June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Corneal deformation dynamics are associated with the retinal nerve fiber layer progression rate in glaucoma suspects and early manifest glaucoma patients
Author Affiliations & Notes
  • Farshad Abedi
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Antonia Kolovos
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Anna Waldie
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Jude Fitzgerald
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Mona Awadalla
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Robert Casson
    Ophthalmology, University of Adelaide, Adelaide, South Australia, Australia
  • Stuart L Graham
    Macquarie University, Sydney, New South Wales, Australia
  • Paul R Healey
    University of Sydney, Sydney, New South Wales, Australia
  • Amirul Islam
    Swinburne University, Melbourne, Victoria, Australia
  • Miriam Keane
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • John Landers
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Jamie E Craig
    Ophthalmology, Flinders University, Adelaide, South Australia, Australia
  • Footnotes
    Commercial Relationships   Farshad Abedi, None; Antonia Kolovos, None; Anna Waldie, None; Jude Fitzgerald, None; Mona Awadalla, None; Robert Casson, None; Stuart Graham, None; Paul Healey, None; Amirul Islam, None; Miriam Keane, None; John Landers, None; Jamie Craig, None
  • Footnotes
    Support  PROGRESSA grant (APP1048037), NHMRC Project grant (AP1031362)
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3141. doi:
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      Farshad Abedi, Antonia Kolovos, Anna Waldie, Jude Fitzgerald, Mona Awadalla, Robert Casson, Stuart L Graham, Paul R Healey, Amirul Islam, Miriam Keane, John Landers, Jamie E Craig; Corneal deformation dynamics are associated with the retinal nerve fiber layer progression rate in glaucoma suspects and early manifest glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3141.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We investigated the association of corneal deformation dynamics and the rate of retinal nerve fiber layer (RNFL) progression in glaucoma suspects and early manifest glaucoma patients.

Methods : In this prospective study, consecutive patients from the Predicting Risk of Glaucoma: Relevant SNPs with Strong Association (PROGRESSA) Study, with optic disc appearances suspicious for glaucoma, performed a Humphrey 24-2 SITA Standard Visual Field (HVF) test. Enrolment required a mean deviation better than -6dB and using Hodapp-Anderson-Parrish criteria, mild or no glaucoma changes on HVF. Corneal deformation dynamics were assessed with the Corvis ST, a tonometer with visualization and measurement of the corneal response to an air pulse. Patients underwent spectral-domain OCT of the RNFL at baseline and 6-monthly for 3 years. OCT Guided Progression Analysis (GPA) measured the superior and inferior RNFL progression rate for each eye over 3 years in microns per year (μm/year). Regression analysis, adjusted for intraocular pressure (IOP) and central corneal thickness, investigated the association of the Corvis ST parameters with the faster RNFL progression rate, either superior or inferior, in the right eyes of the patients.

Results : 198 eyes of 198 patients with a mean age of 61.4±10.3 years were recruited. The mean baseline inferior and superior RNFL thicknesses were 105.0±19.7μm and 100.3±16.5μm. The mean rate of the faster RNFL progression, in the inferior or superior rim, was -1.53±1.6μm/year. The mean deflection length at applanation 2, the applanated part of the cornea on its return from the concave to convex position after the air pulse, was 1.78±0.2mm. This length and the Stiffness Parameter A1 (SP-A1), defined as [air pulse pressure at the corneal surface – biomechanical IOP]/deflection amplitude at applanation 1 (when cornea flattens from the convex position after the air pulse) were significantly associated with the rate of the faster RNFL loss (P= 0.002 and 0.022; β= +0.25 and -0.32, respectively).

Conclusions : Corneal deformation dynamics are associated with the rate of RNFL progression in glaucoma suspects and early manifest glaucoma patients. Such results could help individualize management of these patients.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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