Relationship between central corneal thickness and retinal nerve fiber layer thickness in ocular hypertensive patients.
OBJECTIVE
To examine the relationship between retinal nerve fiber layer (RNFL) measurements obtained using scanning laser polarimetry with variable corneal compensation and corneal thickness measurements in ocular hypertension (OHT) patients.


METHODS
Observational cross-sectional study.


METHODS
The study included 1 eye each from 44 OHT patients and 48 healthy subjects, all of similar age. All subjects had normal optic discs and normal standard automated perimetry (SAP) visual fields. Ocular hypertension patients had intraocular pressure (IOP) measurements higher than 22 mmHg.


METHODS
All patients underwent imaging with the GDx VCC (Laser Diagnostic Technologies, Inc., San Diego, CA) scanning laser polarimeter. We examined the relationship between GDx VCC RNFL measurements and central corneal thickness, a risk factor for development of visual field loss among OHT patients. We also examined the relationship of GDx VCC measurements and age, IOP, SAP pattern standard deviation, and vertical cup-to-disc ratio.


METHODS
Central corneal thickness (CCT) and GDx VCC RNFL thickness parameters.


RESULTS
Central corneal thickness measurements in OHT patients were significantly higher than those in healthy subjects (575+/-30 microm vs. 555+/-32 microm; P = 0.002). Higher GDx VCC parameter nerve fiber indicator (NFI) scores, indicating thinner RNFL, were correlated significantly with thinner CCT measurements in OHT patients (r = -0.502; P = 0.001). Ocular hypertension patients with thinner corneas (n = 22; mean CCT, 553+/-21 microm) had significantly higher NFI scores than OHT patients with thicker corneas (n = 22; mean CCT, 598+/-18 microm) and healthy control subjects (NFI mean +/- standard deviation, 26.9+/-9.5, 20.7+/-9.8, and 19.7+/-7.0, respectively; P = 0.004, analysis of variance). The NFI values were not significantly different between OHT patients with thicker corneas and healthy subjects. In multivariate analysis, only age and CCT measurement were associated significantly with GDx VCC RNFL measurements in OHT eyes.


CONCLUSIONS
Ocular hypertension patients with thinner corneas had significantly thinner RNFL than OHT patients with thicker corneas and healthy control subjects. These findings support the notion that RNFL defects as assessed by the GDx VCC may represent early glaucomatous damage in OHT eyes.
Henderson
Polly A
PA
Hamilton Glaucoma Center and Department of Ophthalmology, University of California San Diego, San Diego, California 92093-0946, USA.
Medeiros
Felipe A
FA
Zangwill
Linda M
LM
Weinreb
Robert N
RN
D000368:Aged; D001837:Body Weights and Measures; D003315:Cornea / Q000473:pathology*; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005901:Glaucoma / Q000175:diagnosis; D006801:Humans; D007429:Intraocular Pressure; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009798:Ocular Hypertension / Q000175:diagnosis*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012307:Risk Factors