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V. S. Hill, C. G. De Moraes, C. C. Teng, C. Tello, R. Ritch, J. M. Liebmann; Corneal Hysteresis is Associated With Visual Field Progression. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4025.
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© ARVO (1962-2015); The Authors (2016-present)
Central corneal thickness (CCT) is a risk factor for glaucoma development and visual field (VF) progression. Corneal hysteresis (CH) has been reported to be decreased in glaucoma and associated with increased risk of progression. We prospectively investigated the correlation between CCT and CH and their relationship to the rate of VF progression.
Consecutive, eligible glaucoma patients seen between 3/09 and 9/09 underwent tonometry with the Ocular Response Analyzer (Reichert, Inc., NY). Only eyes with at least 5 SITA Standard 24-2 VF tests with baseline glaucomatous damage were included. Eyes with other conditions likely to affect the VF were excluded. One eye of each patient was enrolled. Automated pointwise linear regression analysis determined global and localized rates (dB/yr) of change. Progression was defined as 2 or more test points in the same hemifield with a threshold sensitivity decline rate of at least 1.0 dB/year with p<0.01. Global rates were calculated by averaging the slopes of all VF tested points. Age, mean follow-up IOP, CH, CCT, ethnicity and gender were evaluated.
153 eyes (153 patients; mean age, 61.3±14.0 yrs; mean number of VFs, 8.5±3.4; mean follow-up time, 5.3±2.0 yr) were included. The mean global rate of VF change was -0.34±0.7 dB/yr. 25 eyes (16%) reached a progression endpoint. Progressing eyes had thinner CCT (525.0±34.2 vs 542.3±38.5 µm, p=0.04) and lower CH (7.5±1.4 vs 9.0±1.8 mmHg, p<0.01) compared to nonprogressing eyes. CH and CCT correlated significantly (Pearson’s r=0.33, p<0.01). By multivariate analysis, older age (OR=1.04, p=0.04), CH (OR=0.63, p<0.01), and mean follow-up IOP (OR=1.24, p<0.01) remained significantly associated with VF progression.
Corneal biomechanical properties, such as CH and CCT are highly correlated and associated with increased risk of VF progression. Because CH may describe corneal properties more completely than thickness alone, it may be a better parameter to assess the risk of progression.
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