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Hirawat RS, Aron N, Mahalingam K, Gupta V, Angmo D, Dada T, Titiyal JS, Sharma N, Sihota R. Changes in confocal microscopy in glaucoma patients after intraocular pressure reduction with medical therapy. Indian J Ophthalmol 2024; 72:881-884. [PMID: 38317329 PMCID: PMC11232863 DOI: 10.4103/ijo.ijo_1301_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/14/2023] [Accepted: 10/22/2023] [Indexed: 02/07/2024] Open
Abstract
PURPOSE Topical glaucoma medication is the first line of management to reduce intraocular pressure (IOP) in patients with glaucoma. In this study, we intended to compare the ultrastructural findings of the cornea in patients with glaucoma before and after the reduction of the IOP through confocal microscopy. METHODS Ten patients (19 eyes) with newly diagnosed glaucoma were recruited from the glaucoma services of our tertiary care center. Demographic parameters were noted, and basic ocular examination, specular microscopy (Topcon SP3000P, Tokyo, Japan), and ultrasonic pachymetry (300 AP, Sonomed Escalon, Stoneham, MA, USA) were performed. In vivo confocal microscopy of corneal sections was performed using the z-ring Confoscan 4.0 (Nidek, Inc., Freemont, CA) at baseline and after 3 months of starting glaucoma medications. RESULTS The mean age of the patients was 53.53 ± 9.34 years. There was a statistically significant reduction ( P < 0.0001) of IOP from 30.21 ± 7.42 mmHg (baseline) to 16.42 ± 4.14 mmHg (3 months). The mean central corneal thickness at baseline was 533.42 ± 3.96 µm, and it further decreased to 521.94 ± 42.45 µm at the end of 3 months ( P = 0.006). No significant change was noted in the mean epithelial cell density, mean keratocyte density in anterior and posterior stroma, and the mean endothelial cell density and cell area ( P >0.5). There was no significant percentage change in these parameters before and after the lowering of the IOP. CONCLUSION A short-term (3 months) decrease in IOP using topical glaucoma medications caused a significant reduction in corneal thickness but did not have any significant ultrastructural changes in cornea measured using confocal microscopy.
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Affiliation(s)
- Raj S Hirawat
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neelima Aron
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Karthikeyan Mahalingam
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Viney Gupta
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Dewang Angmo
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tanuj Dada
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jeewan S Titiyal
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ramanjit Sihota
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Lu Y, Zhong E, Wu J, Cao Y. The Effect of Prostaglandin Analogs on Central Corneal Thickness of Patients with Glaucoma or Ocular Hypertension: A Systematic Review. Ophthalmic Res 2022; 66:431-444. [PMID: 36455536 DOI: 10.1159/000528461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 08/14/2022] [Indexed: 12/23/2023]
Abstract
BACKGROUND Prostaglandin analogs (PGAs) are first-line antiglaucoma agents that appear to either decrease or increase central cornea thickness (CCT), creating controversy regarding the benefits of PGAs in treating CCT. PURPOSE We performed the first meta-analysis of observational studies to evaluate the effects of PGAs on CCT in patients with glaucoma or ocular hypertension (OHT). METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A literature search was performed of the PubMed, Embase, Cochrane Library, System for Information on Grey Literature in Europe (Open Grey), and ClinicalTrials.gov databases and the references of retrieved studies. Only observational studies were included in the meta-analysis. The final CCT of patients and 95% confidence interval (CI) of each study were extracted. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ). A fixed-effects model was used to calculate the weighted mean difference (WMD) and 95% CI. Subgroup analyses based on several stratified factors such as public bias (Begg's test) and sensitivity analyses were performed. RESULTS Five cohort, 5 case-control, and three cross-sectional studies including 2,722 subjects were included. The pooled effect of all thirteen studies showed that PGAs reduced the CCT of patients with glaucoma or OHT slightly but significantly (WMD = -9.37; 95% CI [-12.18, -6.57]; p = 0.00; I2 = 45.5%). Significant effects were also observed in all three study designs: cohort (WMD = -5.17; 95% CI [-9.52, -0.82]), case-control (WMD = -15.31; 95% CI [-22.66, -7.97]), and cross-sectional (WMD = -8.65; 95% CI [-17.30, -0.01]). In addition, subgroup analysis of exposure time showed the effect of PGAs to be more obvious in the first (WMD = -5.81; 95% CI [-9.49, -2.14]) and second (WMD = -13.73; 95% CI [-20.19, -7.28]) years. CONCLUSIONS The pooled effects of previously reported studies suggest that PGA use can reduce the CCT of patients with glaucoma or OHT slightly but significantly, with this effect more pronounced in the first 2 years. These findings suggest that clinicians must closely monitor changes in CCT in the first 2 years of PGA use to identify cases of intraocular pressure misestimation and the efficacy of PGAs.
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Affiliation(s)
- Ye Lu
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,
| | - Enyu Zhong
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Cao
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Correlations among Corneal Biomechanical Parameters, Stiffness, and Thickness Measured Using Corvis ST and Pentacam in Patients with Ocular Hypertension. J Ophthalmol 2022; 2022:7387581. [PMID: 36510627 PMCID: PMC9741532 DOI: 10.1155/2022/7387581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
Background To preliminary explore the correlations among corneal biomechanical parameters, stiffness, and thickness in patients with ocular hypertension (OHT) before and after treatment with topical antiglaucoma medications. Methods This was a retrospective study that included 35 eyes with newly diagnosed OHT. Axial length (AL), apical corneal thickness, and minimum corneal thickness were measured using Pentacam. The lengths, velocities, and times of the first and second corneal applanations (A1L, A1V, A1T, A2L, A2V, and A2T, respectively); the highest concavity radius; highest concavity peak distance (PDHC); highest concavity deformation amplitude (DAHC); highest concavity time (HCT); pachymetry (PACH); stress-strain index (SSI); stiffness parameter-A1 (SP-A1); deformation amplitude ratio (DA ratio); integrated radius (IR); Ambrosio's relational thickness horizontal (ARTh); corneal biomechanical index; noncorrected intraocular pressure (IOPnct); and biomechanically corrected IOP (bIOP) values were measured using the corneal visualization Scheimpflug technology (Corvis ST/CST). Results After 5 weeks of treatment, Goldman applanation tonometer-IOP, IOPnct, bIOP, PACH, A1T, A2V, SSI, SP-A1, and ARTh decreased, but A1V, A2T, PDHC, DAHC, DA ratio, and IR increased significantly (all p < 0.05). SP-A1 and A1T were positively associated with premedication IOP and IOP changes, whereas A1V, A2T, PDHC, and IR were negatively associated (all p < 0.05). DAHC and DA ratio had significantly negative correlations with IOP variations. PDHC was found to be positively correlated with AL (p < 0.05). A positive relationship was noted between SP-A1 and HCT before medication (p < 0.05). Conclusions SP-A1 was significantly and consistently associated with IOP. HCT might be correlated with SP-A1. SP-A1 and CST parameters could serve as potential biomarkers for evaluating OHT treatment efficacy.
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Fineide F, Lagali N, Adil MY, Arita R, Kolko M, Vehof J, Utheim TP. Topical glaucoma medications – Clinical implications for the ocular surface. Ocul Surf 2022; 26:19-49. [DOI: 10.1016/j.jtos.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022]
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Abstract
To investigate effects of beta blocker (BB; timolol or betaxolol), latanoprost, and latanoprost-timolol combination (LTC) drugs on corneal endothelial cell density (ECD) and central corneal thickness (CCT) in primary open-angle glaucoma (POAG) patients. Sixty-one patients in BB group, 64 patients in latanoprost group, 59 patients in LTC group, and 58 healthy cases in control group were included. Intraocular pressures (IOP), ECDs, and CCTs of groups were recorded at initial (pre-treatment) period, first and third years after treatment, and comparisons were done. In groups, changes of ECDs according to time were not significant (p > 0.05). In BB and control groups, changes of CCTs according to time were not significant (p > 0.05). In latanoprost and LTC groups, CCTs in both first and third years were significantly thinner than initial CCTs (p = 0.039 for latanoprost, p = 0.041 for LTC at first year; p = 0.018 for latanoprost, p = 0.032 for LTC at third year). In latanoprost and LTC groups, CCTs of patients using drugs for 1 year were similar to those of patients using drugs for 3 years (p > 0.05). In our study, uses of BB, latanoprost or LTC did not affect ECD. BB drugs had no effect on CCT. Although latanoprost and LTC appeared to reduce CCT at 3-year follow-up from the statistical point of view, this 8-10 μm difference in CCT was not clinically significant.
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Affiliation(s)
- İrfan Botan Güneş
- Department of Ophthalmology, Medical Park Kocaeli Hospital, Kocaeli, Turkey
| | - Hakan Öztürk
- Department of Ophthalmology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Bediz Özen
- Department of Ophthalmology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
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Wu N, Chen Y, Yang Y, Sun X. The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST. BMC Ophthalmol 2020; 20:422. [PMID: 33081750 PMCID: PMC7576693 DOI: 10.1186/s12886-020-01693-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA). METHODS One hundred eleven newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose-response relation between follow-up time and corneal biomechanics. RESULTS The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (β = -0.0015, P = 0.016), the first applanation velocity (AV1, β = -0.0004, P = 0.00058) decreased and the first applanation time (AT1, β = 0.0089, P < 0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P = 0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P = 0.00002) in NTG than in HTG after adjusting for confounding factors. CONCLUSIONS Chronic use of PGA probably influences the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.
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Affiliation(s)
- Na Wu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratoy of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.,Shanghai Key Laboratoy of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Yuhong Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China. .,NHC Key Laboratory of Myopia (Fudan University); Key Laboratoy of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China. .,Shanghai Key Laboratoy of Visual Impairment and Restoration, Shanghai, 200031, China.
| | - Yaping Yang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratoy of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.,Shanghai Key Laboratoy of Visual Impairment and Restoration, Shanghai, 200031, China
| | - Xinghuai Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratoy of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.,Shanghai Key Laboratoy of Visual Impairment and Restoration, Shanghai, 200031, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China
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Yam GHF, Riau AK, Funderburgh ML, Mehta JS, Jhanji V. Keratocyte biology. Exp Eye Res 2020; 196:108062. [PMID: 32442558 DOI: 10.1016/j.exer.2020.108062] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 12/12/2022]
Abstract
The study of corneal stromal keratocytes is motivated by its strong association with corneal health and visual function. They play a dominant role in the maintenance of corneal homeostasis and transparency through the production of collagens, proteoglycans and corneal crystallins. Trauma-induced apoptosis of keratocytes and replacement by fibroblasts and myofibroblasts disrupt the stromal matrix organization, resulting in corneal haze formation and vision loss. It is, therefore, important to understand the biology and behaviours of keratocytes and the associated stromal cell types (like fibroblasts, myofibroblasts, stromal stem cells) in wound healing, corneal pathologies (including keratoconus, keratitis, endothelial disorders) as well as different ophthalmic situations (such as collagen crosslinking/photodynamic treatment, keratoplasty and refractive surgery, and topical medications). The recent development of ex vivo propagation of keratocytes and stromal stem cells, and their translational applications, either via stromal injection or incorporated in bioscaffold, have been shown to restore the corneal transparency and regenerate native stromal tissue in animal models of corneal haze and other disorders.
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Affiliation(s)
- Gary H F Yam
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Andri K Riau
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore
| | | | - Jodhbir S Mehta
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
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Effect of 6-week washout period on intraocular pressure following chronic prostaglandin analogue treatment: a randomized controlled trial. Can J Ophthalmol 2019; 55:143-151. [PMID: 31712013 DOI: 10.1016/j.jcjo.2019.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/01/2019] [Accepted: 08/29/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the effect of a 6-week washout period on intraocular pressure (IOP) following long-term monotherapy prostaglandin use. DESIGN Prospective, randomized, controlled, single-centre, single-blinded, parallel-group clinical study. PARTICIPANTS Subjects aged >18 years diagnosed with open-angle glaucoma or open-angle glaucoma suspects based on elevated IOP in one or both eyes, using monotherapy topical latanoprost, bimatoprost, or travoprost once daily. METHODS Subjects were prospectively randomized to continue prostaglandin analogue (PGA) monotherapy (control group) or discontinue PGA monotherapy (washout group) for 42 days. IOP was measured at day 0 (day of randomization), 7, 21, and 42. MAIN OUTCOME MEASURE Mean IOP (mm Hg) ± standard deviation. RESULTS 154 eyes (87 participants) completed the study, with 69 eyes (39 participants) in the control group and 85 eyes (48 participants) in the washout group. In the control group, day 0 IOP (14.64 ± 2.68 mm Hg) did not significantly differ from IOP at days 7 (14.25 ± 3.01 mm Hg), 21 (14.57 ± 2.61 mm Hg), and 42 (14.78 ± 2.30 mm Hg) (all p > 0.30). In the washout group, mean IOP values at days 7 (16.19 ± 3.80 mm Hg), 21 (17.28 ± 3.55 mm Hg), and 42 (17.84 ± 3.31 mm Hg) were significantly greater than those at day 0 (14.48 ± 1.94 mm Hg) and day-matched control group values (all p < 0.002). In the washout group, 24.7% of eyes had a day 42 IOP ≥21 mm Hg. No eyes in the control group had a day 42 IOP ≥21 mm Hg. CONCLUSIONS Six weeks of PGA washout after long-term monotherapy resulted in a small but statistically significant IOP increase. Majority of washout group participants maintained an IOP lower than 21 mm Hg after the 6-week washout duration. (https://clinicaltrials.gov/ identifier, NCT03534882).
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Sen E, Inanc M, Elgin U. The effect of topical latanoprost on corneal clarity; 1-year prospective study†. Cutan Ocul Toxicol 2019; 38:253-257. [DOI: 10.1080/15569527.2019.1590390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Emine Sen
- Ulucanlar Eye Research Hospital, Ankara, Turkey
| | - Merve Inanc
- Ophthalmology Department, Ercis State Hospital, Van, Turkey
| | - Ufuk Elgin
- Ulucanlar Eye Research Hospital, Ankara, Turkey
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Tear biomarkers in latanoprost and bimatoprost treated eyes. PLoS One 2018; 13:e0201740. [PMID: 30080906 PMCID: PMC6078293 DOI: 10.1371/journal.pone.0201740] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 07/20/2018] [Indexed: 01/28/2023] Open
Abstract
Purpose Prostaglandin analogues (PGA’s) are the mainstay and first line of treatment in current glaucoma practise. Though latanoprost and bimatoprost are the most commonly used PGA’s with minimal side effects at lower concentrations like bimaotoprost 0.01%, direct comparison of their cytokine/MMP profile in tears has not been evaluated earlier. The study intends to ascribe PGA to the upregulation of MMPs, Cytokines and Chemokines mediating varied pathways to result in side effects of the drugs. Methods Tear sample collection was done from outer canthus of 30 eyes of 30 patients (primary open angle glaucoma (n = 26 and n’ = 20), normal tension glaucoma (n = 4 and n’ = 10), in latanoprost (n) 0.005% and bimatoprost (n’) 0.01% group respectively, with a mean age of 62±10.5 years) on >6 months of PGA use using Tear floTM Schirmer filter strip. Tear samples from 30 eyes of 30 cataract patients without drug treatment were used as the control. Gelatinolytic activity of MMP-9 and MMP-2 were examined by substrate gelatine zymography MMP-1 and TIMP-1 concentrations from tears samples with PGAs were evaluated by ELISA while cytokine concentration in the eluted tears was evaluated using a convenient bioplex kit assay (Milliplex MAP kit, HCYTMAG-60K-PX41, Millipore, Massachusetts, United States). The mean duration of use of PGA in both groups did not differ significantly (median 1.3 years in bimatoprost and 1.1 years in latanoprost eyes, p = 0.6). Results The tear MMP-9 expression was higher in eyes receiving latanoprost while the MMP-2 expression was higher in eyes receiving bimatoprost with MMP1 protein levels being higher in the former. Latanoprost treated eyes had marginally elevated tear cytokines involved in tissue remodelling while bimatoprost eyes showed elevated cytokines regulating allergic pathways. Conclusion Differential cytokine and MMP expression indicates differential signalling pathways mediating different cellular effects (evident as clinical and side effects) with the two drugs which can be explored further.
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Correlation between central corneal thickness and myopia. Int Ophthalmol 2017; 38:2547-2551. [PMID: 29075941 DOI: 10.1007/s10792-017-0766-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To analyze the correlation between central corneal thickness (CCT) and myopia in refractive surgery candidates. MATERIALS AND METHODS Patients that underwent myopic laser refractive surgery between January 2000 and December 2014 were included. Preoperative CCT was measured by ultrasonic pachymetry, and refractive status determined by manifest and cycloplegic refraction. RESULTS A total of 30,245 individuals were included. Mean age was 28.2 ± 8.6 years, and 45.9% were female. Mean refractive error was 4.02 ± 2.17 D (range 0.25-19.5), and the mean CCT measurement was 533.5 ± 35.5 µm (range 404-794). Younger individuals showed higher degree of myopia (p = 0.006). No difference in CCT was found between women and men (533.0 ± 35.1 and 533.6 ± 35.9 µm, respectively, p = 0.19). Though CCT showed no correlation with age (p = 0.226) participants above age 40 expressed higher CCT values (p < 0.001). No significant correlation was found between the CCT and cylinder (p > 0.05). An increase in mean keratometry was associated with a decrease in CCT (p < 0.001). There was a direct correlation between the degree of myopia and CCT (r = 0.94, p < 0.001). The result remained the same after adjusting for age group and gender in stepwise backward regression analysis (p < 0.001). CONCLUSION Central corneal thickness is correlated with the degree of myopia among adults undergoing refractive surgery.
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Wu N, Chen Y, Yu X, Li M, Wen W, Sun X. Changes in Corneal Biomechanical Properties after Long-Term Topical Prostaglandin Therapy. PLoS One 2016; 11:e0155527. [PMID: 27187282 PMCID: PMC4871478 DOI: 10.1371/journal.pone.0155527] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 04/29/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To compare corneal biomechanical properties, measured by a newly developed tonometer (Corneal Visualization Scheimpflug Technology, Corvis ST), in untreated primary open angle glaucoma (POAG) patients, POAG patients with long-term topical prostaglandin analog (PGA) therapy and in normal controls. Further is to investigate the potential effects of PGA on corneal biomechanics. METHODS In this case-control study, 35 consecutive medication naïve eyes with POAG, 34 POAG eyes with at least 2 years treatment by PGA and 19 normal eyes were included. Intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters, including deformation amplitude (DA), applanation time (AT1 and AT2), applanation length (AL1 and AL2), applanation velocity (AV1 and AV2), and peak distance and radius were measured using Corvis ST. Axial length and corneal curvature were measured with partial coherence interferometry (IOLMaster, Zeiss, Germany). General linear model analysis was performed to investigate the corneal biomechanical property changes among the normal controls, newly diagnosed POAG patients and POAG patients with long-term PGA treatment, and among the subgroups of different types of PGA treatment, including bimatoprost, latanoprost and travoprost. Furthermore, pairwise comparisons using Bonferroni correction for least squares means were employed. RESULTS AT1 (p<0.0001), AV1 (p<0.0001), AT2 (p = 0.0001), AV2 (p<0.0001) and DA (p = 0.0004) in newly diagnosed glaucoma patients were significantly different from those in normal subjects and in patients underwent at least 2 years topical PGA therapy after adjusting for age and gender. After adjusting for age, gender, IOP, CCT, axial length and corneal curvature, a significant difference was detected for DA between glaucoma patients without PGA treatment and patients with long-term PGA therapy (p = 0.0387). Furthermore, there were no statistical significant differences in all of the corneal biomechanical parameters among the 3 types of PGA therapy subgroups, namely bimatoprost, latanoprost and travoprost. CONCLUSIONS Significant changes in corneal deformation parameters were found among untreated POAG patients, POAG patients with long-term topical PGA therapy and normal controls. Long-term topical PGA treatment might have a direct effect on corneal biomechanical properties in addition to the indirect effect owing to the PGA-induced IOP reduction and CCT decrease on corneal dynamic properties.
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Affiliation(s)
- Na Wu
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China
| | - Xiaobo Yu
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China
| | - Mengwei Li
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China
| | - Wen Wen
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
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