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J.S. Weizer, S.S. Stinnett, L.W. Herndon; Change in Central Corneal Thickness Over Time . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4854.
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Purpose: To determine if central corneal thickness changes over time and if this change is related to glaucoma progression. Methods: Sixty–four eyes of 39 patients with open angle glaucoma, ocular hypertension, glaucoma suspect status, or a normal eye exam were included. At each of two separate clinic visits, the following data were obtained: age, race, sex, family history of glaucoma, presence of diabetes and systemic hypertension, diagnosis, central corneal thickness, visual acuity, spherical equivalent, intraocular pressure, vertical and horizontal cup–to–disc ratios, number of glaucoma medications prescribed, Advanced Glaucoma Intervention Study (AGIS) score and mean deviation of Humphrey visual field testing, and glaucoma interventional treatment required. Statistical analysis used the Wilcoxon signed ranks test, linear regression, and analysis of variance. Results: Mean follow–up time between visits was 8.2 years. Mean patient age at the second visit was 66.9 years. Fifty–four percent of patients were female. Sixty–nine percent of patients were white and 23% were black. Twenty–nine percent of patients had a positive family history of glaucoma. At the second visit, 18% of patients had diabetes and 44% had systemic hypertension. At the second visit, 54% of patients had primary open angle glaucoma, 3% had pseudoexfoliation glaucoma, 8% had pigmentary glaucoma, 3% had ocular hypertension, 10% were glaucoma suspects, and 23% had a normal diagnosis. Between the two visits, central corneal thickness decreased on average by 17 microns in right eyes (p<0.002) and by 23 microns in left eyes (p<0.001). This decrease was greater in POAG patients than in normal patients (p<0.041 for right eyes and p<0.106 for left eyes). Other examination parameters did not change significantly. There was no significant association between change in central corneal thickness and glaucoma progression, as measured by change in: visual acuity, intraocular pressure, AGIS score and mean deviation of visual fields, vertical and horizontal cup–to–disc ratios, and number of glaucoma medications prescribed. Change in central corneal thickness was not significantly associated with topical carbonic anhydrase inhibitor use. Conclusions: In this longitudinal study, central corneal thickness appears to decrease over time especially in POAG patients, but this change may not be related to glaucoma progression. It may be necessary to perform pachymetry more than once in a patient’s lifetime.
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