Purchase this article with an account.
J. K. Lee, E. Viriya, A. Madu, U. Mian; Thin Central Corneal Thickness: Risk Factor for Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3080.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
This study evaluated central corneal thickness (CCT) in patients with retinal vein occlusions. The utility of CCT in the screening, diagnosis, and management of glaucoma has been firmly established and has been incorporated into standard of care. However, we report a new application of CCT measurements- in assessing risk for retinal vein occlusions (RVO).
We conducted a retrospective study of patients seen at the retina service of the Montefiore Medical Center from 2003 to 2005 who had branch retinal vein occlusions (BRVO) or central retinal vein occlusions (CRVO). Patients’ demographics (including age, race, sex, and pertinent medical history and ocular history) were obtained. CCT measurements by ultrasound pachymetry were recorded for each patient and compared to historical controls.
The records for 42 eyes of 37 patients were reviewed. Mean age was 66 years (range 53 to 82 years). There were 13 men and 24 women. In the largest survey to date (1955 eyes), the mean CCT was 551.16 + 34.55. In comparison to this control, the mean CCT of RVO eyes in our study was significantly less 523.25 + 37.26 (p<0.0001). The mean CCT of the fellow unaffected eye was also thinner 526.49 + 41.34 (p<0.002). There was no statistical difference between the mean CCT of affected and unaffected eyes (p<0.731). 73% of the patients did not have preexisting glaucoma. This sub-group of patients also had a lower mean CCT of 526.80 + 33.74 (p<0.001).
This study demonstrates a strong association between thin CCT and retinal vein occlusions. The pathophysiology may be elucidated by recent data. Studies have shown that thinner corneas correlate with larger and more deformable optic discs. Large cup-to-disk ratio is a significant predictor of incident RVO (Beaver Dam Eye Study). We hypothesize that lamina cribosa displacement (compliance) may lead to retinal occlusive events. Ten-year incidence data from the Blue Mountains Eye Study report that age, increasing arterial blood pressure, and atherosclerotic retinal vessel signs are significant predictors of incident RVO. Patients who are found to have thin CCT during routine eye exams or glaucoma workup should be warned of their increased risk of developing retinal vein occlusions.
This PDF is available to Subscribers Only