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P.J. Foster, D. Machin, G. Gazzard, R. Husain, J.G. Devereux, P.T. Chew, F.T. Oen, P.T. Khaw, S.K. Seah; CENTRAL CORNEAL THICKNESS AND RISK OF GLAUCOMA . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4495.
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Purpose: To examine the potential association between central corneal thickness (CCT) and glaucomatous optic neuropathy (GON). Methods: Subjects were drawn from the Tanjong Pagar population study of eye disease in Chinese Singaporean people, aged 40 to 79 years, and a hospital trial of glaucoma surgery. Subjects in the population study underwent a detailed clinic assessment including visual field screening, frequency doubling technology testing, applanation tonometry, gonioscopy and a biometric examination of the optic disc. Glaucoma suspects underwent threshold field–testing. Hospital glaucoma patients underwent baseline assessment including disc examination by a fellowship trained glaucoma specialist, and threshold visual field testing. In both cohorts, GON was diagnosed on the basis of structural damage to the optic disc and reproducible visual field loss with no alternative explanation. CCT was measured by optical pachymetry in both groups. Gonioscopy was used to differentiate open–angle (POAG) and angle–closure glaucoma (PACG). Results: CCT in people without glaucoma in the community (n=1044, mean age 59.0 yrs) was 539 (SD 32) microns. In the community, people with POAG (n= 16, mean age 68.4 yrs) had mean CCT of 547 (34), and people with PACG (n= 6, mean age 69.4 yrs) had a mean CCT of 543 (19). Hospital POAG (n= 136, mean age 62.1 yrs) patients had a mean CCT of 552 (38). Hospital PACG patients (n= 105, mean age 61.9 years) had a mean CCT of 551 (33). CCT was 13 and 12 microns thicker in those in hospital patients with POAG and PACG (respectively) than normal people in the community (p < 0.001). This difference remained substantially unchanged after controlling for age and gender. The use of topical or systemic carbonic anhydrase inhibitors had no significant effect on mean CCT. Conclusions: People with established, treated POAG and PACG had thicker corneas than normal people in the population. There was no difference in CCT between POAG and PACG. This does not support the previous observation that thinner corneas may be a risk factor for GON.
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