Central corneal thickness and progression of the visual field and optic disc in glaucoma.
OBJECTIVE
To determine whether central corneal thickness (CCT) is a significant predictor of visual field and optic disc progression in open angle glaucoma.


METHODS
Data were obtained from a prospective study of glaucoma patients tested with static automated perimetry and confocal scanning laser tomography every 6 months. Progression was determined using a trend based approach called evidence of change (EOC) analysis in which sectoral ordinal scores based on the significance of regression coefficients of visual field pattern deviation and neuroretinal rim area over time are summed. Visual field progression was also determined using the event based glaucoma change probability (GCP) analysis using both total and pattern deviation.


RESULTS
The sample contained 101 eyes of 54 patients (mean (SD) age 56.5 (9.8) years) with a mean follow up of 9.2 (0.7) years and 20.7 (2.3) sets of examinations every 6 months. Lower CCT was associated with worse baseline visual fields and lower mean IOP in the follow up. In the longitudinal analysis CCT was not correlated with the EOC scores for visual field or optic disc change. In the GCP analyses, there was a tendency for groups classified as progressing to have lower CCT compared to non-progressing groups. In a multivariate analyses accounting for IOP, the opposite was found, whereby higher CCT was associated with visual field progression. None of the independent factors were predictive of optic disc progression.


CONCLUSIONS
In this cohort of patients with established glaucoma, CCT was not a useful index in the risk assessment of visual field and optic disc progression.
Chauhan
B C
BC
Department of Ophthalmology and Visual Sciences, Dalhousie University, 2nd Floor Centennial Building, Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada B3H 2Y9. bal@dal.ca
Hutchison
D M
DM
LeBlanc
R P
RP
Artes
P H
PH
Nicolela
M T
MT
D000328:Adult; D000368:Aged; D003315:Cornea / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005902:Glaucoma, Open-Angle / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009898:Optic Disk / Q000473:pathology*; D011446:Prospective Studies; D011601:Psychophysics; D058609:Visual Field Tests; D014794:Visual Fields