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Joanna Wasielica-Poslednik, Giuseppe Politino, Irene Schmidtmann, Norbert Pfeiffer, Susanne Pitz; Measurements performed with the ocular response analyzer and their correlation to Goldmann applanation tonometry in mucopolysaccharidosis patients and healthy subjects.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3706.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the ocular response analyzer (ORA) to “gold standard” Goldmann applanation tonometry (GAT) and to investigate biomechanical properties of the cornea and their influence on intraocular pressure-measurements in mucopolysaccharidosis patients (MPS) and healthy controls.
Both eyes of 8 MPS IV patients (4 male), 9 MPS VI patients (6 male) and 18 age-matched healthy controls (7 males) were prospectively included in this study. All subjects underwent slit lamp examination in order to assess a grade of corneal clouding, GAT, measurements of Goldmann-correlated intraocular pressure (IOPg), corneal-compensated intraocular pressure (IOPcc), corneal resistance factor (CRF) and corneal hysteresis (CH) using ORA as well as assessment of central corneal thickness (CCT) using Pentacam. Exclusion criteria were corneal pathologies other than MPS-related corneal clouding in MPS patients and history of refractive or ocular surgery in all study groups. Statistical analysis was performed using ANOVA and Pearson correlation coefficients.
In the MPS IV group 12 eyes revealed mild and 4 eyes moderate corneal clouding. In the MPS VI group 2 eyes presented clear cornea, 12 eyes mild, 2 eyes moderate and 2 eyes severe corneal clouding. There was no significant difference between study groups regarding GAT-IOP (p=0.76), IOPg (p=0.48), CRF (p=0.14) and CCT (p=0.5). CH was increased in MPS VI in comparison to MPS IV and healthy controls (MPS VI > MPS IV > healthy) and differed significantly between MPS VI and healthy controls (p=0.03), but not between MPS IV and other two groups. IOPcc was significantly decreased in MPS VI in comparison to MPS IV (p=0.02) and healthy controls (p=0.01). Corneal clouding in both MPS groups correlated positively with GAT-IOP, IOPg, CH, CRF, and CCT (r= 0.6, 0.4, 0.7, 0.7, 0.6 in MPS IV and 0.2, 0.6, 0.6, 0.7, 0.7 in MPS VI respectively), but did not correlate with IOPcc (r= -0.1 in MPS IV and r=0.07 in MPS VI).
CH, CRF and CCT correlate strongly with corneal clouding in MPS IV and VI. IOPcc seems to be less affected by the MPS-related corneal opacity than GAT and hence may be an attractive alternative in glaucoma diagnostic in MPS patients.
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