≥568 μm). CONCLUSIONS Adjusting IOP using CCT-based formulae resulted in poorer agreement with PDCT IOP when compared with unadjusted G AT IOP. If PDCT is the closest measure we have to intracameral IOP, there is a risk of creating clinically significant error after adjustment of GAT IOP with CCT-based correction formulae, especially in thicker corneas. This study suggests that although CCT may be useful in population analyses, CCT-based correction formulae should not be applied to individuals.
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Evaluation of central corneal thickness measurement with RTVue spectral domain optical coherence tomography in normal subjects. Cornea 2011; 30:121-6. [PMID: 20885314 DOI: 10.1097/ico.0b013e3181e16c65] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine (1) repeatability of central corneal thickness (CCT) measurements by spectral domain optical coherence tomography (RTVue; Optovue, Inc, Fremont, CA) and (2) agreement between CCT measurements by RTVue and those by ultrasonic pachymetry, Orbscan, and anterior segment optical coherence tomography (ASOCT). METHODS In a prospective observational study, 2 cohorts of normal subjects were recruited. In the first cohort (51 subjects), 5 measurements of CCT were obtained by RTVue during the same visit to determine the repeatability. In the second cohort (65 subjects), CCT measurements were obtained by RTVue, ultrasonic pachymetry, Orbscan, and ASOCT during the same visit to determine the agreement among these instruments. Repeatability was assessed by intraclass correlation coefficient (ICC), within-subject standard deviation, coefficient of repeatability, and within-subject coefficient of variation. Agreement was assessed by ICC and Bland and Altman plots. RESULTS Repeatability of CCT measurements by RTVue as assessed by ICC, within-subject standard deviation, coefficient of repeatability, and within-subject coefficient of variation was 0.99 (0.99-0.99), 2.2 (1.9-2.5), 4.2 μm (3.6-4.8), and 0.4% (0.3-0.5), respectively. The average CCT by RTVue (529 μm) was comparable to that by ultrasonic pachymetry (539 μm; P = 0.15), Orbscan (536 μm; P = 0.54), and ASOCT (526 μm; P = 0.77). The 95% limits of agreement on Bland and Altman plots ranged from 20 μm (between RTVue and ASOCT) to 33 μm (between RTVue and Orbscan). CONCLUSIONS CCT measurements by RTVue have an excellent repeatability. Although CCT measurements by RTVue are comparable to that by ultrasonic pachymetry, Orbscan, and ASOCT, the difference between instruments can be significant depending on the clinical situation considered.
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Fan DSP, Chiu TYH, Congdon N, Chan JCW, Cheung EYY, Lam DSC. Measurement of intraocular pressure with pressure phosphene tonometry in children. J Pediatr Ophthalmol Strabismus 2011; 48:167-73. [PMID: 20672766 DOI: 10.3928/01913913-20100618-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 02/05/2010] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the accuracy and acceptability of intraocular pressure (IOP) measurement by the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer in children. METHODS Fifty children (5 to 14 years old) participated in this prospective comparative study. IOP was measured with the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer by three different examiners who were masked to the results. The children were also asked to grade the degree of discomfort from 0 to 5 (0 = no discomfort; 5 = most discomfort). RESULTS The mean IOPs measured by the Goldmann tonometer, pressure phosphene tonometer, and non-contact tonometer were 15.9 mm Hg (standard deviation [SD]: = 5.5 mm Hg; range: 10 to 36 mm Hg), 16.0 mm Hg (SD: 2.9 mm Hg; range: 12 to 25 mm Hg), and 15.7 mm Hg (SD = 5.1 mm Hg; range: 8 to 32 mm Hg), respectively (P = .722). The mean difference between pressure phosphene tonometer and Goldmann tonometer readings was 2.9 mm Hg and that between non-contact tonometer and Goldmann tonometer readings was 2.1 mm Hg. The 95% confidence interval of the mean difference between pressure phosphene tonometer and Goldmann tonometer readings was -1.07 and 1.19, and that between non-contact tonometer and Goldmann tonometer readings was -1.07 and 0.53. The mean discomfort ratings for the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer were 0.6, 2.0, and 2.3, respectively (P < .001). CONCLUSION Although the pressure phosphene tonometer was less accurate than the non-contact tonometer compared with Goldmann tonometer, it gave a reasonably close estimate and had a high specificity of raised IOP. In addition, measurement by the pressure phosphene tonometer is most acceptable to children. The pressure phosphene tonometer can be considered as an alternative method of IOP measurement in children.
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Affiliation(s)
- Dorothy S P Fan
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China
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Garcia-Medina M, Garcia-Medina JJ, Garrido-Fernandez P, Galvan-Espinosa J, Martin-Molina J, Garcia-Maturana C, Perez-Pardo S, Pinazo-Duran MD. Central corneal thickness, intraocular pressure, and degree of myopia in an adult myopic population aged 20 to 40 years in southeast Spain: determination and relationships. Clin Ophthalmol 2011; 5:249-58. [PMID: 21468330 PMCID: PMC3065564 DOI: 10.2147/opth.s16594] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To determine the values of, and study the relationships among, central corneal thickness (CCT), intraocular pressure (IOP), and degree of myopia (DM) in an adult myopic population aged 20 to 40 years in Almeria (southeast Spain). To our knowledge this is first study of this kind in this region. METHODS An observational, descriptive, cross-sectional study was done in which a sample of 310 myopic patients (620 eyes) aged 20 to 40 years was selected by gender- and age-stratified sampling, which was proportionally fixed to the size of the population strata for which a 20% prevalence of myopia, 5% epsilon, and a 95% confidence interval were hypothesized. We studied IOP, CCT, and DM and their relationships by calculating the mean, standard deviation, 95% confidence interval for the mean, median, Fisher's asymmetry coefficient, range (maximum, minimum), and the Brown-Forsythe's robust test for each variable (IOP, CCT, and DM). RESULTS In the adult myopic population of Almeria aged 20 to 40 years (mean of 29.8), the mean overall CCT was 550.12 μm. The corneas of men were thicker than those of women (P = 0.014). CCT was stable as no significant differences were seen in the 20- to 40-year-old subjects' CCT values. The mean overall IOP was 13.60 mmHg. Men had a higher IOP than women (P = 0.002). Subjects over 30 years (13.83) had a higher IOP than those under 30 (13.38) (P = 0.04). The mean overall DM was -4.18 diopters. Men had less myopia than women (P < 0.001). Myopia was stable in the 20- to 40-year-old study population (P = 0.089). A linear relationship was found between CCT and IOP (R(2) = 0.152, P ≤ 0.001). CCT influenced the IOP value by 15.2%. However no linear relationship between DM and IOP, or between CCT and DM, was found. CONCLUSIONS CCT was found to be similar to that reported in other studies in different populations. IOP tends to increase after the age of 30 and is not accounted for by alterations in CCT values.
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Noche CD, Eballe AO, Bella AL. Central corneal thickness in black Cameroonian ocular hypertensive and glaucomatous subjects. Clin Ophthalmol 2010; 4:1371-7. [PMID: 21179220 PMCID: PMC2999550 DOI: 10.2147/opth.s14951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate central corneal thickness (CCT) in a black Cameroonian population of ocular hypertensive and glaucomatous subjects. MATERIAL AND METHODS This was a prospective study undertaken with an ultrasonic pachymeter from January 2009 to December 2009 in an eye clinic (INNEL Medical center) in Yaoundé, Cameroon. RESULTS One hundred subjects (200 eyes) were enrolled in the study. Sixty subjects were glaucomatous (primary open angle glaucoma, POAG group), and 40 ocular hypertensive (OHT group). The mean age of the sample was 52.60 ± 12.23 years. For the whole sample, CCT was 534.71 ± 37.95 μm in the right eye and 533.61 ± 37.67 μm in the left eye, with no statistically significant difference between the 2 eyes (P = 0.446). CCT in the POAG group was 526.30 ± 37.34 μm in the right eye and 524.90 ± 35.92 μm in the left eye. CCT in the OHT group was 547.32 ± 35.71 μm in the right eye and 546.67 ± 36.85 μm in the left eye. There was a statistically significant difference between CCT of the 2 groups (right eye: P = 0.013; left eye: P = 0.007). CONCLUSION Mean CCT of ocular hypertensive subjects was thicker than CCT of glaucomatous ones in our Cameroonian sample. However, in both ocular hypertensive or glaucomatous patients, CCT of black Cameroonians is thinner than that reported in other studies in Caucasian populations.
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Vitart V, Bencić G, Hayward C, Skunca Herman J, Huffman J, Campbell S, Bućan K, Navarro P, Gunjaca G, Marin J, Zgaga L, Kolcić I, Polasek O, Kirin M, Hastie ND, Wilson JF, Rudan I, Campbell H, Vatavuk Z, Fleck B, Wright A. New loci associated with central cornea thickness include COL5A1, AKAP13 and AVGR8. Hum Mol Genet 2010; 19:4304-11. [PMID: 20719862 DOI: 10.1093/hmg/ddq349] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Central corneal thickness (CCT) is a highly heritable trait, which has been proposed to influence disorders of the anterior segment of the eye. A genome-wide association study (GWAS) of CCT was performed in 2269 individuals from three Croatian and one Scottish population. In the discovery set (1445 individuals), two genome-wide significant associations were identified for single nucleotide polymorphisms rs12447690 (β = 0.23 SD, P = 4.4 × 10(-9)) and rs1536482 (β = 0.22 SD, P = 7.1 × 10(-8)) for which the closest candidate genes (although ≥90 kb away) were zinc finger 469 (ZNF469) on 16q24.2 and collagen 5 alpha 1 (COL5A1) on 9q34.2, respectively. Only the ZNF469 association was confirmed in our replication set (824 individuals, P = 8.0 × 10(-4)) but COL5A1 remained a suggestive association in the combined sample (β = 0.16 SD, P = 1.1 × 10(-6)). Following a larger meta-analysis including recently published CCT GWAS summary data, COL5A1 was genome-wide significant (β = 0.13 SD, P = 5.1 × 10(-8)), together with two additional novel loci. The second new locus (defined by rs1034200) was 5 kb from the AVGR8 gene, encoding a putative transcription factor with typical ZNF and KRAB domains, in chromosomal region 13q12.11 (β = 0.14 SD, P = 3.5 × 10(-9)). The third new locus (rs6496932), on 15q25.3 (β = 0.13, P = 1.4 × 10(-8)), was within a wide linkage disequilibrium block extending into the 5' end of the AKAP13 gene, encoding a scaffold protein concerned with signal transduction from the cell surface. These associations offer mechanistic insights into the regulation of CCT and offer new candidate genes for susceptibility to common disorders in which CCT has been implicated, including primary open-angle glaucoma and keratoconus.
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Can Mean Central Corneal Thickness and Its 24-hour Fluctuation Influence Fluctuation of Intraocular Pressure? J Glaucoma 2010; 19:418-23. [DOI: 10.1097/ijg.0b013e3181aff432] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Huang JY, Pekmezci M, Yaplee S, Lin S. Intra-examiner repeatability and agreement of corneal pachymetry map measurement by time-domain and Fourier-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2010; 248:1647-56. [PMID: 20352443 DOI: 10.1007/s00417-010-1360-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 03/01/2010] [Accepted: 03/05/2010] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To assess the intra-examiner repeatability and agreement of corneal pachymetry maps measured by time-domain (Visante OCT) and Fourier-domain optical coherence tomography (RTVue OCT). METHODS This observational cross-sectional study enrolled 72 eyes from 72 volunteers. Only one eye of each patient was chosen randomly to receive repeated scanning with both devices by the same examiner, in order to test the intra-observer repeatability. The first scan by each device from all enrolled eyes was used to analyze the difference and agreement between the two devices. The agreement between the two devices was analyzed by the Bland-Altman method. Intra-observer repeatability of each OCT device was analyzed by intra-class correlation (ICC). RESULTS The mean corneal thickness of the central 2 mm zone was 524.3 ± 35.7 µm and 525.4 ± 35.3 µm by the Visante OCT and the RTVue OCT respectively (p = 0.089). The intra-observer repeatability of the RTVue OCT (ICC = 0.994) was superior to that of the Visante OCT (ICC = 0.989) in the central 2 mm zone. However, the intra-observer repeatability of the RTVue OCT in the pericentral 2 to 5 mm zone was not superior to that of the Visante OCT. Both OCT devices had similar repeatability in the pericentral 2 to 5 mm zone [ICC of the Visante OCT = 0.991; 95% confidence interval (CI) 0.986-0.995), ICC of the RTVue OCT = 0.991; 95% CI 0.985-0.994)). CONCLUSIONS The difference in CCT measurement by the Visante OCT and the RTVue OCT is probably too small to influence clinical decision making for refractive surgery and glaucoma management. The RTVue OCT demonstrated better intra-observer repeatability in the central 2 mm zone, which probably was related to its rapid image acquisition capability.
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Affiliation(s)
- Jehn-Yu Huang
- Department of Ophthalmology, University of California, San Francisco, Box 0730, 10 Koret Way K325, San Francisco, CA 94143-0730, USA
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Charlesworth J, Kramer PL, Dyer T, Diego V, Samples JR, Craig JE, Mackey DA, Hewitt AW, Blangero J, Wirtz MK. The path to open-angle glaucoma gene discovery: endophenotypic status of intraocular pressure, cup-to-disc ratio, and central corneal thickness. Invest Ophthalmol Vis Sci 2010; 51:3509-14. [PMID: 20237253 DOI: 10.1167/iovs.09-4786] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE. Primary open-angle glaucoma (POAG) is a complex disease with a genetic architecture that can be simplified through the investigation of individual traits underlying disease risk. It has been well studied in twin models, and this study was undertaken to investigate the heritability of some of these key endophenotypes in extended pedigrees. METHODS. These data are derived from a large, multicenter study of extended, Caucasian POAG families from Australia and the United States. The study included 1181 people from 22 extended pedigrees. Variance components modeling was used to determine the heritabilities of maximum intraocular pressure (IOP), maximum vertical cup-to-disc ratio (VCDR), and mean central corneal thickness (CCT). Bivariate quantitative genetic analysis between these eye-related phenotypes and POAG itself was performed to determine whether any of these traits represent true endophenotypes. RESULTS. Heritability estimates for IOP, VCDR, and CCT (0.42, 0.66, and 0.72, respectively) were significant and show strong concordance with data in previous studies. Bivariate analysis revealed that both IOP (RhoG = 0.80; P = 9.6 x 10(-6)) and VCDR (RhoG = 0.76; P = 4.8 x 10(-10)) showed strong evidence of genetic correlation with POAG susceptibility. These two traits also correlated genetically with each other (RhoG = 0.45; P = 0.0012). Alternatively, CCT did not correlate genetically with risk of POAG. CONCLUSIONS. All the proposed POAG-related traits have genetic components. However, the significant genetic correlations observed between IOP, VCDR, and POAG itself suggest that they most likely represent true endophenotypes that could aid in the identification of genes underlying POAG susceptibility. CCT did not correlate genetically with disease and is unlikely to be a useful surrogate endophenotype for POAG.
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Affiliation(s)
- Jac Charlesworth
- Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, Texas, USA
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Vitart V, Bencić G, Hayward C, Herman JS, Huffman J, Campbell S, Bućan K, Zgaga L, Kolcić I, Polasek O, Campbell H, Wright A, Vatavuk Z, Rudan I. Heritabilities of ocular biometrical traits in two croatian isolates with extended pedigrees. Invest Ophthalmol Vis Sci 2010; 51:737-43. [PMID: 19875653 PMCID: PMC2868464 DOI: 10.1167/iovs.09-3720] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 05/04/2009] [Accepted: 09/16/2009] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess the effects of body stature and years of education, in addition to age and sex, on six oculometric traits and to estimate the heritabilities of these quantitative traits in two Croatian cross-population studies. METHODS Adult subjects living on the two Croatian islands of Vis and Korcula were recruited for a large epidemiologic and genetic study that included eye biometry, keratometry, and autorefraction. Effects and heritabilities were estimated by using general linear mixed models for axial length (AL), anterior chamber depth (ACD), corneal curvature (CC), corneal thickness (CT), lens thickness (LT), and spherical equivalent refraction (SER). Both cohorts were genotyped with dense SNP arrays, allowing the use of kinship coefficients derived from genotypic data (realized kinship) rather than from pedigree information (expected kinship). RESULTS Across cohorts, body mass index (BMI) did not consistently influence any of the ocular traits adjusted for age and/or sex, whereas height and years in education (YrEd) did, explaining up to an additional 5% of the variance (in CC). CT was the trait least influenced by covariates. Estimated heritabilities in Vis and Korcula, respectively, were 84% and 52% for CC, 75% and 71% for CT, 37% and 32% for LT, 59% and 45% for ACD, 37% and 74% for AL, and 0% and 17% for SER. CONCLUSIONS While heritabilities of CT and CC seemed uniformly high across studies of Caucasian datasets, estimates for SER varied widely and were at the lower end of the spectrum of published observations in our study.
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Affiliation(s)
- Veronique Vitart
- MRC (Medical Research Council) Human Genetics Unit, IGMM (Institute of Genetics and Molecular Medicine), Edinburgh, Scotland, United Kingdom.
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Abstract
BACKGROUND Glaucoma is a chronic, progressive ocular neuropathy that leads to the loss of retinal ganglion cells and varying degrees of visual impairment or blindness. MANAGEMENT There are three major factors to consider in the management of patients with glaucoma. First, extensive damage to retinal ganglion cells often can occur before the appearance of any functional deficits is detected by perimetry. Second, the rate of glaucoma progression varies considerably among different patients and even for the same patient at different times. Third, the lack of correspondence between structural and functional change may reflect the limitations of current assays in measuring each. Given the variability of disease progression, early detection and continued vigilance of both structure and function in the form of regular patient monitoring are essential. CONCLUSION This review presents six case histories that demonstrate the differing rates of progression that may be observed in the clinic and the importance of early detection and treatment in controlling the disease. In addition, major lessons from randomised clinical trials are summarised, including the likelihood of progression from diagnosed ocular hypertension to the development of glaucoma, the risks of progression of established glaucoma and the effectiveness of therapy.
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Iester M, Mete M, Figus M, Frezzotti P. Incorporating corneal pachymetry into the management of glaucoma. J Cataract Refract Surg 2009; 35:1623-8. [PMID: 19683164 DOI: 10.1016/j.jcrs.2009.05.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Revised: 03/31/2009] [Accepted: 05/06/2009] [Indexed: 11/18/2022]
Affiliation(s)
- Michele Iester
- Anatomical-Clinical Laboratory for Functional Diagnosis and Treatment of Glaucoma and Neuroophthalmology, Clinica Oculistica, Department of Neurological Sciences, Ophthalmology, Genetic, University of Genoa, Genoa, Italy.
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Novel quantitative trait loci for central corneal thickness identified by candidate gene analysis of osteogenesis imperfecta genes. Hum Genet 2009; 127:33-44. [PMID: 19714363 DOI: 10.1007/s00439-009-0729-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Accepted: 07/29/2009] [Indexed: 01/14/2023]
Abstract
Osteogenesis imperfecta (OI) is a rare connective tissue disorder caused by mutations in the type I collagen genes, COL1A1 and COL1A2, and is characterised by low bone mass and bone fragility. In this study, we explored the relationship between type 1 collagen genes and the quantitative trait central corneal thickness (CCT). CCT was measured in a cohort of 28 Australian type I OI patients and mean CCT was found to be significantly lower compared to a normal population (P < 0.001). We then investigated CCT and corneal collagen fibril diameter and density in a mouse model of OI with a col1a2 mutation. Mean CCT was significantly lower in mutant mice (P = 0.002), as was corneal collagen fibril diameter (P = 0.034), whilst collagen fibril density was significantly greater in mutants (P = 0.034). Finally, we conducted a genetic study to determine whether common single nucleotide polymorphisms (SNPs) in COL1A1 and COL1A2 are associated with CCT variation in the normal human population. Polymorphism rs2696297 (P = 0.003) in COL1A1 and a three SNP haplotype in COL1A2 (P = 0.007) were all significantly associated with normal CCT variation. These data implicate type 1 collagen in the determination of CCT in both OI patients and normal individuals. This provides the first evidence of quantitative trait loci that influence CCT in a normal population and has potential implications for investigating genes involved in glaucoma pathogenesis, a common eye disease in which the severity and progression is influenced by CCT.
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Effect of diabetes mellitus on biomechanical parameters of the cornea. J Cataract Refract Surg 2009; 35:715-9. [PMID: 19304094 DOI: 10.1016/j.jcrs.2008.12.013] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 12/01/2008] [Accepted: 12/02/2008] [Indexed: 11/21/2022]
Abstract
PURPOSE To compare parameters of biomechanical response of the human cornea measured as corneal hysteresis (CH) and corneal resistance factor (CRF) in patients with diabetes mellitus and healthy control subjects. SETTING Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel. METHODS In the right eye of each participant, the CH, CRF, Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were measured with the Ocular Response Analyzer. Central corneal thickness (CCT) was measured by ultrasonic pachymetry and intraocular pressure by Goldmann applanation tonometry (IOP GAT). Findings were compared between the 2 groups (control and diabetic). RESULTS Forty diabetic patients (17 women, 23 men) and 40 healthy subjects (19 women, 21 men) were prospectively recruited. The mean CH was 9.3 mm Hg +/- 1.4 (SD) and 10.7 +/- 1.6 mm Hg and the mean CRF was 9.6 +/- 1.6 mm Hg and 10.9 +/- 1.7 mm Hg in the control group and diabetic group, respectively (both P < .0001). Diabetic corneas were significantly thicker (P = .019); the mean CCT was 530.3 +/- 35.9 microm in the control group and 548.7 +/- 33.0 microm in the diabetic group. The CH and CRF remained significantly different in multivariate analysis that included CCT. There was no statistically significant difference between the 2 groups in IOPcc, IOPg, or IOP GAT measurements. CONCLUSIONS Diabetes mellitus affected biomechanical parameters of the human corneas, including increased CH, CRF, and CCT. Whether this observation has implications in the clinical management and understanding of corneal ectasia and glaucoma requires further study.
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Kutschan A, Schroeder B, Hager A, Dave H, Wegscheider K, Wiegand W. Hornhautdickenabhängige Korrekturfaktoren bei der Goldmann-Applanationstonometrie. Ophthalmologe 2009; 107:30-5. [DOI: 10.1007/s00347-009-1926-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. CANADIAN JOURNAL OF OPHTHALMOLOGY 2009. [DOI: 10.3129/i09.080] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Guide factuel de pratique clinique de la Société canadienne d’ophtalmologie pour la gestion du glaucome chez l’adulte. Can J Ophthalmol 2009. [DOI: 10.1016/s0008-4182(09)80037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Doughty MJ, Gillis N, MacGill J, Montgomery DM. Goldmann tonometry and pachymetry measures in patients with and without topical medical treatment at a glaucoma clinic. Ophthalmic Physiol Opt 2009; 28:558-67. [PMID: 19076558 DOI: 10.1111/j.1475-1313.2008.00596.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate, by audit, the intraocular pressure (IOP) and central corneal thickness (CCT) of patients attending a routine glaucoma clinic, in order to assess the potential effect of CCT on IOP measures. METHODS Data on current IOP (Goldmann), CCT (ultrasound) and glaucoma medications use were collected from 140 patients who presented for a follow-up visit over a 3-month period. Baseline IOP was retrieved from patient records. RESULTS The IOP was lower at follow-up, an expected effect of the use of IOP-lowering medications. However, the CCT was lower in medicated patients indicating, but not proving, that it changed in response to the lowering of IOP. Overall, the measured IOP was higher in patients with greater CCT values (p < 0.001) but this IOP-CCT relationship was most noticeable in patients with normal tension glaucoma and not obvious in those diagnosed with ocular hypertension. Overall, the slope of the IOP-CCT relationship was slightly steeper for those patients prescribed glaucoma medications. CONCLUSIONS In the routine assessment of glaucoma patients, corneal thickness can be shown to have an impact on applanation tonometry data. However, this effect may not be uniformly evident in patients with different types of glaucoma and may be different for patients under topical medical treatment.
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Affiliation(s)
- Michael J Doughty
- Department of Vision Sciences, Glasgow-Caledonian University, Cowcaddens Road, Glasgow G4 OBA, UK.
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